NURSING

INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

TOPIC 3: ETHICAL ASPECTS OF INFORMATICS

● Wisdom

LOOKING BACK
● Healthcare is at least a decade behind
most other industries in significantly
redesigning its business and clinical
practices to optimize the use of technology
across departments and services (Skinner,
2003)
● While early investments in healthcare
information technology were focused on
back office and administrative functions,
technology in the clinical domain is an
increasingly pervasive element of
healthcare delivery in many countries.
Information technology is now top of the
agenda for modernizing many healthcare
systems (Royal College of Nursing UK,
2006)

INTRODUCTION
WHY EMBRACE TECHNOLOGY?
● Nurses like many other healthcare
Informatics
professionals are embracing
● science of how to use data, information technologically enabled care delivery for
and knowledge to improve human health two key reasons:
and delivery of health care services ○ the need to reduce the cost of
healthcare delivery
Nursing Informatics ○ the desire to improve quality and
enhance the patient experience
● can be applied to model the human
processing of data, information, and BENEFITS OF HEALTHCARE IT
knowledge within a computer system in ● Access to clinical information at the point
order to automate the processing of of care;
nursing data to information and the ● A single clinical record facilitating
transformation of nursing information to improved communication and
nursing knowledge collaboration across the multidisciplinary
care team;
DIKW FRAMEWORK ● Less time spent creating clinical
● Data documentation;
● Information ● More time available to deliver patient care;
● Knowledge

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NURSING
INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

● Creation of an auditable record of ● Any interest or activity that encourages

delivered care; nurses to make use of technology is
● Support for care planning and integrated laudable
care pathways;
● Real time integration of monitoring ETHICAL ASPECTS OF INFORMATICS
devices’ vital sign information directly into Ethics
a patient record;
● moral principles that govern a person’s
● Proactive prompts for key Nursing
behavior or the conducting of an activity
interventions;
● refers to well-founded standards of right
● Alerts that advance patient safety;
and wrong that prescribe what humans
● Data for quality assurance and outcomes
ought to do, usually in terms of rights,
analysis;
obligations, benefits to society, fairness, or
● Opportunity to collect data for research;
specific virtues
and
● Refers to the study and development of
● Use of standardized language to
one’s ethical standards
document care.
ETHICS IN HEALTHCARE TECHNOLOGY
● The possibilities of futuristic technology
are immeasurable; so too the ethical
questions surrounding its use. And it is not
just future technology - ethical issues arise
even now, with technologies already
familiar to healthcare (Simpson, 2005)
● Autonomy
● Privacy
● Dignity
● Integrity
● Well-being
● Trust and responsibilities
● No harm
● Safety and security Beneficence
● Equitable resources
● Reliability and justification ● comes across in everyday nursing practice
● connotes acts of mercy, charity, and
NURSE INFORMATICIST kindness which are suggestive of love,
● The pervasive influence of technology in humanity, altruism and promotion of good
healthcare has created a new role for to others
nurses - Nurse Informatician (NI) ● do good
● This group of specialty nurses has been ● nurses’ actions should promote good
educationally and operationally prepared ● nurses are obligated to implement actions
to leverage advanced technology in an that benefit clients and families
enhanced care environment

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NURSING
INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

Nonmaleficence ● This includes all potential risks, benefits,

● minimize or do no harm
● whatever is done or said must not harm
the patient, physically or psychologically
● includes being honest with patients; lying
to patients or telling only part of the truth
will very probably cause harm
● for every intervention, the potential
benefits must be weighed against possible
adverse effects
● treatments should not be prescribed
unless there is a strong chance they will
help the patient and only a small chance of
unpleasant adverse effects
Veracity
● is defined as being honest and telling the
truth and is related to the principle of
autonomy
● basis of the trust relationship established
between a patient and a health care
provider
● patients are expected to be truthful about
their medical hx, treatment expectations,
and other relevant facts
● telling the truth
● honesty in disclosure is essential at the all
levels of professional practice
● Patients have a right to know about the
existence of their electronic records and
how they will be used
Autonomy
● is recognizing each individual patient’s
right to self-determination and
decision-making
● As patient advocates, it is imperative that
nurses ensure that patients receive all
medical information, education, and
options in order to choose the option that
is best for them
and complications to make well-informed
decisions
Representation of Credentials
Professional Qualifications Include:
● Abilities
● Training
● Certification
● Relevant professional experience
● Professionals should not pad their resumes
by overstating their education, experience,
or capabilities
● Professionals should only report
continuing education units that are
actually earned and should not correct any
inaccuracies
RESUME INFLATION/FRAUD
● Resume inflation is to include false or
misleading information on one’s resume to
make oneself a more attractive candidate
for a job. Resume Fraud
● Examples include adding degrees or
awards one never received or positions one
never held
WHISTLEBLOWING
● Professionals have the duty to report any
malpractice committed by their colleagues

