AUTHOR
Jenny Ohman Persson

ABSTRACT

This paper focuses on different ethical dilemmas occurring when real working life situations are to be analyzed and built into tools as customized software for computer-supported office work. The problems are discussed on different levels and in different settings. The levels concern problems with the understanding of what a work is, of how to avoid to reduce the interpretations of work situations into information processes and how to deal with the fact that there are two parallel, but at the same time different ongoing development processes – the development of the work and its organization on the one hand and the development of the customized computer system on the other hand. Discussions are raised about difficulties of being aware of our preconceived notions affecting the understanding of interpreted situations and solutions.

The combination of IT-development and organizational development is of vast interest. The increasing number of people developing health problems in poorly designed, computer-supported work environments, is a problem of great concern. Negative effects from inferior software and poor organization management are consequently in focus for discussion in this paper, while the possibility to move towards achieving efficient and effective organizations built on ideas that will contribute to a superior and satisfying life for people at work is one of the overall goals.

The empirical data that will be presented is gathered mainly within one governmental authority in Sweden. The empirical data deals with problems concerning the development of one specific customized computer system to be used by one specific work group in the authority. The empirical data also deals with problems occurring when developing an IT-strategy on a central level concerning the authority in its entirety.

The notion that interpretations are affected by our experiences, thoughts and preconceived notions is an issue to take into consideration. Basic values are the underlying sonority that colors all our ways of acting. In the interpretation of our environment, basic values have great impact. One inescapable conclusion is that the difficulties in development strategies and organizational change are several and severe. But the result most important to discuss here, is the fact that in every moment and with every move, we are challenging the understanding of the environment with all our previous beliefs and experiences. It is only through awareness of one’s own basic values and knowledge that we can begin to talk about a genuine understanding of reality.

In a changing environment, we use metaphors to better communicate different conditions, for instance, in an organization or in a software development project. A metaphor can be used as a tool in the interpretation and understanding of the organization. In relation to the discourse on basic values, these values are not to be seen as a tool, but as a more or less conscious interpretive filter, through which we look at our environment. Basic values thereby also color the interpretation of a metaphor, which will provide us with different images depending on our interpretive filter. If we are unaware of the bias of our own basic values, our interpretation of a metaphor runs a great risk of contributing to strategic decisions that will sub-optimize parts of the business.

When redrawing an organization plan, or chart of any kind, there may be no clear awareness that the work is theoretical, in the sense that the organizational units that we are moving around, are a complex system of people, physical work environments, work space, relations, affections etcetera. It would be extremely difficult to manage change, if all the conditions that affect the change, and are affected by the change, were taken into consideration. In this sense, the discussions about the organizational changes must be about changes in an organizational plan, or in the work processes, or in work content or other aspects that might influence reality. But as a basis for discussion about the abstraction of the organization, the discussion can also be interpreted as a sub-discussion, which we – if we don’t look up once in while and take time to reflect – will lose ourselves in. The change will only be in the image of the organization and not in the organization itself – or it will have consequences for the organization that were not represented in the image.

Healthy work can be seen as a consequence of a well-implemented development process, but it can also be treated as a main target in the development process. The reasons can differ as to why an organization shows an interest in healthy work. In order to successfully motivate or negotiate for improving the work environment in an organization with the aim of creating a healthy work environment, the efficiency potential must usually be brought to the fore, if interest in the idea of healthy work is to be aroused.

Awareness helps us reflect over our ideas and our understanding of the world. The notion of being in control can be sufficient if we understand that we all create our own framework of how things in the world are related to each other. This framework helps us in various ways, in our struggle through daily life, in conducting research or in handling the different phases we pass through in life. If we can accept this, then the structure of the world can be dynamic and can be used as a context for development that we can challenge. Through awareness, it may be possible for us to promote a healthier climate in organizations. It is only through awareness that we can find the confidence and courage to adhere to our beliefs and ideas of what is right and wrong.

AUTHOR
Debi Ashenden

ABSTRACT

Introduction

As increasing amounts of data are stored electronically it becomes easier to allow information to be shared across a number of parties who could find access to the information useful. Not only can information be shared but it can also be aggregated and used to make inferences. There may often be significant benefits in facilitating information sharing but, as this paper will demonstrate, there is a need to approach information sharing with caution if we are to protect the ordinary citizen in the process. The ultimate aim has to be to ensure that we achieve the benefits of allowing wider access to information whilst still protecting the public interest.

