Ethical aspects of digital health from a justice point of view

• Published in: European journal of public health 2019-10, Vol.29 (Supplement_3), p.18-22
• Main Authors: Brall, Caroline, Schröder-Bäck, Peter, Maeckelberghe, Els
• Format: Article
• Language: English
• Subjects: End users; Ethical standards; Ethics; Fairness; Health care; Health disparities; Health services; Human dignity; Information dissemination; Informed consent; Justice; Medical ethics; Ownership; Public health; Regulators; Storage; Supplement Papers
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz167

Abstract Digital health is transforming healthcare systems worldwide. It promises benefits for population health but might also lead to health inequities. From an ethical perspective, it is hence much needed to adopt a fair approach. This article aims at outlining chances and challenges from an ethical perspective, focusing especially on the dimension of justice—a value, which has been described as the core value for public health. Analysed through the lenses of a standard approach for health justice—Norman Daniels’ account of just health and accountability for reasonableness—most recent and relevant literature was reviewed and challenges from a justice point of view were identified. Among them are challenges with regard to digital illiteracy, resulting inequities in access to healthcare, truthful information sharing to end users demanding fully informed consent, dignity and fairness in storage, access, sharing and ownership of data. All stakeholders involved bear responsibilities to shape digital health in an ethical and fair way. When all stakeholders, especially digital health providers and regulators, ensure that digital health interventions are designed and set up in an ethical and fair way and foster health equity for all population groups, there is a chance for this transformation resulting in a fair approach to digital health.