What people think about the reliability of medical information on the Internet

AUTHOR

Anton Vedder (Netherlands)

ABSTRACT

The Internet is quickly becoming one of the most consulted sources of information about diseases and medical treatment. Important characteristics of the Internet are the easy accessibility of the medium for people who look for information and for people who provide information. One can easily seek and find an abundance of information through the Internet. It is also almost equally easy to diffuse information through the Internet. Because of both the ease with which the information is accessible and the ease with which information can be dispersed, it is also relatively easy to disperse incorrect information, or to diffuse manipulated information, or to manipulate the presentation of, in other respects, correct information, intentionally or unintentionally. Conversely, the seeker of information can relatively easily be misled, misinformed, or be tempted to misinterpret information that, in other respects, is correct. Because medical information can be the basis of important decisions and actions regarding health and life, the phenomenon calls for critical ethical assessment.

From a moral point of view, the situation as described gives rise to three main questions:

  • How should this situation be evaluated in moral terms from a general point of view? (Is it at all bad that medical information on the Internet is not always reliable? In what way could answers to this question in any respect amount to collective actions aimed at warranting or enhancing reliability of medical information on the Internet? Is it not, for instance, the responsibility of the users of the information to check its reliability?)
  • What can or should be done eventually in order to warrant the reliability of medical information on the Internet?
  • Who or what institution can be considered to be responsible for guaranteeing the reliability of medical information on the net?

In this paper, I deal with some preliminaries to these questions. Central to it is the question whether the reliability of medical information on the Internet is really a matter of concern to people. I will, first, give a critical overview of previous research on this topic. The main part of the paper, however, will be dedicated to the results of an enquiry (through in-depth interviews held in the spring and early summer of 2002) among a group of patients/consumers, physicians and content providers in the Netherlands in order to investigate what people actually think about the problems indicated. The first results of that inquiry will be published in this paper. (The inquiry is carried out as part of a research project of Tilburg University and the University of Maryland financially supported by the Netherlands Organization for Scientific Research). The paper will focus onthe respondents’ views on the reliability of information on the Internet when compared to other media, the factors that cause the (un-)reliability, the ways in which they assess the reliability of information, experiences of possibly negative consequences of (un-)reliable information on the Internet, possible remedies, and the possibly arising conflicts between these solutions and commonly accepted principles of freedom of speech, privacy, tolerance, and the informational freedoms. Among the respondents will be also content providers and general practitioners. The former are included in order to see whether there is an awareness of the possible problems. The latter are included in order to see whether and how they are confronted with patients who obtain information from the Internet, and what influence this has on the doctor-patient relationship.

With the results of the inquiry, I will be in a better position to measure the extent and seriousness of the problems relating to the reliability of medical information on the Internet. Furthermore, I will use the results to point out the different ways in which people assess the reliability of information from traditional media and from the Internet. Especially, I will clarify what I have elsewhere called secondary epistemic criteria and culturally embedded credibility conferring systems.

(Please, note that the term medical information is used here to refer to medical information in databases on sites of the World Wide Web that can be consulted by patients and consumers or, simply, the general public. Excluded are: (information through) newsgroups and email-distribution lists aiming at the communication to or among patients, electronically enhanced transactions for ordering and selling and buying products, making appointments etc., and online consulting of cyberdoctors or traditional health care professionals. Furthermore, sites (predominantly) aiming at obtaining information from the public, e.g., for purposes of trials and monitoring, and at telemedicine are excluded.)

Image informatics in the Virtual University

AUTHOR

Paula Roberts (Australia)

ABSTRACT

This paper extends the image informatics ethics debate from issues of truth to considerations of the virtual university and the ethical dilemmas posed by the management and visual presentation of information in hyperreality.

Issues of truth which dominated ethical considerations in image informatics since computer technology made possible a seamless alteration of the photograph and its representation of reality (Roberts & Webber 1999), have moved more recently to concerns regarding the computer synthesis of images, which could allow, theoretically at least, a presidential candidate to be generated, credentialed, and elected without ever being publicly seen (Cooper 1998). Previously, photographs had represented historical truth as an expression of ‘a past that cannot be retrieved’ (Barthes 2000). However, synthesized images, such as the morphed image of the multicultural young woman on a 1993 Time cover, have overtaken the photograph. But, as Haraway (1997) points out, the Time ‘woman’, created from a mix of racial computerized images as a means of representing centuries of racial synthesis, is not ‘real’ visual information, and, as such, cannot convey ‘all the bloody history caught by the ugly word miscegenation’.

