Digital Health Tools (DHTs), also known as patient self-surveilling strategies, have increasingly been promoted by health-care policy makers as technologies that have the capacity to transform patients’ lives. At the heart of the debate is the notion of empowerment. In this paper, we argue that what is required is not so much empowerment but rather a shift to enabling DHTs as digital companions. This will enable policy makers and health-care system designers to provide a more balanced view—one that (...) capitalises on the benefits of DHTs, while minimising the risks of potential harms. -/- . (shrink)

Digital Health Technologies (DHTs) are currently the subject of much debate both in terms of their technological frontiers as well as their ethical, legal and societal implications (ELSI). Regulation of such technologies as medical devices currently lacks behind their level of adoption. Digital Twins are the next evolution step of such DHTs and provide an opportunity to anticipate and act on ELSI before adoption again leaps before the necessary review. This paper introduces the concept and use cases of (...) digital twins in medicine, then frames the debate through the lens of related technologies, machine learning and personalized medicine, and maps ethical challenges stemming from those. Finally, we lay out how digital twins may change and challenge the future practice of medicine. (shrink)

One of the core goals of Digital Health Technologies (DHT) is to transform healthcare services and delivery by shifting primary care from hospitals into the community. However, achieving this goal will rely on the collection, use and storage of large datasets. Some of these datasets will be linked to multiple sources, and may include highly sensitive health information that needs to be transferred across institutional and jurisdictional boundaries. The growth of DHT has outpaced the establishment of clear legal pathways to (...) facilitate the collection, use and transfer of potentially sensitive health data. Our study aimed to address this gap with an ethical code to guide researchers developing DHT with international collaborative partners in Singapore. We generated this code using a modified Policy Delphi process designed to engage stakeholders in the deliberation of health data ethics and governance. This paper reports the outcomes of this process along with the key components of the code and identifies areas for future research. (shrink)

In this dissertation, I argue that all extant theories of prudential value are either a) enumeratively deficient, in that they are unable to accommodate everything that, intuitively, is a basic constituent of prudential value, b) explanatorily deficient, in that they are at least sometimes unable to offer a plausible story about what makes a given thing prudentially valuable, or c) both. In response to the unsatisfactory state of the literature, I present my own account, the Disjunctive Hybrid Theory or DHT. (...) DHT answers to and remedies each of the above inadequacies in a way that no other approach can. This account has the following general structure:Disjunctive Hybrid Theory (DHT): Thing x is basically good for person P if and only if x is either a) cared about (sufficiently and in the right way) by P, b) a bearer of (the right kind of) attitude-independent value, or c) both.Although it follows other recent accounts in combining elements from objective and subjective theories, DHT is a hybrid theory of a quite new kind. This is because it denies both subjective necessity (the constraint that, if thing x is to be basically good for person P, P must have some pro-attitude toward x) and objective necessity (the constraint that, if thing x is to be basically good for person P, x must have some attitude-independent value). I argue that the rejection of both necessity claims is called for if we are to move beyond the enumerative and explanatory limitations of existing accounts.I begin by outlining the general structure of DHT. I then argue, against various recent authors, that desire-satisfactionism remains the most appealing subjectivist approach to prudential value, in that it is best able to capture the central subjectivist insight. This insight is that a person can confer prudential value upon things by caring about them (sufficiently and in the right way). The subjectivist strand of DHT will thus be a version of desire-satisfactionism, which must be interpreted in line with what I call the object, as opposed to the combo, view. I move on to further motivate and develop the second, objectivist strand of DHT. This part of the theory involves a commitment to robustly attitude-independent prudential goods. I close by addressing some puzzles for the theory, and considering some of its more specific applications. (shrink)