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NURSING
INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

● can cause conflict with feelings of loyalty

● may result in retaliation by the concerned
colleague
○ snubs by co-workers
○ loss of promotions or raises
○ physical and psychological assault
● There are laws that may protect
whistleblowers

RESPONDING TO UNETHICAL PRACTICES

● Health informatics professionals will refrain
from impugning the reputation of
colleagues but will report to the
appropriate authority any unprofessional
conduct by a colleague - IMIA Code of
Ethics 2011)
● A health information professional shall Autonomy
take adequate measures to discourage,
● is recognizing each individual patient’s
prevent, expose, and correct the unethical
right to self-determination and
conduct of colleagues (AHIMA Code of
decision-making
Ethics 2011)
● As patient advocates, it is imperative that
nurses ensure that patients receive all
medical information, education, and
options in order to choose the option that
is best for them
● This includes all potential risks, benefits,
and complications to make well-informed
decisions

Respect for others

● Includes the client’s right for

self-determination
GENERAL ETHICAL PRINCIPLES IN HEALTHCARE ● sensitivity to cultural, religious, and lifestyle
Obligatory Ethics diversity transcend respectful nursing
practice
● focused on rules and regulations; what you
should and should not do
Justice
Virtue Ethics
● is the principle that when weighing up if
● characterized by showing the right
something is ethical or not, we have to
attitude, the right character or manner in
think about whether it’s compatible with
professional acts

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NURSING
INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

the law, the patient’s rights, and if it’s fair guidelines for confidentiality (McWay, 2010,
and balanced p. 174)
● it also means that we must ensure no one
is unfairly disadvantaged when it comes to
access to healthcare
● in the context of healthcare is described as
the moral obligation to act on the basis of
fair adjudication between competing
claims
● Gillon, 1994 - categorized as
○ fair distribution of scarce resources
(distributive justice)
○ respect for people’s rights
(rights-based justice)
○ respect for morally acceptable laws
(legal justice)
● right to be treated equally

Confidentiality

● Refers to the obligation of professionals

who have access to patient records or
communication to hold that information in
confidence
● patients have a right to have their personal
information kept secret from all other
people except those that are giving the
care
● Rooted in confidentiality of the
patient-provider relationship that can be
traced back to the fourth century BC and
the Oath of Hippocrates, this concept is
foundational to medical professionals’

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NURSING
INFORMATICS
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

Privacy 3. Ensure the usability, integrity, and highest

possible technical quality of the records
● Patients’ right to control how their health **an obligation of professionals to advocate for
information is used and when and laws about protecting patients’ health
whether it is disclosed information
● is considered to be the top guiding ethical 4. Professionals should
principle for health informatics a. provide best data security
professionals (AHIA and IMIA) measures
b. maintain the highest possible
Security qualitative standards of data
● Patient’s right to have their information collection, storage, retrieval
protected from being inappropriately processing, accessing,
accessed by others communication, and utilization
c. practice appropriate systems for
ETHICAL DUTIES OF HEALTH INFORMATICS evaluating the technical, legal, and
PROFESSIONALS ethical acceptability of the data
Code of Ethics 5. Ensure that patient data is maintained in a
safe, reliable manner
● Principles based on the organization’s core 6. Never use patients’ data for outside
values and the standards to which the purposes
professional is held 7. Treat the data of all patients with equal
● How professionals are supposed to act and respect
approach problems
CONSEQUENCES OF ETHICS BREAKDOWNS
Ethical Duties of Health Informatics ● Could cause harm to patients
Professionals ● erosion of trust and voluntary participation
● Patients withhold or oppose information
● Represent credentials accurately
● DAmage to reputation
● Protect patient privacy, including
● Legal liability
confidentiality and security
● Costly data-recovery procedures
● Respect patients and co-workers
● Respond to unethical practices by others

2011 IMIA CODE OF ETHICS

● 12 tenets that address common ethical

dilemmas faced by medical interpreters
and serve as a guide to professional
behavior
1. Provide informatics services necessary for
healthcare professionals to carry out their
obligations
2. Provide timely and secure access to
relevant electronic records

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