There is currently a great deal of interest in issues of data sharing and multi-agency working1 but relatively little work has been undertaken on the governance structures that could support these aspirations. There is a recognised need for IT systems to provide the technological support that will allow the sharing of information to take place but at the same time there is a need to develop appropriate governance processes that will be used in the operation of such systems. Governance has been defined as ‘the system by which organisations are directed and controlled’ and the three fundamental principles of governance are ‘openness, integrity and accountability’2. This paper is based on research undertaken in the UK in the public sector and outlines the issues that need to be considered when implementing governance models for information sharing.

The requirement for sharing information is applicable across both the public and private sectors and depends largely on trust. This paper explores what we mean by ‘trust’ with regard to information sharing and the elements that contribute to the building of trust in each element of the information sharing architecture.

Context

This paper considers the importance of understanding the different contexts across which information will be shared and the way that current relationships (both formal and informal; internal and external to the organisation) and working practices shape expectations of what can be achieved with information sharing. It moves on to explore the conclusion that in order to implement ethical governance processes for sharing information it is necessary to separate out the specific implementations from general aspirations and to consider the impact on the individual (both as citizen and as employee) alongside the welfare of society as a whole.
Requirements

This section of the paper looks at the broad requirements that must be satisfied to ensure that information sharing is successful. A case is made for separating out the technical implementation from the governance processes and for ensuring that there is both technical robustness and operational flexibility in the system. Other criteria that are examined include the need to ensure that governance processes are aligned with organisational structures and ways of achieving stakeholder buy-in. Finally, the breadth of legislative requirements is considered such as human rights, data protection and freedom of information and the impact that this has on information sharing aspirations.

Tensions

The middle section of the paper concludes that there are a number of tensions that need to be balanced in order to develop good governance processes for information sharing. These include the need to balance organisational structure with public perception by implementing rigorous audit trails and ensuring that privacy of the individual is maintained.

A further tension that has been highlighted in current research in this area is that between ‘formal institutions of law and guidance on the one hand, and the informal institutions of organisation and inter-organisational functioning on the other’. This is explored in the paper alongside the difficulties of classifying the information that is shared as objective or subjective, and the issue of what happens when information is aggregated across systems and used to draw inferences.

The final area of tension that is examined is between the need to separate the IT implementation from the governance structure and yet to maintain communication and alignment between the two. Some areas of particular concern that threaten to complicate this issue are to do with outsourcing, acquisition of technology and services, building and maintaining supplier relationships and the addition of new partners and/or technology to the information sharing structure.

Governance

Given the requirements and tensions that have been highlighted the paper goes on to consider the governance structure for information sharing and explores the roles and responsibilities that have to be assigned. In this section the paper highlights the need to comply with various standards and regulations, the need to have an external facing role that can promote the need for information sharing, the separation between technical and procedural accreditation issues and the difficulties of building a team with the relevant expertise to handle the governance processes.

Conclusions

The paper concludes by highlighting the principles that need to be considered in order to gain the benefits of information sharing whilst still protecting the privacy of the individual citizen. Furthermore it highlights areas where there is still significant research to be undertaken and explores how an inter-disciplinary approach is likely to be the most successful way forward.

REFERENCES

See the Bichard Inquiry final report for a discussion of the need to share information across law enforcement agencies http://www.bichardinquiry.org.uk

Cadbury quoted in ‘Towards a ‘Generic Framework’ for Information Sharing between Public Sector Agencies’, Framework for Multi-Agency Environments (FAME), p.8

‘Data Sharing and Confidentiality: Spurs, Barriers and Theories’, Perri 6, Christine Bellamy and Charles Raab, paper given at the Political Studies Association Conference, University of Lincoln, April 5-8, 2004

AUTHOR
Leoni Venter, MS Olivier and JJ Britz

ABSTRACT

The integration of mobile technology, wireless networks, ubiquitous computing and artificial intelligence with thousands of embedded devices such as sensors and actuators may result in networks that can proactively monitor and respond to human behaviour without human interaction or supervision. Decisions that can influence or alter the environment will be made at faster-than-human speeds. This technology could have some very positive uses to enhance human life, but it can also be misunderstood or be misused, creating some ethical issues that need to be addressed.

Computer systems as we know them are designed to be interactive with their human users. Personal computers with graphical user interfaces spend most of their CPU time idling as they wait for the user to initiate and action or respond to a computer event. These systems are configured by human users and are maintained and utilized by human users.