Robins (1996) argues that the ‘hyperreality’ of the digital image, with its increasing autonomy as a new source of information, threatens conventional reality. Similarly, Dreyfus (2001a) warns that supporters of virtual education systems boast that school experience will be electronically simulated, and, as early as primary school, ‘kindergartners will use mouse pads to finger paint’, and older students ‘will do virtual chemistry experiments with animated beakers and electronic Bunsen burners’, thus sacrificing the reality of tactile experience to the limitations of the hyperreal.

Borgmann (2000) is concerned also with the desensitizing of knowledge in virtual reality which despite its promise of more tantalizing shape and colour, variety and availability, than anything in the actual world, cannot equate with realistic, lived experience, for ‘no one has been carried from a virtual race course or ski hill with burns or fractures’. Likewise, Penny (1995) argues that virtual reality acts as an insulator from reality, in being ‘as real as a picture of a toothache.’

Simulation technologies, however, have proved their usefulness, for example, virtual environments have provided therapeutic benefits in helping people with fears such as acrophobia by ‘walking’ them through computer-generated representations (Strickland et al., 1997). And simulations are used in controlling, at a distance, operations at hazardous sites such as space and deep-sea exploration, and nuclear and other toxic environments. However, the publicly televised military application of simulation technology in the Gulf War, (and more recently in Afghanistan) has demonstrated also the ethical dangers of the derealization effect of virtual reality, which has made it appear these wars were being conducted in an imaginary space where fighters were engaged in a computer game, rather than destructive combat (Robins 1996).

The ethical dangers in simulations lie in the threat they pose to understanding the difference between reality and hyperreality, between ‘true’ and ‘false’, and between ‘real’ and ‘imaginary’ (Baudrillard 1983), and in providing a temptation to live in a world of simulated images and simulated commitment, which might lead to a simulated life which inhibits ethical action (Dreyfus 2001b).

Feminists also raise ethical concerns that virtual reality creates a gendered, disembodied space, which not only denies the body, but represses it (Hayles 1993). However, concern for the body does emerge in virtual environments with the construction (in the anonymity and acceptance which exists in cyber communities) of lives more expansive than those lived in reality Turkle (1995). But the self constructed in virtual reality differs from the real self in its absence of voice, for virtual reality is mute and substitutes sight for sound, and subordinates language to visual perception (Bolter 1996). And online, disembodied relationships more often than not leave participants feeling isolated and depressed (Kraut et al., 1998). A lack of human warmth in virtual interactions might explain the large number of daily electronic visitors to the website known as JenniCAM. This web-site, with its combination of virtual reality and the digital camera, records the daily life happenings of a young woman, in representations which confuse the ideological dichotomies of body/machine, private/public and reality/virtual reality (Jimroglou 2001), and might suggest a model for an electronic, social context of information.

In conclusion, the paper questions whether the nonlinear dynamics of virtual reality represent a shift to new philosophical and epistemological models of information management and presentation. An interesting conjecture is whether the virtual university will incorporate these new models and also provide not only authentic representations of information but on-line contexts which acknowledge the ‘social life of information’, that is, that information is embedded in social relationships and institutions, and that knowledge management must focus on the social and ethical dimension, as much as on technology (Fukuama, in Brown & Duguid, 2000), in ways which are at the foundation of the traditional university.

REFERENCES

Barthes, R., cited in Bolter, J. David & Grusin, R. (2000). Remediation: Understanding New Media.

Baudrillard, J. (1983). Simulations (P. Foss, P. Patton & P. Beitchman Trans.)

Bolter, J. David (1996). Virtual reality and the redefinition of self. In L. Strate, R. Jacobson & S.B.

Gibson (eds.) Communication and Cyberspace: Social Interaction in an Electronic Environment’

Borgmann, A. Holding on to Reality: The Nature of Information at the Turn of the Millenium.

Brown, J.S. & Duguid, P. (2000). The Social Life of Information.

Cooper, T.L. (1998). New technology effects inventory: Forty leading ethical issues. Journal of Mass Media Ethics. 13: 71-92.

Dreyfus, H.L. (2001a). On the Internet..

Dreyfus, H.L. (2001b). Kierkegaard on the Internet: Anonymity vrs. Commitment in the Present Age, http://ist-socrates.berkeley.edu/~hdreyfus/ (14/5/01)

Haraway, D. (1997). Modest_Witness@Second_Millennium.FemaleMan © _Meets_OncoMouse.

Hayles, N.K. (1993). The materiality of informatics. Configurations 1: 147-170.

Jimroglou, K.M. (2001). A camera with a view: JenniCAM, visual representation and cyborg subjectivity. In E. Green & A. Adam (eds.) Virtual Gender.

