AUTHOR

László Fekete

ABSTRACT

At least on the surface, the rise of the global network economy seems to accomplish the predictions of a long-held and widespread utopianism, which still attributes the transformation of the well-established economic paradigm to the general use of the new information and communications technologies. According to these once-futuristic ideas, the impact of the new information and communications technologies on economic organizations and the rules of economic interactions brings about the rise of the global network economy, thereby creating infinite and boundless growth, knowledge-based production, increased productivity, an optimal allocation of resources, and the perfect competitive market system. This utopianism also manifests the political, social, and cultural messages pertinent to the network society and its moral values. These sets of values are restrictively identified as constitutive of the new economy but will in fact change all spheres of life, not just the economic organizations and the rules of economic interactions. This new metaphor first appeared in the influential oeuvres of professional futurists, but it began to be popularized by the American business media in the mid-1990s. The term new economy quickly became the distinguished catchword of political and popular discourses. Shortly thereafter, professional economists began asserting the analytical soundness of the new economy. Criticism of the over-simplification of current economic trends almost totally disappeared from the economic literature. Meanwhile, the “eternal” constellation of the most important attributes of the new economy – steady, high and smooth growth rates, business-cycle resistance, the unlimited opportunities of financing new investments by issuing company bonds and stocks, low interest rates, high corporate profits, low inflation, declining unemployment rates, increasing multi-factor productivity as a consequence of the synergy of the application of the new communication technologies and organizational change and etc. – suddenly disappeared in April 2000 and the economic actors have had to face the well-known problems again. Before April 2000, few economists discussed critically the soundness of the speculations about the astonishing effects of the use of the new information and communications technologies on economic growth and corporate profits. Among these few was American economic historian Robert Brenner, who stated the following about the long-term performance of the American economy in his book – The Economics of Global Turbulence – published in 1998: “Nevertheless, there has been scant improvement in economic performance to accompany the rise in profit rate: indeed, in terms of growth of aggregate output, investment (capital stock), productivity, and wages, the boom of the 1990s was the weakest of the postwar epoch.” In opposition to the critical views, there was almost unanimous agreement among the political and professional advocates of the new economy, of the new epoch beginning in the mid-1990s, and they rewrote the well-established rules and principles of the economic textbooks.

The different predictions and forecasts relevant to the new economy are not confined to the economic issues. Even the technical analyses express the obvious political, social, and cultural aims and moral values linked to network society. In this way, the new economy is supposed to designate the future way of life, which translates into the social and economic autonomy and freedom of the individual; a perfect competitive market with low entry barriers, where the contractual transactions of equal, informed and cooperative parties takes place; the abolition of bureaucratic interventions and regulations of the states. The advocates of the new economy expect to overcome the political, mental and physical barriers that continue to hinder the fulfillment of the above-mentioned aims via the new information and communications technologies and the creation of network society. This political agenda is not especially novel. These notions have served as the basic tenets of legitimating the representative political system and the rationality of the self-regulating market for a long time. As normative rules of the political and economic systems, they are still on the list of outstanding debts of the liberal democracies. This political philosophical tradition appears to inadequately reflect the reality that the social and economic interactions of individuals take place inside large political and economic organizations whose disciplinary and punitive rules do not allow too much freedom for the autonomy, choice and integrity of the individual actors. In spite of the well-known political circumstances, the rise of the global network economy brings about the strong conviction that economic interactions in the network economy are based on mutual, cooperative, informed and transparent communication, which counteracts the negative welfare effects of unequal bargaining power, the opacity of the intentions of the parties, opportunistic behaviors, monopolies, market failures, negative externalities and etc. The economic transaction based on the communication of informed parties is supposed to lead to the fulfillment of the moral values in the forms of trust, confidence, the transparency of intentions, cooperation, reciprocity, fair distribution, general welfare and etc. As Alan M. Webber, the founder of Fast Company, says: “The new economy begins with technology and ends with trust.” These moral gains purportedly associated with the use of the new information and communications technologies are verbal ammunition for the conservative communitarian moral philosophy and liberal contractarianism alike.

While a transformation in the rules of economic interactions in the global network economy certainly exists, it does not follow a clear path toward fair, cooperative and consensual agreements or trust-based relationships as imagined by the contractarian or communitarian advocates of the new economy. Briefly, the new rules are based on neither the communitarian virtue of trust nor on fair contracts between equal, cooperative, self-interested and informed parties. The new rules of economic interactions represent some kind of corporative “private legislation” which usually interferes with the interests and general welfare of clients, customers or consumers.

