Nav: Home

New in the Hastings Center Report, January-February 2019

February 21, 2019

Social Media, E-Health, and Medical Ethics

Mélanie Terrasse, Moti Gorin, and Dominic Sisti

Given the profound influence of social media and emerging evidence of its effects on human behavior and health, bioethicists have an important role to play in the development of professional standards of conduct for health professionals using social media and in the design of online systems themselves. The authors examine several ethical issues: the impact of social networking sites on the doctor-patient relationship, the development of e-health platforms to deliver care, the use of online data and algorithms to inform health research, and the broader public health consequences of widespread social media use. The authors also make recommendations for addressing bias and other ethical challenges. Mélanie Terrasse is a PhD candidate in sociology and social policy at Princeton University, Moti Gorin is an assistant professor of philosophy at Colorado State University, and Dominic Sisti is assistant professor in medical ethics and health policy at the University of Pennsylvania.

Other Voices: Several articles respond to Terrasse, Gorin, and Sisti. In "Welcoming the Intel-ethicist," John Banja argues that two concerns--that digital platforms will diminish the therapeutic value of medicine and that artificial intelligence algorithms will increase errors and unfair decision-making--may be exaggerated. Patients are already adapting to AI systems that serve particular medical uses, such as screening for diabetic retinopathy, and health care providers, just like AI tools, are prone to making errors and acting on biases when diagnosing conditions and recommending treatments. With ethical oversight, AI systems can learn from their mistakes, too, Banja writes.

In "Deep Ethical Learning: Taking the Interplay of Human and Artificial Intelligence Seriously," Anita Ho writes that while the use of AI technologies can pose ethical issues like perpetuating human biases, it would be irresponsible to not employ them in ways where they can improve care, such as using electronic monitoring systems to track the long-term care of seniors. AI tools should be part of a larger effort for health care quality improvement while administrators and developers monitor and address the ethical problems that can arise from their use.

In "Ethical Use of Social Media Data: Beyond the Clinical Context," Catherine M. Hammack argues that the use of social media and other digital tools in research poses new and distinct challenges, in part because the law offers less protection of individual privacy in research than in clinical care. One relevant risk is that privacy settings on digital platforms may not prevent companies from sharing data with third parties or using it for marketing and product development and other types of research.

Artificial Intelligence and Black-Box Medical Decisions: Accuracy versus Explainability

Alex John London

While many AI systems can provide highly accurate diagnoses and other predictions critical for medical care, the reasoning by which they arrived at their findings can be inscrutable, leading some commentators to question whether health care practitioners should trust these systems. But knowing how a machine arrived at its decision is less relevant than its ability to produce accurate results, writes London. Opaque clinical judgment and uncertainty about how decisions are made are commonplace in many non-AI aspects of health care, and it would be misguided to devalue an AI system simply because its decision-making process is inaccessible. London is a Clara L. West professor of ethics and philosophy at Carnegie Mellon University, where he directs the Center for Ethics and Policy.
Also in this issue:

* The Strange Tale of Three Identical Strangers: Cinematic Lessons in Bioethics

* Capacity for Preferences and Pediatric Assent: Implications for Pediatric Practice

* At Law: Fighting Novel Diseases amidst Humanitarian Crises


Susan Gilbert, director of communications

The Hastings Center
845-424-4040 x244

The Hastings Center

Related Health Care Articles:

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.
Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.
The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .
Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.
High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.
Health insurance changes, access to care by patients' mental health status
A research letter published by JAMA Psychiatry examined access to care before the Patient Protection and Affordable Care Act (ACA) and after the ACA for patients grouped by mental health status using a scale to assess mental illness in epidemiologic studies.
Medical expenditures rise in most categories except primary care physicians and home health care
This article was published in the July/August 2017 issue of Annals of Family Medicine research journal.
Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
More Health Care News and Health Care Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at