Kraut, R., Patterson, M., Lundmark, V., Kiesler, S., Mukophadhy, T. & Scherlis, W. (1998). Internet paradox: A social technology that reduces social involvement and psychological well-being? American Psychologist, 53: 9, 1017-1031.

Roberts, P.M. & Webber, J.L. (1999). Visual truth in the digital age: Towards a protocol for image ethics. Australian Computer Journal, 31, 3: 78-82, August.

Robins, K. (1996).The virtual unconscious in postphotography. In T. Druckrey, (ed.) Electronic Culture: Technology and Visual Representation.

Strickland, D., Hodges, L., North, M. & Weghorst, S. (1997.) Overcoming phobias by virtual exposure. Communications of the ACM, 40: 8, 34-39.

Turkle, S. (1995). Life on the Screen: Identity in the Age of the Internet.

Adopting Socio-technical Concepts for Eliciting Groupware Requirements in the Educational Environment

AUTHOR

Alan Hogarth (UK)

ABSTRACT

Group working and its sister technology groupware are currently gaining favour in the manner in which organisations conduct their activities. However, organisations tend to view groupware as a technical product to solve a technical problem and pay scant regard to the social, cultural and ethical requirements of introducing groupware to their organisation or institution. Moreover, there has been minimal research into the social and cultural effects of introducing Groupware technology. Neither has there been much interest in developing a framework or approach that would take such social, cultural and ethical requirements into account. However there is in one body of research called Social Informatics whose concepts, if utilised properly, may be able to alleviate some of the aforementioned problems. This paper will consider how group computing, facilitated by groupware, can be introduced into the educational environment. The paper will also discuss whether adapting some of the concepts advocated by Social Informatics, specifically those pertaining to Socio-Technical development approaches, can alleviate some of the aforementioned problems of introducing Groupware into the educational environment. In order to enhance this process a case study survey conducted by the author will be discussed.

Initially the role of group working and groupware in business and education is discussed. Consideration will be given to the importance of social and cultural aspects as well as technological ones when introducing groupware. To this end a discussion of Social Informatics will be undertaken with a view to using aspects of this approach to aid in the implementation of a groupware system. Specifically socio-technical design approaches such as those advocated by authors in the field will be considered. Further the findings of a survey undertaken by the author with several groups of students from Glasgow Caledonian University will be discussed. Based on the findings in the literature and the results of his survey the author will propose an initial approach for introducing groupware into the educational environment.

Social Informatics is an area of study that considers the social aspects of introducing Information and Communications Technology (ICT) into an organisation. Such research includes the roles of ICT in social and organisational change and the way that the social organisation of information technologies are influenced by social forces and social practices. Social Informatics studies’ aim to ensure that technical research agendas and system designs are relevant to peoples lives. The key word is relevance, ensuring that technical work is socially driven rather than technology driven. Social informatics also refers to the interdisciplinary study of the design, uses and consequences of ICTs that takes into account their interaction with institutional and cultural contexts.

This definition of social informatics helps to emphasise that ICTs do not exist in social or technological isolation. Their cultural and institutional contexts influence the ways in which they are developed, the kinds of workable configurations that are proposed, how they are implemented and used and the range of consequences that occur for organisations and other social groupings such as universities.

The problem is that systems professionals tend to concentrate on technical aspects
when designing information systems whether it be traditional ICT applications or the introduction of Groupware technology. Good information systems are neither obvious nor effective when they are based on technological considerations alone. Early research showed that information systems were much more effectively utilised when the people who worked with them routinely had a contribution to make during the design. One approach called ‘participatory design’ built on this insight. Further, it was discovered that it was important to change work practices and systems designs together, rather than adapt work practices to ICTs that were imposed in organisations. Systems specialists and managers should not impose ICTs on people without involving them in shaping the new system and redesign of work or educational practices. Significantly, in recent years, there has been a noticeable shift in working and educational practices with both business organisations and educational institutions placing greater emphasis on team working and more participative approaches to working. This in turn has the obvious effect of altering the social and cultural structures of these organisations . Further, coupled with this increase in team-based working there has been a parallel increase in the use of ICTs and Groupware technology, particularly in the business world. Therefore, if team working has to be computerised then by its nature Groupware must necessarily be used for this collaborative type of working. Nonetheless research is showing that those organisations which introduce ICT systems while considering not only technical aspects but also the social, cultural and ethical impact are more productive than those who do not. It is apparent from the literature that, although many business organsiations now incorporate Groupware systems and have done so for many years, proportionately fewer academic institutions are availing themselves of this technology for teaching and learning purposes. Yet Groupware systems for project work in universities, if conducted in the correct manner, could prove to be a most effective learning medium. The case study referred to in this paper is the current phase of the author’s research for his PhD. The work is based on the general theme of this presentation in regard to collaborative working and the use of Groupware technologies in the educational environment. It was the author’s intention to compare the social and cultural issues that arise within the ‘manual’ group project with those that arise within the technology based group project. The study comprises of ten groups, 35 students in total. The groups have six weeks to complete the task and will be instructed to plan, control, schedule and organise the project themselves. Only in times of extreme disagreement have they to call upon the author to mediate. On completion of this first stage of the study the students will asked to complete a questionnaire. The results of this survey will also be discussed in the paper.