AUTHOR

Jill Evans and John Mahoney

ABSTRACT

Introduction

The last two decades have seen huge technological advances in the creation, manipulation and distribution of images. The relatively low-cost availability of imaging hardware and software has led to a widespread enthusiasm for creating digital images for a range of purposes. Many of these self-created images are put onto the Web with little thought about how they might be used by others or the moral rights of those portrayed in those images. Increasingly, however, those who publish and use images of individuals in electronic format are being called on to justify their actions and motives.

The BioMed Image Archive (http://www.brisbio.ac.uk/) is an established archive of freely- available images for non-profit use in learning, teaching and research in the medical, dental and veterinary disciplines. The archive has entered a new development phase that will allow educationalists to deposit their own images with the archive from their desktops. Offering the community this degree of autonomy could lead to a possible loss in control of overall quality and credibility, thus it is particularly important to provide clear ethical guidelines on what image content is and is not appropriate to potential image donors.

Initial research has found that current guidelines on ethical considerations deal in a generic way with research materials emanating from individuals but are lacking in specific guidance on the publication and use of image-based materials. The various guidelines can also be interpreted in a number of ways. Although project research initially focused on the medical applications of such images, it soon became apparent that the legal, ethical, cultural and social issues arising have far wider implications for a very broad range of subject areas.

Human and Moral Rights: Public Awareness

Until recently, widely-reported accounts of legal disputes over ownership of images, purported invasion of privacy, and claims of pictorial misrepresentation have been almost exclusively in regard to celebrities. However, increasing unauthorised use of images of private citizens, for example captured via Closed-Circuit Television (CCTV) or satellite technology and broadcast on television, or in advertising campaigns, has raised public awareness of the potential for abuse of their innate human rights to privacy and to be treated with dignity.

Education has traditionally been seen as somewhat exempt from the concerns of the commercial, industrial world because of the widely-perceived altruism and benevolence of its pursuits but these assumptions can no longer be taken for granted.

Education and Image Ethics: Brief Examples

Typically, a lecturer might place a tutorial, including text and images, on open access on the Internet, where it is publicly available without restriction for downloading. Images in the tutorial might be downloaded by another and used in a brochure to promote, for example, awareness of sexually-transmitted diseases.

A number of questions arise as a consequence of this: did the lecturer get permission from the individual to publish their image openly on the Web? If permission was not obtained, what actions could be taken by the person portrayed to have the images removed? What legal actions could be taken by the person portrayed? Who would be legally responsible: the lecturer or his/her institution? Should the lecturer have anonymised the image so that the individual was, in theory, unrecognisable? Does the lecturer’s institution or department have a policy regarding the publication of such images? Who is the owner of the images: the lecturer or his/her institution? What are the legal implication for those who downloaded and used the images out of context? What are the legal and moral rights of the subject of the image regarding misrepresentation of their image? There does not appear to be clear, agreed upon, consistently applied solutions to many of these questions. As a consequence there is confusion and uncertainty about how to handle and use images of people.

In some fields it is particularly important to be aware of any changes or manipulations that an image has undergone as well as the chain of authorship and responsibility for the creation of new versions. Image users need to know that they can trust an image and that there will not be a problem if they should use it. Users also want to be sure that what they see is the real truth or reality, a certainty that is becoming harder to establish when image manipulation is so easy to carry out and so difficult to detect. Unauthorised manipulation of images threatens the integrity of both the subject of an image and its owner or creator. It is a violation of both the moral rights of the individual and copyright laws.

These unresolved issues could have serious implications for the creation, storage and use of reusable learning objects.

Conclusion

Many lecturers have a keen interest in incorporating digital images into their teaching practice and tools. Information and computer technology permits lecturers to use digital images in a variety of ways to help students to learn and to perform more effectively. However, there are ethical issues regarding what images can safely be put on the Web and what can safely be done with images downloaded from the Web. A contentious but pressing issue currently facing those in education is how they should approach the legal, moral, ethical and professional challenges of using digital images of people. Addressing these issues fully will have implications for currently accepted practices and behaviours. These are issues that must be addressed and all those who use images of people, whatever the educational context, must be prepared to modify their behaviour and presumptions.

While it is important that those depicted in images are treated with respect and dignity, it is also essential that unique and valuable image collections are not destroyed or hidden because of fear of prosecution or bad publicity. The BioMed Image Archive is hoping to work with the education community to debate this difficult area, to share experience and to formulate some shared approaches to handling the collection, dissemination and vital preservation of irreplaceable visual resources.

