Applying ethical guidelines to ubiquitous health care in China

1,572 views
1,309 views

Published on

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,572
On SlideShare
0
From Embeds
0
Number of Embeds
6
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Applying ethical guidelines to ubiquitous health care in China

  1. 1. Applying Ethical Guidelines to Ubiquitous Health Care in China I. Jantunen , X. Wang, M. Pekkola, and T. Korhonen Comnet / Aalto University http://www.ubi-serv.org
  2. 2. Ethical assessment (MINAmI) From results of MINAmI project. V. Ikonen, E. Kaasinen, M. Niemelä, and J. Leikas, Ethical Guidelines for Mobile-Centric Ambient Intelligence , 2008. http://www.fp6-minami.org/uploads/media/MINAmI_WP1_D14_EthicalguidelinesforAmI_v12.pdf
  3. 3. China-specific issues in ubiquitous health services TCM = Traditional Chinese Medicine
  4. 4. Elderly in the society: West and East Li Yang: Ost trifft West
  5. 5. Elderly in the society: West and East Li Yang: Ost trifft West
  6. 6. Elderly in the society: West and East Li Yang: Ost trifft West
  7. 7. Ethical guidelines for the East <ul><li>Group orientation vs. individualism </li></ul><ul><li>Privacy </li></ul><ul><li>Benefit to the society </li></ul><ul><li>Medical paternalism </li></ul><ul><li>Traditional Chinese Medicine (TCM) </li></ul>
  8. 8. Group orientation vs. individualism <ul><li>Ubiquitous health care and welfare services for the Chinese should include the patient’s family in discussing the patient’s needs. </li></ul><ul><li>In general, the family's role as the main authority for medical decision-making in China is strikingly different to the Western approach where the patient's family is involved in the decision-making only with the consent of the patient. </li></ul>
  9. 9. Privacy <ul><li>Protection of privacy is usually not of top priority for Chinese patients. The information, on the contrary, can be circulated within the close people or relevant health care professionals. </li></ul><ul><li>In some extreme cases (terminal illness), the information should typically be known first by people close to the patient, who bear the responsibility of deciding whether to conceal potentially upsetting information from the patient. </li></ul>
  10. 10. Privacy <ul><li>Protection of privacy is usually not of top priority for Chinese patients. The information, on the contrary, can be circulated within the close people or relevant health care professionals. </li></ul><ul><li>In some extreme cases (terminal illness), the information should typically be known first by people close to the patient, who bear the responsibility of deciding whether to conceal potentially upsetting information from the patient. </li></ul><ul><li>Information disclosure without authorization from the care-givers to the patient could even result in a court judgment </li></ul>
  11. 11. Benefit to the society <ul><li>Ubiquitous health care and welfare services should not be only for the rich. </li></ul><ul><li>In China, of the most reported ethical issues are uncontrolled levels of medical fees and refusal to treat patients who could not show evidence of their ability to pay. </li></ul>
  12. 12. Benefit to the society <ul><li>Ubiquitous health care and welfare services should not be only for the rich. </li></ul><ul><li>In China, of the most reported ethical issues are uncontrolled levels of medical fees and refusal to treat patients who could not show evidence of their ability to pay. </li></ul><ul><li>In a health care system based on private health care insurances there is also a risk that ambient intelligence applications restrict the life of the patient , e.g., to the area covered by mobile phone network. </li></ul>
  13. 13. Medical paternalism <ul><li>An example of medical paternalism is a physician withholding relevant information about a terminal illness of a patient to protect him/her from psychological stress. </li></ul><ul><li>Chinese elders tend to prefer the passive role, and enjoy the care and support from their relatives as well as physicians. </li></ul>
  14. 14. Medical paternalism <ul><li>An example of medical paternalism is a physician withholding relevant information about a terminal illness of a patient to protect him/her from psychological stress. </li></ul><ul><li>Chinese elders tend to prefer the passive role, and enjoy the care and support from their relatives as well as physicians. </li></ul><ul><li>Due to tremendous gap between supply and demand, some claim that doctor’s time is better spent on deciding and applying treatments than explaining complicated processes and consequences. </li></ul>
  15. 15. Traditional Chinese Medicine vs. Western Medicine <ul><li>Traditional Chinese Medicine </li></ul><ul><li>inductive and synthetic </li></ul><ul><li>individualized </li></ul><ul><li>experience-based </li></ul><ul><li>summary of clinical observations </li></ul><ul><li>emphasizes the role of the body in healing </li></ul><ul><li>herbs and natural agents </li></ul><ul><li>behavior of the system as a whole </li></ul><ul><li>works to maintain health </li></ul><ul><li>Western Medicine </li></ul><ul><li>reductive and analytical </li></ul><ul><li>standardized </li></ul><ul><li>evidence-based </li></ul><ul><li>result of laboratory experimentations </li></ul><ul><li>mainly relies on medication and procedures </li></ul><ul><li>pure chemical compounds </li></ul><ul><li>structure and function of the parts </li></ul><ul><li>manages disease </li></ul>
  16. 16. Unidirectional computer interfaces <ul><li>Chinese characters are basically ideograms </li></ul><ul><li>Chinese character input not based in characters assigned to keys on keyboards </li></ul><ul><li>Most used input system for computers, Pinyin, is based on phonetics of Mandarin Chinese </li></ul><ul><li>Very many elderly people are uneducated on Pinyin and their native Chinese dialect has little resemblance to the phonetics of Mandarin </li></ul><ul><li>E-inclusion issues, push for medical paternalism </li></ul>
  17. 17. Conclusions 1 <ul><li>Ubiquitous health care and welfare services must take into account the culture on the target market. </li></ul><ul><ul><li>Political and economical differences, infrastructure </li></ul></ul><ul><ul><li>Ethical issues may differ between different cultures </li></ul></ul><ul><li>China compared to Europe: the main differences on ethical issues were identified to relate to autonomy and privacy of the user. </li></ul><ul><ul><li>In a collectivist culture the privacy and autonomy of an individual is not regarded as important as in the West. </li></ul></ul><ul><ul><li>Solid connection between the elderly and in-group members </li></ul></ul>
  18. 18. Conclusions 2 <ul><li>Benefits of new technology to the society must be taken into account. </li></ul><ul><ul><li>The income level of the Chinese is still lower than in the West and the income differences are high within China. </li></ul></ul><ul><ul><li>AmI technologies for health care & welfare offer a promise of cheaper services , but the cost may still be too high for the poor majority. </li></ul></ul><ul><li>Younger family members often play a significant role in the adoption of ICT by the elderly people. </li></ul>
  19. 19. Recommendations <ul><li>AmI-based home healthcare and assisted living services or applications in China be marketed first and foremost to the younger generations </li></ul><ul><li>Any AmI applications, offering seamless connections between the elderly and their families should be treated as important as providing functionalities which assist the elders’ daily life. </li></ul><ul><li>AmI applications for Chinese elderly could adopt medical paternalism, leaving only a few control-related options to user oneself. </li></ul>
  20. 20. Acknowledgements <ul><li>MIMOSA & MINAmI project partners, especially Eija Kaasinen , Head of MIMOSA&MINAmI WP1 </li></ul><ul><li>UBI-SERV project partners in Finland and China </li></ul><ul><ul><li>Aalto University, Peking University, Fudan University </li></ul></ul><ul><li>Li Yang for Ost trifft West </li></ul>

×