Socio-cultural implications of virtual organizing

AUTHOR

Janusz Wielki (Poland)

ABSTRACT

Rapid changes have taken place in companies’ business environment at the turn of the century. Lowering differentiation of products, splintering mass markets, lowering effectiveness of mass media, shortening product life cycle, rising clients’ expectations, changes in their behavior patterns and attitudes, diminishing level of their loyalty and increasing competition accompanied by its rapid globalization are the most important factors.

Operating in this highly unpredictable and quickly changing business environment, where all of the competitors possess comparable professional competencies, puts pressure on companies to diminish continuously overall costs, increase effectiveness of all operations, achieve far greater flexibility as ever before as well as be able to faster response to customers’ expectations. In this situation enterprises commonly reach for information and communication technology, as a means which allows them to react almost instantaneously to changes in their business and become a “real-time enterprise”. Basing on ICT utilization, they try to implement new business models and establish new organizational forms.

Such a new business model, claimed by Venkatraman and Henderson as “twenty-first century business model”, is virtual organization. Although concept of virtual organizing, which is a response of contemporary enterprises to requirements of the marketplace, has been commonly discussed in recent years, not all aspects were given the same attention. The most frequently mentioned issues comprise: role of enabling technologies, stages of virtualization, strengths and weaknesses of virtual organizations, business network strategy, coordination aspects, communication across virtual teams or efficiency of VOs.

It seems that element which is very rarely considered, are socio-cultural implications of employees’ work in new business models based on ITC utilization, which virtual organization is the best known example. In fact it is very important and disregarded aspect of virtual organizing approach and attention of this the paper is focused on this issue.

In the first part of the paper business environment of contemporary companies operating in business-to-business segment, has been characterized and the most important trends, which can be observed there have been presented and discussed. Particular attention has been paid to the role of information and communication technology and its impact on enterprises’ functioning, their business processes, relations with business partners as well as with customers.

Second part of this article is focused on virtual organizing concept. It begins with defining virtualness as organization’s strategic characteristic and next various approaches to virtual organization concept are presented and discussed. Particular heed has been paid to Internet-based virtual organization. Also forms and types of VOs are characterized in this part of the paper. Three virtual organizing vectors are briefly discussed as well.

The following part of the paper concentrates on human aspects of virtual organizing. Since implementation of virtual organization concept with ICT placed in the center requires radical rethinking and redesigning numerous business process, in consequence many social and cultural implications emerge. They relate both to internal groups within a company (own employees) as well as to people outside the organization (vendors, subcontractors, customers etc.). The most important implications relate to changes in:

  • skills (e.g. ability to operate in electronic environment, utilization of Internet-based tools)
  • behavior on the job (e.g. changes in workers’ scope of responsibilities, work in cross-functional and cross-organizational teams, shifts in so far used procedures)
  • employees’ knowledge (e.g. security issues connected with operating in electronic environment)
    organizational culture.

In case of implementing any changes in organization’s functioning, extremely important issue is people resistance. Since virtual organizing requires numerous deep shifts in many elements of company’s functioning and employees’ behavior, this aspect must be also taken into consideration. All those mentioned above issues are widely discussed and considered in this part of the paper.

The next part of the article presents the case study of the modernization company operating in the power industry along with analysis of possibilities of implementation a virtual organization concept in case of this firm. First, the current model of this enterprise’s functioning is briefly described. Next, the concept of Internet-based virtual organization is presented and socio-cultural implications connected with its implementation have been identified. Attention is especially focused on two issues, which seem to be the most important. First one are consequences arising from deep redesign of so far used business model. Although from technical point of view creating a virtual organization is a relatively easy process, socio-cultural consequences of radical shifts in the way the work is performed can be quite hard for people involved in it. And these aspects are considered in this part of the paper.

Second issue, which is discussed are psychological barriers connected with implementation of virtual organization concept. Generally three kind of such barriers can be identified and all of them are examined. Namely, they comprise:

  • internal individual resistance
  • internal group resistance (formal and informal)
  • external resistance (i.e. performed by people outside the organization as customers or suppliers).