AUTHOR

Y. K. Dwivedi and J. Choudrie

ABSTRACT

Researchers in the IS field have widely studied the adoption and impact of Information and Communication Technologies (ICTs) at the organizational and individual level; however, studies related to household adoption and the impacts of ICT are largely overlooked. One of the first studies within the Information Systems field to examine the adoption of Personal Computers (PC) in the household was undertaken by Venkatesh and Brown (2001). Although such studies are becoming prevalent, they have not yet been extended to examine the diffusion of emerging ICTs such as broadband. The majority of the research associated with the topic of broadband is exploratory in nature, mainly focusing on the usage of the technology and provides little insight into consumer adoption or rejection determinants.

Systematic research on the adoption of broadband in households necessitates the identification of all the possible factors, which is a view founded on similar research that has been undertaken on PC adoption (Venkatesh and Brown, 2001). Identification of the factors is also necessary, as it will assist in developing a model that can subsequently be utilised to determine the adoption of broadband in households. The model will be further developed to examine issues such as behaviour and diffusion. Therefore, this paper aims to develop an initial model of broadband adoption (MBA) based on the decomposed theory of planned behaviour (Taylor and Todd, 1995), the diffusion of innovation theory (Rogers 1995) and model of adoption of technology in households (Venkatesh and Brown 2001). In the completed final paper for ETHICOMP 2004 these models will be discussed in detail.

The proposed model postulates that an individual’s intention to adopt broadband at homes is determined by four independent variables. These are (1) attitude, which describes the perception towards broadband technologies; (2) subjective norms, which describes the social influences that may affect the intention to adopt broadband; (3) perceived behavioural control that describes the beliefs about having the necessary resources and opportunities to adopt broadband in the home; and (4) Social attributes, which directly explains consumer behaviour. The first three independent variables are deemed necessary in order to determine the intention to adopt broadband, which in turn, is expected to predict the actual adoption of broadband. Comparatively, the fourth independent variable, social attribute (i.e. age, gender, occupation, income, and education) is included to determine the socio-economic characteristics of adopters and non-adopters. A brief description of the aforementioned factors is given below. More in-depth details of the factors will be offered in the final completed version of the paper.

Attitude. According to Venkatesh and Brown (2001) the different magnitude of attitudinal belief towards the adoption of PC in the household can be measured using three main constructs, namely, utilitarian outcomes, hedonic outcomes, and social outcomes. For examining broadband adoption in the household, this research will adopt hedonic outcomes, utilitarian outcomes (Venkatesh and Brown, 2001) and relative advantage (Rogers, 1995). Since broadband is not a directly observable product, therefore the social outcome construct of the model of adoption of technology in household was considered irrelevant to this study.

Subjective norms. Venkatesh and Brown (2001) have considered the social influence of family, friends, TV, and newspaper as a construct that can be used to measure subjective norms. The findings of Venkatesh and Brown (2001) suggest that social influences are significant determinants of the purchasing behaviour of PCs. Similarly, it is expected that households with broadband connections are likely to influence their relatives and friends by informing them about the benefits and convenience offered by broadband. Therefore, it is appropriate to consider social influence as a measure of subjective norm for broadband adoption in the household.

Perceived Behavioural Control. Venkatesh and Brown (2001) identified and validated five specific barriers that can inhibit the adoption of PCs in the household including, a rapid change in technology, declining costs, the high cost of PCs, ease/difficulty of use and a requisite knowledge of the use of PCs. Since the subscription cost of broadband access is stable and technology is not changing rapidly, the declining cost and rapid changes in technology were considered irrelevant factors for the adoption of broadband technologies; hence not included in this research. This study considered the factors of high costs, the ease/difficulty of PCs and Internet use, the lack of knowledge of broadband benefits, and lack of needs as barriers to the adoption of broadband.

Social Attributes. Key variables such as age, education, gender and income (Burgess, 1986) provide important information on the characteristics of the population under investigation. This theoretical claim is supported by findings obtained from a regression analysis of the US census data that examines PC adoption (Venkatesh, et al, 2000). This research indicates that important variables when considering PC adoption are, gender, race, education, and income (Venkatesh, et al, 2000). These variables were also included in other previous studies that examined the adoption of the PC (Venkatesh, et al 2000), Internet (Anderson, et al 2001) and Broadband (Anderson, et al 2002) in households. Since PCs, telephone, and Internet(both dial-up and broadband) belong to the cluster of ICT technology (Rogers, 1995) the socio-economic variables employed in previous studies, was also considered in the proposed model of broadband adoption used in this research.

