Personal health monitoring in the armed forces - scouting the ethical dimension : A case study in the Netherlands Armed Forces during the Covid-19 pandemic.
Armed forces
Ethical dimension
Ethics support
Moral dilemmas
Personal health monitoring
Responsible
Values
Journal
BMC medical ethics
ISSN: 1472-6939
Titre abrégé: BMC Med Ethics
Pays: England
ID NLM: 101088680
Informations de publication
Date de publication:
09 03 2023
09 03 2023
Historique:
received:
23
12
2022
accepted:
02
03
2023
entrez:
9
3
2023
pubmed:
10
3
2023
medline:
14
3
2023
Statut:
epublish
Résumé
The field of personal health monitoring (PHM) develops rapidly in different contexts, including the armed forces. Understanding the ethical dimension of this type of monitoring is key to a morally responsible development, implementation and usage of PHM within the armed forces. Research on the ethics of PHM has primarily been carried out in civilian settings, while the ethical dimension of PHM in the armed forces remains understudied. Yet, PHM of military personnel by design takes place in a different setting than PHM of civilians, because of their tasks and the context in which they operate. This case study therefore focusses on obtaining insights into the experiences and related values of different stakeholders regarding an existing form of PHM, the Covid-19 Radar app, in the Netherlands Armed Forces. We carried out an exploratory qualitative study, using semi-structured interviews with twelve stakeholders in the Netherlands Armed Forces. We focussed on participation in the use of PHM, reflections on the practical use and use of data, moral dilemmas and the need for ethics support, all in regard to PHM. The data was analysed using an inductive thematic approach. Three interlinking categories reflecting ethical dimensions of PHM emerged: (1) values, (2) moral dilemmas, and (3) external norms. The main values identified were: security (in relation to data), trust and hierarchy. Multiple related values were found. Some, but no broadly shared, moral dilemmas were identified and no strong need for ethics support was expressed. This study shed light on key values, provide insights in the experienced and presumed moral dilemmas and bring to mind ethics support considerations when looking at PHM in the armed forces. Some values bring a certain vulnerability to military users when personal and organisational interests are not aligned. Furthermore, some identified values may hinder a careful consideration of PHM because they potentially conceal parts of ethical dimensions of PHM. Ethics support can assist in uncovering and addressing these concealed parts. The findings highlight a moral responsibility for the armed forces to devote attention to the ethical dimensions of PHM.
Sections du résumé
BACKGROUND
The field of personal health monitoring (PHM) develops rapidly in different contexts, including the armed forces. Understanding the ethical dimension of this type of monitoring is key to a morally responsible development, implementation and usage of PHM within the armed forces. Research on the ethics of PHM has primarily been carried out in civilian settings, while the ethical dimension of PHM in the armed forces remains understudied. Yet, PHM of military personnel by design takes place in a different setting than PHM of civilians, because of their tasks and the context in which they operate. This case study therefore focusses on obtaining insights into the experiences and related values of different stakeholders regarding an existing form of PHM, the Covid-19 Radar app, in the Netherlands Armed Forces.
METHODS
We carried out an exploratory qualitative study, using semi-structured interviews with twelve stakeholders in the Netherlands Armed Forces. We focussed on participation in the use of PHM, reflections on the practical use and use of data, moral dilemmas and the need for ethics support, all in regard to PHM. The data was analysed using an inductive thematic approach.
RESULTS
Three interlinking categories reflecting ethical dimensions of PHM emerged: (1) values, (2) moral dilemmas, and (3) external norms. The main values identified were: security (in relation to data), trust and hierarchy. Multiple related values were found. Some, but no broadly shared, moral dilemmas were identified and no strong need for ethics support was expressed.
CONCLUSION
This study shed light on key values, provide insights in the experienced and presumed moral dilemmas and bring to mind ethics support considerations when looking at PHM in the armed forces. Some values bring a certain vulnerability to military users when personal and organisational interests are not aligned. Furthermore, some identified values may hinder a careful consideration of PHM because they potentially conceal parts of ethical dimensions of PHM. Ethics support can assist in uncovering and addressing these concealed parts. The findings highlight a moral responsibility for the armed forces to devote attention to the ethical dimensions of PHM.
Identifiants
pubmed: 36894976
doi: 10.1186/s12910-023-00899-9
pii: 10.1186/s12910-023-00899-9
pmc: PMC9998002
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
21Informations de copyright
© 2023. The Author(s).
Références
Healthc (Amst). 2015 Sep;3(3):153-6
pubmed: 26384227
J Med Syst. 2011 Oct;35(5):1165-79
pubmed: 21611788
Perspect Clin Res. 2013 Jan;4(1):53-7
pubmed: 23533983
Nanomaterials (Basel). 2019 May 29;9(6):
pubmed: 31146479
Healthc Inform Res. 2017 Jan;23(1):4-15
pubmed: 28261526
J Sci Med Sport. 2021 Oct;24(10):975-981
pubmed: 34148796
Sleep Health. 2017 Apr;3(2):126-131
pubmed: 28346159
Int J Environ Res Public Health. 2021 Aug 20;18(16):
pubmed: 34444564
J Sci Med Sport. 2018 Nov;21(11):1147-1153
pubmed: 29960798
JMIR Mhealth Uhealth. 2019 Sep 11;7(9):e12861
pubmed: 31512582
Sci Eng Ethics. 2018 Feb;24(1):1-28
pubmed: 28155094
JMIR Mhealth Uhealth. 2020 Jul 9;8(7):e17216
pubmed: 32480361
Health Inf Manag. 2020 May-Sep;49(2-3):150-156
pubmed: 31146589
Philos Ethics Humanit Med. 2018 Sep 3;13(1):12
pubmed: 30176930