Shifting Responsibilitiesin Medicine 4.0 – A Project Report

Abstract

"In this contribution, we anticipate the results of the research project “Medicine 4.0 – the ethical basis of digitalization in healthcare” funded by the German Ministry of Health, which investigated the ethically relevant effects of digitalized medicine using mobile health (mhealth) and telemedicine as prime examples, with the final aim of deriving policy-relevant overarching recommendations. In an iterative interdisciplinary approach, we linked social science research with analytic research on the ethically relevant effects of these technologies, including on the doctor-patient relationship, the relationship between responsibility and solidarity in healthcare and on the autonomy of the individual. In both the ethical and social science research, a key focus concerned the identification and analysis of an apparent diversity of stakeholder values and perspectives. In mobile or mhealth, which we concentrate on for this presentation, technology developers, insurances, physicians and public health professionals as well as ‘patient-consumers’ need to be looked at and involved. Their outlook in turn may converge, but also be in tension or collide, e.g. regarding conditions for data access and use, liability in case of malfunction or misuse and the overall question of responsibilities in a context of shifting roles and role anticipations. The research combines ethical insight and expert stakeholder perspectives on the most pressing issues in this fast-moving field. Further, traditional issues such as informed consent, confidentiality and the role of individual autonomy, are in part redefined with the emerging role of automated or algorithmic decision-making. "