Digital Health Technologies: Law, Ethics, and the Doctor-Patient Relationship PDF
Preview Digital Health Technologies: Law, Ethics, and the Doctor-Patient Relationship
‘This book provides an excellent overview of the types of digital technologies that are being introduced into the clinic and the way that they are changing clinical practice. Using carefully selected case studies, the book analyses the complex ethical, legal and regulatory issues that are raised by implementing digital innovation. Carolyn Johnston is a lawyer who is well equipped to do this, having had many years working with clinicians and scientists who are navigating these issues. The threads that go through this book will provide readers with a rich understanding of these complex issues and generate insights into the way that clinical practice is changing.’ —Jane Kaye, Professor of Health, Law and Policy and Director of the Centre for Health, Law and Emerging Technologies (HeLEX) at University of Oxford ‘Carolyn Johnston’s book offers plain language insights into the complex and rapidly expanding world of digital health technologies. Consumers want the best, most convenient technologies to manage their health, yet clinicians may be wary of the traditional relationship power shifts and treatment efficacy concerns that result from the digital health care revolution. Johnston explores eight new technologies and takes us back to the fundamentals of ethics, respect, humanity and evidence that should guide consumers, clinicians, regulators and society more broadly as this revolution unfolds. A timely scholarly contribution.’ —Mark Cormack, Honorary Professor at the College of Health and Medicine, Australian National University (ANU) DIGITAL HEALTH TECHNOLOGIES Increasingly digital technologies are used in healthcare. This book explores eight digital health technologies, situated the context of a life span, from high-throughput genomic sequencing technologies and do-it-yourself (DIY) insulin delivery for diabetes management in paediatrics, to the use of robotic care assistants for older adults and digital advance care decisions. A scene-setting case scenario at the start of each chapter describes the digital technology and identifies the sometimes competing interests of the key stakeholders. Broad themes of resource allocation, access to technologies, informed consent, privacy of health data and ethical concerns are considered in context, alongside analysis of legal duties owed by healthcare professionals to act in their patients’ best interests. This book addresses legal and ethical issues arising from the use of emerging digital health technologies and is of interest to academics, clinicians and regulators and anyone interested in the development of health technologies and the challenges they may present. It focusses on the Australian legal framework, with some comparison to other jurisdictions. Carolyn Johnston is a legal scholar and currently research fellow at the University of Tasmania, exploring legal and ethical obligations to provide raw genomic information to research participants. She was previously a member of the Centre for Health, Law and Emerging Technologies research team at the University of Melbourne and taught at Melbourne Law School. Carolyn is an experienced clinical ethicist and is chair of the Clinical Ethics Response Group at Monash Children’s Hospital, Melbourne, providing clinical ethics consultation. Law and Change: Law in Times of Crisis Series Editor Professor Mark Findlay Singapore Management University, Singapore Artificial Intelligence (AI) is touted as the remedy for many of the economic, social, political and cultural contentions in an epoch where social demographics are unbalance, economic growth is slowing, labour markets are fragile, and global trade is wracked with protectionism. The arrival of the pandemic has heightened calls for AI and big data to help innovate economies out of the worst. This transition presents significant challenges for the ecosystems of law firms, and the require- ments of due process in the exercise of litigation. Against the realisation of seismic shifts brought about by current and impending global watersheds, this series reflects how first the pandemic and then inevitable future crises will change the law, and how law can be understood as a change agent, talking to today in upheaval, and to new tomorrows. The series provides a space for scholars, educators, practitioners and leaders to share their contributions on the present and future relevance of the law and reflect on law and change and change through law in times of global crises. The contribu- tions will be critical, focusing on contemporary challenges to social ordering and global sustainability where law in context has much to say. In addition, the series will question law’s regulatory relevance across a wide range of substantive and pro- cedural fields currently facing transition. Titles in this series include: Digital Health Technologies Law, Ethics and the Doctor-Patient Relationship Carolyn Johnston DIGITAL HEALTH TECHNOLOGIES Law, Ethics and the Doctor-Patient Relationship Carolyn Johnston Cover image: © Getty Images First published 2023 by Routledge 4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2023 Carolyn Johnston The right of Carolyn Johnston to be identified as author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Johnston, Carolyn, author. Title: Digital health technologies : law, ethics, and the doctor-patient relationship / Carolyn Johnston. Description: Abingdon, Oxon ; New York, NY : Routledge, 2023. | Series: Law and change | Includes bibliographical references and index. Identifiers: LCCN 2022035708 | ISBN 9781032115061 (hardback) | ISBN 9781032115054 (paperback) | ISBN 9781003220190 (ebook) Subjects: LCSH: Medical technologyLaw and legislationAustralia. Classification: LCC KU1525 .J64 2023 | DDC 344.9404/1dc23/ eng/20221101 LC record available at https://lccn.loc.gov/2022035708 ISBN: 978-1-032-11506-1 (hbk) ISBN: 978-1-032-11505-4 (pbk) ISBN: 978-1-003-22019-0 (ebk) DOI: 10.4324/9781003220190 Typeset in Bembo by Apex CoVantage, LLC To Anthony, Amy, Patrick and Grace. CONTENTS Acknowledgements x 1 Introduction 1 2 Digital genomic sequencing: who should have access to genomic information? 10 3 Internet of Things and personalised medicine: DIY-ing diabetes management 28 4 Smartphone apps for mental health 47 5 AI in the diagnosis of health conditions 63 6 Symptom checker chatbots and informed consent 81 7 Telehealth: what has been learned through the COVID-19 pandemic? 98 8 Robotic care assistants and older adults 116 9 A new use for existing technology: digital advance care decisions 135 Index 152
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