The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Recent publications on digital health technologies highlight the importance of ‘responsible’ use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping (...) review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher’s Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing ‘role responsibilities’ among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a ‘responsibility gap’ where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients’ accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health. (shrink)

What is the relationship between consciousness and our brain? Are they one and the same? Who are we really? The Consciousness Network presents a novel account of one of the greatest scientific challenges of the 21st century: understanding the connection between brain and mind. The book explores remarkable cases of patients who demonstrate how our impression of reality is created by the brain. Age-old questions about dreams, colour perception, phantom sensations and hallucinations are illuminated by surprising discoveries from the latest (...) brain research. How does consciousness differ from memory, emotions and behaviour? How did it develop during the evolution of life on earth, and does it serve a purpose? Does the brain leave room for free will? In this unique blend of philosophy, history, psychology and neuroscience, Cyriel Pennartz breaks new ground by presenting an original theory of brain and mind, substantiated by brain research in patients and healthy people. This theory, inspired by the 17th century philosopher Spinoza, goes significantly deeper than current thinking based on computer models or artificial intelligence. The Consciousness Network is essential reading for students working at the interface of neuroscience, cognitive psychology, philosophy of mind and cognitive science, as well as anyone interested in consciousness and the brain. (shrink)

This study discusses how perceptions of ethics are formed by certified public accountants (CPAs). Theologians are used as a point of comparison. When considering CPA ethical dilemmas, both subject groups in this research project viewed confidentiality and independence as more important than recipient of responsibility and seriousness of breach. Neither group, however, was insensitive to any of the factors presented for its consideration. CPA reactions to ethical dilemmas were governed primarily by provisions of the CPA ethics code; conformity to that (...) code may well be evidence of higher stage moral reasoning. (shrink)

First published in 1995. Routledge is an imprint of Taylor & Francis, an informa company.

There has been considerable research on confusion and frustration that has treated them as two unitary constructs, distinct from each other. In this article, we argue that there is instead a constellation of different types of confusion and frustration, with different antecedents, manifestations, and impacts, and that the commonalities between many types of confusion and frustration justify thinking of them as part of the same constellation of affect, distinct from other prominent affective categories. We discuss how these types of affect (...) have been considered historically and in key models. We then discuss unusual manifestations of each form of affect that have been documented in the literature, and what light they shed on the broader constructs. We conclude with a discussion of a new theoretical framing that treats confusion and frustration as a confrustion constellation, and the opportunities and open questions that this perspective presents. (shrink)