With the proliferation of small computing devices such as cellular phones, personal digital assistants (PDA’s), smart cards and other devices, people are carrying on their person many devices capable of communicating with other devices over wireless networks. Further development of small processing chips allows embedding of computing devices into almost anything. Smart clothes, wearable computers and the like will make ubiquitous computing a reality, with a person interacting with hundreds or even thousands of devices embedded in his/her environment.

Interaction on a one-to-one basis with devices on this scale is humanly impossible. A single user cannot possibly configure and maintain every embedded device manually. The proffered ideal situation would be that the devices configure themselves and decide for themselves what actions should be taken given a certain situation.

This leads to the concept of proactive computing (Tennenhouse, 2000). Proactive computing envisions networks of computing devices, sensors and actuators that dynamically configure and maintain themselves, monitor the environment and respond to or even adapt to the environment. They may even change the environment itself. These networks of devices will operate without human supervision. As such they will no longer be interactive and can therefore operate at faster-than-human speeds.

Current Interactive computers are normally used for personal reasons such as communication, making money, doing work etc. Proactive systems, on the other hand will be concerned with the environment of their users. Such systems would have the ability to influence the environment in such a way that it could help or hurt users.

Proactive computing is often touted as a technological advance that will benefit the wellbeing of people (Noury, 2003). If this is the case, it shares a purpose with medical science. If one accepts the purpose or ????? as the essence of ethics, the well-known clinical ethical principles, viz. autonomy, beneficence, non-maleficence and justice might also apply to proactive computing. However, using teleological reasoning to establish this relationship is insufficient. If Aristotelian ethics is applied to equipment, it implies that virtues also have to be ascribed to such equipment. Our paper argues that this potentially contentious notion indeed has merit, but it draws much wider parallels between proactive computing and clinical care. These parallels include the balance between the ability to do good with the potential to harm. It will argue that the individual is vulnerable (in addition to the expectation of benefiting) from both cases. The remainder of the paper then proceeds, accepting the validity of transferring the clinical ethics principles to proactive computing.If proactive systems can influence the wellbeing of users, then it has something in common with medical science, which is also concerned with the wellbeing of patients. It is therefore interesting to evaluate proactive systems in terms of clinical ethics, with regards to autonomy, beneficence, non-maleficence and justice.

In a nutshell, the principles cover the following. Autonomy refers to the right of the user to decide what should happen as result of a given situation. Beneficence is the expectation that the use of the computer will be for doing good; non-maleficence is the expectation that the computer will not be used with bad intent; justice is the expectation that the use of the computer will be fair.

Our paper argues that these principles are all necessary, in the sense that absence of any one of the principles may lead to abuses. This is demonstrated with suitable examples.

This leads to an obvious dilemma: If (individual) autonomy is a necessary principle and proactive computing makes decisions at faster-than-human speeds, proactive computing seems to be inherently unethical. We address this by revisiting the requirement of autonomy. In revisiting autonomy, we accept Lyotard’s (1991:2) concern: “what if what is ‘proper’ to humankind were to be inhabited by the inhuman?” We conclude that proactive computing can only be considered ethically acceptable when it does not transgress this boundary. However, we also demonstrate that this boundary is fuzzy, and hard to characterise in practise.

This problem forms part of a larger problem that is discussed in the final part of our paper: We argue that clinical ethics principles have practical value (even though they are not perfect) because they have been institutionalised by the community at large and have been internalised by practitioners. Examples of such ‘institutions’ include professional bodies, clinical review boards, and government agencies. Our argument that these principles have been internalised is more empirical, and rests on anecdotal evidence. However, when the field of computing is concerned, it is simple to demonstrate a lack of institutionalisation and internalisation of such ethical principles. In fact, sufficient examples can be cited that indicate a resistance from the community at large to institutionalising such ethical principles in the field of computing.

We therefore conclude that, while well-known principles exist for the application of proactive computing, a significant change in the community is required before such principles can be applied in any practical sense.

When we look at proactive computing we discover that although its beneficent, non-maleficent and just use can be envisioned, autonomy for the user is not possible, since the systems will be operating without human supervision.

In the medical world there are many professional societies, governing bodies and control councils to ensure that medical practitioners and researchers act in an ethical manner. New drugs must be approved and will only be released on the market after thorough testing to ensure that they will do no harm.

Despite many years of discussion and debate about computer ethics (Bynum, 2001), there is still no standard set of rules or guidelines, and certainly no easy answers to solve the ethical issues posed by normal computer usage. Proactive systems will only add to these issues, and if there is no ethical guidance in the deployment and operation of these systems, chaos may ensue.