In the final part of the paper, the most important conclusions and suggestions are provided.

Ethics and Public Policy within a Digital Environment

AUTHOR

Rafael Capurro (Germany)

ABSTRACT

The paper deals with the question of the relation between ethics and public policy in general as well as with the role of ethic bodies in democratic systems within a digital environment in particular. In the last years different kinds of ethic bodies have been created within the political system in order to give ethic advice particularly in the fields of biotechnology and information technology. The ethic discourse is thus not restricted to universities or research institutions remaining a theoretical one and more or less disconnected with the field of action but becomes part of the political, legal, and of a large social debate. What are the functions of such bodies? What is their relation to the Executive, the Parliament, the Legislative as well as to the mass-mediated public opinion itself? And how is it in its process as well as in its results integrated within a digital environment?

Some of these questions have a long tradition in Western philosophy. Aristotle situated ethics (techne ethike) within practical philosophy. His conception of the distinction and relation between ethics and politics or between man as rational being (zoon logon echon) and as an individual belonging to the city (zoon politikon) is opposed to Plato’s identity between both fields. Modernity created a disjunction between individual and civil society or between morality and politics. Mass media as well as the Internet brought new forms of mediation.

Ethic committees as political bodies may be considered as situated within the political system providing a reflection on the relation between the scientific, technical, economic, moral and legal foundations of political options. They have a deliberative character that is related but not identical to the parliamentary debate as well as to the creation and diffusion of opinions through mass media. Politically institutionalised ethic discourse provide a reflection on the foundation and application of moral standards as related to economic, scientific, technical, and political rationality. They neither predetermine or even substitute political decision making nor intend to just sanction a given morality. They are an instrument for policy counsel and public awareness. This does not mean that they owe per se a kind of specific moral authority although at least some of their members should be qualified by their ethical expertise. Their political legitimation is to be seen within the context of complex modern societies within a digital environment.

Modern science and technology challenges more and more basic philosophic assumptions and provokes thus directly or indirectly a crisis or at least a basic insecurity with regard to moral standards that were either sanctioned by law or remained tacit presuppositions. The rise of ethics within the political arena may be interpreted as a symptom of a moral crisis within modern societies.

The paper deals particularly with the role and activity of the European Group on Ethics in Science and New Technologies (EGE) of the European Commission (http://europa.eu.int/comm/europan_group_ethics) as an example of how ethic discourse is established within public policy. It will address EGE present and future activities as a body providing different services within a digital environment.

Building ETHICS ONLINE Course

AUTHOR

Anna Grabowska (Poland) and Prathiba Nagabushan (Australia)

ABSTRACT

This paper presents the experience of two teachers from Australia and Poland in building an online course on “Ethics” using ICT. The aim of the paper is to share the knowledge and skills acquired by these teachers in the areas of content, pedagogy and ICT. Starting with how this project has been conceived and developed after these two teachers met each other in the WCCE 2001, held in Copenhagen, Denmark, the paper unfurls the evolution of an online course on the philosophy of “Ethics” using ICT.

This online Ethics course developed together is intended to serve students in all parts of the world, with increased flexibility regarding time, place and pace of study and creating a highly user-friendly environment that is marked by ready access to information resources in the area of the subject.

This unit is designed to give students the opportunity to

  • Discover ways of acting that are worthy of choice and of discerning those that are unworthy of choice.
  • Answer the questions that open up an ethical issue for fruitful discussion, for example, what? Why? How? Who? When? Where? What are the foreseeable effects? What are the viable alternatives?
  • Learn the ethical implications of traditional beliefs and observances.
  • Establish a body of information about the ethical issues and the debates surrounding them.
  • Learn the skills of research, analysis and discussion, appropriate to the study of ethical issues and decision-making.

Objectives of studying about ethics would enable the students to

  • Exercise greater sensitivity, reflection and method in moral decision-making with regards to personal, professional, societal, national and global issues.
  • Contrast ethical perspectives on selected issues.
  • Analyse the contributions of religious beliefs and values to traditional and/or contemporary ethical debates.
  • Understand the sources and role of authority in ethical debate and
  • Learn and improve upon the skills of research, analysis and discussion about ethical issues and decision-making.

It should have been stressed that it will be the first course in the subject of Ethics offered for students from Gdansk University of Technology. We think that the course will have a great impact on moral attitude to personal and professional behavior and will influence an ethical approach to decision-making.

ETHICS ONLINE course is now opened for testing and adding comments on a BOARD at the address: http://dec.dec.pg.gda.pl/ethics/