The final paper for ETHICOMP 2004 will provide an initial model that can be used to examine broadband adoption in the household. The contribution of this research should then benefit several groups. For industry the contribution is that providers will be offered an argument that demonstrates how broadband diffusion should be encouraged. This is important since factors such as, high costs, lack of requisite knowledge to use a PC and the Internet and a lack of knowledge about the usage and the benefits of broadband are inhibiting the adoption; thereby, causing a significant problem known as the digital divide. Examining the topic of broadband adoption is also helpful in understanding the adoption of B-2-C electronic commerce in the context of the households and emerging e-government services.

REFERENCES

Anderson, B., Gale, C., Jones, M.L.R., and McWilliam, A. (2002) Domesticating broadband-what consumers really do with flat-rate, always-on and fast internet access, BT Technology Journal 20 (1), 103-114

Anderson, B. and Tracey, K. (2001) Digital Living: The Impact (or Otherwise) of the Internet on Everyday Life, American Behavioral Scientist, 45 (3), pp. 456-475

Burgess, R (1986). Key Variables in Social Investigation, London, Routledge

Rogers, E. M. (1995) Diffusion of Innovations (4th ed.), Free Press, New York

Taylor, S. and Todd, P. A. (1995) Understanding Information Technology Usage: A Test of Competing Models, Information Systems Research, 6 (2), pp. 44-176

Venkatesh, A et al. (2000) A longitudinal analysis of computing in the home census data 1984-1997. In Home informatics and Telematics: Information, Technology and Society. Eds. Sloane and Felix van Rijn pp 205-215

Venkatesh, V and Brown, S (2001). A longitudinal investigation of personal computers in homes: Adoption determinants and emerging challenges. MIS Quarterly, 25 (1), pp 71-102

AUTHOR

Penny Duquenoy

ABSTRACT

Research and development in ICT aims to bring us smaller, smarter and seamless information exchange. Pervasive and ubiquitous computing are commonly used terms to describe a new information age where life is made easier by technology operating in the background – invisible and non-disruptive in our everyday lives.[1] Whilst such technologies already exist in many spheres (domestic appliances and cars are simple examples) and are uncontroversial, the integration and inter-connection of these intelligent devices has a significant impact on individuals as citizens of the information society.

This significance is recognised by the European Commission (Information Society Technologies) in its 6th Framework programme in which we see the recurrence of the words “integration” and “intelligence” appearing in a number of spheres: (i) “Intelligent, adaptive and self-configuring systems”; (ii) “wearable or implantable systems … intelligent and communicating clothing and/or implants”; (iii) “intelligent systems that empower persons”; and (iv) “intelligent road vehicles and aircraft …”.[2]

In earlier EU discussions the notion of “Ambient Intelligence” [3] was promoted, described as “an environment where people are surrounded by intelligent intuitive interfaces that are embedded in all kinds of objects and an environment that is capable of recognising and responding to the presence of different individuals in a seamless, unobtrusive and often invisible way.” (Preface to the ISTAG report). In this ISTAG report four futuristic scenarios were devised to aid thinking on technical, economic and socio-political issues surrounding the integration of these technologies. What was not included was the ethical perspective.

A preliminary analysis of the four scenarios, from the ethical perspective, was carried out at a workshop session (facilitated by this author) at the 2nd IFIP Summer School 2003 “Risks and Challenges of the Networked Society”. [4] Participants in the workshop included academics, postgraduate students, and representatives from industry.

This paper builds on the above work by introducing comparable contemporary scenarios to draw out issues that are of concern today. By referencing the issues of today against the issues of the future (as depicted by the ISTAG scenarios), we can not only see the recurring problems, but should also be able to see emerging areas for consideration. Certain outcomes may not be surprising – for example, privacy issues are likely to increase -however, the method of categorisation and analogy could provide useful insights into where efforts for technical and legal support should be focussed. Areas of priority can be identified.