Given the history of “computer ethics” with its lack of clear results, it looks as if the future may be quite complicated.

REFERENCES

Lyotard, J. F., The Inhuman: Reflections on time, Stanford University Press, 1992

Noury, N., et al, New trends in health smart homes, ITBM-RBM (RBM), June 2003, vol. 24, no. 3, pp. 122-135(14)

Tennenhouse, D. Proactive Computing. Communications of the ACM, 43(5):43-50, 2000

AUTHOR
J. Barrie Thompson

ABSTRACT
At the University of Sunderland in the UK we offer a range of taught Masters programmes in computing. In the majority of these programmes we include a compulsory research skills module entitled “Research, Ethical, Professional and Legal Issues” (REPLI). The aim of the module is “to provide the students with an ability to undertake postgraduate level research and an appreciation of relevant ethical, professional and legal issues”. Essentially the ethical, professional and legal issues provide a research domain but the overall purpose is to ensure that the students gain research skills that will support them in the rest of their programme, in their future careers, and that they will undertake their research activities in an ethical and professional manner. Most importantly we wish to ensure that they are aware of issues associated with cheating (including plagiarism) and the means that are to available to prevent/detect such cheating.

At ETHICOMP 2002 I presented a paper [1] entitled “University Research, Plagiarism and the Internet: Problems and Possible Solutions” This paper highlighted that in today’s digital age almost unimaginable quantities of information is instantly on hand via the Internet and on-line databases. Also, that such resources are not seen as only the domain of researchers but of all students within an institution. A major development in learning approaches is a greater and greater expectation that undergraduates, as they progress through the stages of their degree programmes, will be able to undertake tasks at higher intellectual levels relying more and more on academic resources, and that postgraduate students on Master’s level programmes will be able to critically evaluate current research and advanced scholarship [2]. However, the range and volume of “instantly” available information resources has a major downside in that it has exacerbated the age-old academic problem of plagiarism which in these circumstances is often referred to as the New Plagiarism [3].

The 2002 paper provided details of various approaches that can be considered in combating plagiarism and of the particular approach that had been developed at Sunderland. The Sunderland approach centres on a systematic strategy that consists of:

• In lectures and in tutorials we emphasise the importance not only of citing sources but citing sources of appropriate academic value.
• We make use of special “How to cheat” and “How to get caught” lecture sessions
• The assignments we set are formally specified, the assessment criteria is explicitly defined, and where a formal feedback form is used in the marking, then a copy of that is also included with the assignment. All this should ensure that there are no misunderstandings regarding what is being assessed.
• We provide the lists of topics from which the students have to select.
• We require specific components within each paper including appropriate, fully referenced, academic sources, which we would expect to be reasonably recent.
• The research paper proposal (in the form of an extended abstract and initial references) ensures that students start their work early, and so that staff can provide initial feedback very quickly the proposals are marked with the student present in one of the tutorial sessions.
• We publicise the use of World Wide Web tools that can be used in the detection of plagiarism (such as Turnitin [4])
• We make use of peer group reviewing processes to deter and detect plagiarism. This stage involves the use of software tools such as Turnitin [4].
• Finally each student makes a short presentation on their paper and this is followed by questions that have been identified when the paper was marked.

Since writing the 2002 paper we have gained much more experience in running the module. Also, the University has agreed to use the software and associated services that are provided by the UK Joint Information Systems Committee (JISC) and which are intended to address the problem of plagiarism. The JISC service is known as the JISC Plagiarism Detection Service (PDS) [5] and is provided the company iParadigms, LLC who provide the Turnitin software tool referred to above.

The final paper for ETHICOMP 2005 will centre on our further experiences with the REPLI module and our use of JISC PDS. Individual sections of the paper will detail:

• The philosophy behind the module, overall learning and teaching approach, and our approach to assessment.
• How our experience with Turnitin fed into the University’s decision to adopt JISC PDS.
• Evaluations by staff and students of the approaches used within the module, particularly the use of JISC PDS.
• A detailed evaluation of the JISC PDS itself highlighting its strengths and weaknesses.

Finally the paper will present an overall evaluation of our approach and details of how we plan to progress matters in the future.

REFERENCES

[1] J. Barrie Thompson and Simon C. Stobart, (2002) University Research, Plagiarism and the Internet: Problems and Possible Solutions, Sixth International ETHICOMP Conference. The Transformation of Organisations in the Information Age: Social and Ethical Implications, ETHICOMP 2002, 13-15 November, Lisbon, Portugal

[2] The framework for higher education qualifications in England Wales and Northern Ireland, Quality Assurance Agency for Higher Education, United Kingdom, available from www.qaa.ac.uk

[3] McKenzie J. (1998) The New Plagiarism: Seven Antidotes to Prevent Highway Robbery in an Electronic Age, The Educational Technology Journal, Vol. 7, No. 8, May.

[4] Turnitin details at: www.turnitin.com

[5] Details of JISC PDS is available from: http://online.northumbria.ac.uk/faculties/art The actual JISC PDS facility is accessed from: http://submit.ac.uk

AUTHOR
Alexander R. Benzer and Robert Marsel

ABSTRACT

Advances in information and communication technology have consistently given us more efficient means of obtaining information and sharing it with others. This trend has not abated; we are continually developing faster ways of communicating with one another. While this has helped foster new eras in science, industry and commerce, many believe that it has also resulted in a depersonalization of the way we communicate. As our communication methods become increasingly rushed and abbreviated, tones, inflections, gestures, and other meaningful aspects of conversation are lost. Additionally, as our communication becomes less interpersonal and more anonymous and automated, some participants feel deprived of their character or sense of personal identity. This paper examines the various ways in which this depersonalization is sociologically important while not necessarily permanent.

Awareness and criticism of this trend has grown in recent years among academics and consumers. As a result, developers of new information and communication technologies are attempting to create products that offer consumers “re-personalized” interaction with computers or electronic communication with other people. Both Microsoft and Apple, for example, have attempted to re-personalize their latest operating system software by replacing “usernames” with “names” and offering an assortment of both functional and aesthetic personal customization options. Oddcast, a web-based software developer, has created a unique product named SitePal which it calls “conversational character technology.” SitePal is a customizable animated character that can deliver product information, answer customers’ questions, and simulate basic interpersonal conversation. Many prominent organizations have already recognized the value of this technology; Oddcast’s product has been implemented by Coca-Cola, Chevrolet, NASA, Heineken, and dozens of other large corporations. While such technology is relatively inefficient in providing information, its simulated form of interpersonal interaction is attractive to many Internet users.

The depersonalization of information and communication technology has been often viewed as a harmful sociological phenomenon. George Ritzer, author of The McDonalidzation of Society, suggests that consumers are becoming disenchanted because of the implementation of various efficiency-maximizing technologies. Ritzer presents creations such as the fast food drive-thru and automated food ordering machines as examples of this trend towards depersonalization. Ritzer affirms that while these technologies benefit corporations by lowering costs and increasing customer predictability, they result in a loss of value for consumers. Ritzer also infers that the depersonalization of consumers through the use of such technology is unethical.

As the theories of sociologists like Ritzer are becoming more mainstream, some consumers are beginning to identify and resist the depersonalization that now permeates consumer culture in the United States, Europe, Eastern Asia and other economically developed areas. Consequently, companies are developing re-personalized products in an attempt to create value for these consumers. For example, camera phones are now being sold heavily in these areas. Marketing campaigns for camera phones often encourage consumers to share their photos and customize their phones, color themes, and ring tones to match their personality. A decade ago, cellular phones were purely designed for function; now, they are marketed largely based on their aesthetic appeal. Cellular phones are also marketed towards younger generations as socially desirable items; Verizon’s most recent slogan is “Are you in?” Apple uses a similar strategy: Personalization through brand association. Apple has capitalized on consumers’ growing propensity to define themselves by the brands of electronic products they use. As a result, Apple users have become significantly more loyal to their brand than users of other computer brands.

This paper first provides an overview of the depersonalization trend that has gathered momentum over the past thirty years. We focus on several key developments that were particularly crucial in this process, including the advent of the fax machine, cellular phone, email, and instant messaging. Secondly, this paper investigates how communication technology such as instant messaging and two-way cellular radio has lowered our expectations for proper conversation and refocused our concerns on saving time. Thirdly, and most importantly, we focus on how the movement towards re-personalization began and is continuing to grow. To illustrate the growth of this trend, we examine how naturally depersonalized products such as cellular phones have been modified with added functionality and branding to give consumers a feeling of renewed personalization. We also explain how the use of web-based technologies like SitePal and online journals are being used to re-personalize the experience of using the Internet. Further evidence of this movement towards re-personalization in technology is given by the presentation and analysis of several cases, including the changes in Microsoft’s operating system software and Apple’s overall product design. Finally, this paper concludes with an ethical analysis of the new trend of re-personalization in information and communication technology.