The future as envisaged by ISTAG is approaching at an alarming rate – the year of their scenarios is 2010. Whilst many of their concepts are unlikely to have evolved within the next 7 years, current advances in mobile communications systems and intelligent systems, together with wearable and embedded devices, urge some forward-thinking. Citizens can be seduced by the appeal of this integrated technology [5], the responsibility of its development and safe use is with the developers, designers, academics, and governments. Anticipating future issues is a sensible precaution, advocated by COMEST: “[There is an] increasing importance of ethical reflection in the light of the cultural and social effects of the rapid advance of scientific knowledge and technology.”[6]

REFERENCES

[1] Pervasive computing is described as providing a paradigm “for all the time, everywhere services” (Second IEEE International Conference on Pervasive Computing and Communications. PerCom2004 http://www.percom.org). The call for papers includes topics such as “Intelligent environments, wearable computers, smart devices and smart spaces” amongst others. Note also 4th International Workshop on Smart Appliances and Wearable Computing (http://www.unl.im.dendai.ac.jp/IWSAWC/).

[2] (i) Applications and services for the mobile user and worker; (ii) E-health; (iii) E-inclusion; (iv) E-safety for road and air transport. http://www.cordis.lu/fp6/ist.htm

[3] Scenarios for Ambient Intelligence in 2010, Final Report, Compiled by K.Ducatel, M. Bogdanowicz, F.Scapolo, J. Leijten and J-C Burgelman, February 2001, IPTS Seville. http://cordis.lu/ist/istag.htm

[4] Duquenoy, Penny and Vijay Masurkar (2003) “Surrounded by Intelligence” in Proceedings of 2nd IFIP Summer School “Risks and Challenges of the Networked Society”. Forthcoming.

[5] Di Pietro, Roberto and Luici V. Mancini “Security and Privacy Issues of Handheld and Wearable Wireless Devices” Communications of the ACM, September 2003/Vol.46.No.9: 75-79

[6] World Commission on the Ethics of Scientific Knowledge and Technology (COMEST) Sub-Commission on “The Ethics of the Information Society” Report, September 2001.

AUTHOR

Jenny S. Darzentas and John Darzentas

ABSTRACT

The term ‘Design for All’, or ‘Universal Design’ is frequently misunderstood. Most often its detractors take it as a euphemism for ‘designing for the disabled’, i.e. designing products and systems for a small minority and requiring specialist knowledge on the part of the design team, such as rehabilitation engineers, physiotherapists, etc. Another misinterpretation is that universal design seeks to find a utopian solution, a kind of “one size fits all” to suit all types of users.

However, a more realistic definition of Design for All within the area of ICT is available. It allows for a graded approach and defines Design for All as, in the first instance, the design of products, services and applications, suitable for most of the potential users without any modification, then, to the design of products, which are easily adaptable to different users (i.e. by incorporating adaptable or customisable user interfaces) and finally, to the design of products which have standardised interfaces, capable of being accessed by specialised user interaction devices.

Are designers of ICT products and systems concerned about Accessibility and Design for All? Lately there has been a growing interest in the subject. This is partly a response to legislation passed to do with accessibility of information (content) and information systems. It is interesting that this stems from legislation to do with the accessibility of the built environment and of transport systems. Under this legislation some very expensive litigation has taken place. This has led to a search for guidelines and standards to be used by designers to ensure their companies’ products and systems are not liable for any infringements of the law.

A further factor contributing to the increase in awareness are the demographic statistics. These point to the fact that the population of the Western world is aging. Ageing brings with it disability in the guise of decreased mobility, less acuity of hearing and sight, not to mention increased propensity to succumb to the debilitating effects of diseases like cancer, diabetes, Parkinson’s and Altzheimer’s. With this in mind, and realising that their customer base may soon be made up of retired couples with money and leisure time to spend, car manufacturers designing their in-vehicle telematic systems for navigation, security, comfort and entertainment are actively targeting elderly drivers as their user group.

Perhaps by far the most cogent of all these factors is the voice of the users themselves. For many disabled or socially excluded people, technological advances have given them the means to communicate with the world. The Internet and the support it offers for activities such as shopping, banking, voting, entertainment, and education, not to mention the lifelines provided by various online communities, have opened up opportunities that were not possible for these users before. With these communication channels they are also able to make their voices heard, and their need for accessible content, input and output mechanisms, is being proclaimed loud and clear – for those who have ears to hear.

So with these factors at work, why hasn’t the take-up of Design for All been more widespread. There are several answers to this. The legislation is still fairly new, the industry still regards ‘universal design’ as design for a niche market, – that of assistive technology. Then there are those skeptics of the demographic argument who believe that the statistics are overrated and that the aging population with be computer literate and well able to make personalised adaptations for themselves to standard applications and hardware. However, by far the most important obstacle to the dissemination of Design for All practice is that the knowledge is so fragmented and that it is not widely taught:- only a handful of courses are available for professionals and students at universities and colleges.