AUTHOR
Carlisle George and Penny Duquenoy

ABSTRACT

The growth of the Internet over the last 10 years as a medium of information and as a communication technology has, not unsurprisingly, provided a foundation for the growth of direct-to-the-public online sales. Amongst the many commercial activities that are now flourishing in this environment are Internet Pharmacies, providing a variety of products (e.g. health and beauty products) as well as prescription drugs. Some pharmacies only dispense drugs with a valid prescription, some provide online consultations for prescribing and dispensing medicines, and some dispense medications without a prescription.

This paper reports on how technology has facilitated the practice of medicine online, and discusses the benefits to consumers in terms of access and convenience, together with the problems that have arisen as a result of remote consultations and lack of professionalism. It is this latter aspect that provides the focus of the paper.

We explore the ethical issues that emerge within the context of remote/online medical consultations and prescribing. We refer to current United States and United Kingdom practitioner guidelines to aid our discussions. For example, members of medical boards of all US states (The Federation of State Medical Boards) published, in 2002, ‘Model Guidelines for the appropriate use of the Internet in Medical Practice’1. Two of the guidelines specifically address the issues of remote prescription practices, referring to “documented patient evaluation” (including a patient history and physical evaluation) and stating that “Issuing a prescription based solely on an online questionnaire or consultation does not constitute an acceptable standard of care”. Further, guidelines issued by the American Medical Association in 2003 regarding the prescribing of medicines to patients via the Internet state that a physician who prescribes medications via the internet must establish or have an established a valid patient-physician relationship2. This includes among other things obtaining a reliable medical history and performing a physical examination of the patient. In 2004 the General Medical Council (GMC) in the United Kingdom issued new practice guidelines which has similar regulatory goals to the US position but some noticeable differences. The GMC details conditions to be met for remote prescribing in situations where a practitioner is either: continuing to care for a patient; deputising for another doctor responsible for the patient; or has prior knowledge and understanding of the patient’s condition and medical history and has access to the patient’s medical records. In the absence of these situations, however, the GMC does not expressly forbid remote prescribing but gives additional conditions to be satisfied if remote prescribing is to be used.

The above guidelines indicate the concern of regulatory bodies regarding Internet pharmacies and the prescribing of drugs. These concerns are particularly genuine in light of the increasing use and availability of the Internet for healthcare. We argue that online medical services have become a global market, due to widespread availability of online consultations and prescriptions irrespective of geographic location. We discuss among other issues whether current regulatory guidelines in the UK and US provide sufficient safeguards at present for society, organisations and individuals. We also discuss their impact on the future growth on online medicine.

In exploring ethical issues surrounding current online medical practices we refer to instances of prosecutions for online consultation both in the United States and United Kingdom. Such cases include Dr Richard Franklin who was found guilty of serious professional misconduct and suspended by the GMC in January 2002 after prescribing drugs online1, and Dr Shreelal Shindore, of Florida who in 2004 was forced to relinquish his license for violating standards of care when prescribing drugs over the Internet2. Using these cases we further highlight ethical issues of concern and provide concrete examples of what can go wrong. We also assess where problem areas may arise, and provide guidance on formulating recommendations for the future.

We conclude with an overview of the social and ethical issues of concern regarding online medical consultation and prescribing. We highlight how these present concerns are relevant to looking forward into the future. We also discuss how advances in technology can impact on online healthcare, both in terms of providing solutions to present difficulties and in creating further ethical concerns. Finally we provide some ethical guidance on how online medical practice can be safeguarded as a genuine consumer alternative.

REFERENCES

C.Radatz, Internet Pharmacies, Wisconson Briefs, Brief 04-5, March 2004. http://www.legis.state.wi.us/lrb/pubs/wb/04wb5.pdf

Model Guidelines for the Appropriate use of the Internet in Medical Practice. Accessed via the FSMB homepage: http://www.fsmb.org/

H-120.949 Guidance for Physicians on Internet Prescribing: http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/HnE/H-120.949.HTM

See: http://www.gmc-uk.org/standards/default.htm

BBC News, Viagra web doctor suspended. 10th January 2004. http://news.bbc.co.uk/1/hi/england/1752670.stm

http://w3.health.state.ny.us/opmc/factions.nsf