This is a serious bottleneck. For designers with no knowledge in this area, ‘retro-fitting’ or trying to adapt software to take account of accessibility concerns is notoriously difficult, time-consuming, expensive and demoralising. More often than not, complete new designs are required. At the same time, designers appreciate the extra usability afforded by ideas adopted from assistive technology or solutions devised for the disabled. Many of these are now standard features, for instance, flashing and vibrating alerts for mobile phones, inspired by systems for the deaf and the vision impaired respectively, as well as voice generation systems (text readers) for the blind.

This aim of this paper is to describe the work that is being done in the design of curricula for Design for All, and to point to best practice in the area, in order to serve as a reference point for designers of Information Society products and systems, as well as for the educators of future generations of designers. In the effort to draw up curricula, the primary task is to understand what are the knowledge and skill sets to be taught. The work of the IDCnet (Inclusive Design Curricula Network – www.idcnet/info) is concerned with just this task. Defining these sets means showing how all the requirements, arising from legislation, demographic concerns, and the users themselves, and be brought to bear in order to mainstream Design for All into the whole design cycle, from concept to reality. It is particularly acute to deal with this situation now. As the work on ubiquitous computing continues, we see examples of designs which block out whole sections of the population, for instance touch screens, or menu driven screens both unusable by the vision impaired. This includes the blind, those who are partially sighted, as well as those people whose situation or context of use, precludes them from seeing a screen, or touching a screen? If we are to prevent the evils of e-exclusion, including the disenfranchisement of those groups so lately freed up from disability by technology, then we must take our responsibility to Accessibility and Design for All with the same seriousness we give to issues of privacy, security, copyright etc. and make sure this important issue is part of every Information Society Designer’s education. This is both socially responsible and good sense.

AUTHOR

Göran Collste

ABSTRACT

Since many years information technology is used in health care. However, lately one can notice a growing interest for different kinds of applications, partly explained by the need of a faltering IT-industry to find new markets. Naturally, ICT can in different ways enhance the practice of health care. However, it is necessary to examine the applications in the light of the ethical values of health care.

In this paper I will discuss the ethical implications of the introduction of two new computerised information- and communication systems in health care. One is a system for patient surveys. The system, named IRIS, is used in the public health system and makes patient information available to any authorised care provider irrespective of at what place in the organisation he or she works. The use of IRIS is so far limited to the regional health care organisation, but in principle it can have a broader application and be used even at a European level. The other system I will discuss is a system for patient Internet accesses to his/her own medical case sheet.

There are several good reasons for introducing the new systems. IRIS will make patient information more accessible for doctors and other health care professionals, it will speed up the treatment and it will decrease the number of medical specimens and examinations. The system that provides patient access to his/her own medical case sheet will probably make patients more informed about their medical condition. The potential of both systems has relevance from an ethical point of view, for instance with reference to the principles of beneficence, non-maleficence and autonomy.

However, there are also possible risks with the new ICT-systems. Both systems will process confidential patient information and thus there is a risk for privacy violations. Furthermore, this risk will eventually lead to mistrust among both care providers and patients. This could eventually lead to a “censuring” of information, which, in its turn, will decrease the reliability of the systems. It is not clear who shall have access to IRIS. At the moment, the access is limited to persons involved in a “relation of care” but that could be interpreted as everyone working at a caring unit. But with such a broad access the possibility of misuse will also increase.

In order to protect the patients, the systems will use the highest security technology. Further, the patient has to give his/her informed consent to the processing of information. However, how a practice of informed consent shall be implemented without too many practical problems is a question that yet has to be answered.

The decision to introduce systems of this kind implies difficult and some times controversial ethical balancing. There are different ways to proceed, and I will discuss some possible alternatives. One can here make a distinction between criteria and procedures: which norms and values have priority, and according to which procedures should the system be designed and introduced?

One may, in accordance with utilitarianism, follow a kind of cost/benefit methodology and transform the different values at stake to a common unit. Or one may, from a deontological point of view, identify the relevant moral principles and norms and then either balance them in order to be able to decide which principle takes precedence or specify the norms in order to bring them to bear on practice.

Procedures for a morally justified introduction of new technologies include “participatory design” and, in accordance with the method of reflective equilibrium, “interactive technology assessment” (Reuzel et al). Then, different stakeholders’ perspectives will be taken into account in the processes of design and assessment.

In this paper, I will first describe the system for patient survey and the “open medical case sheet”-system. I will then analyse the ethical problems associated with the systems and, finally, discuss different moral criteria and possible procedures in order to come to a justified decision.