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The ethics and values of tele-care technology in palliative care : a discourse analysis

Sandhof, Alexander (2016) The ethics and values of tele-care technology in palliative care : a discourse analysis.

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Abstract:What impact does modern communication technology have on the ethics and values in the highly sensitive context of caring for the dying ? As palliative care and its ethics emerged over the last 60+ years, it impacted the care for the dying in a myriad of beneficial ways - bringing death as the natural outcome of life back into the medical disciplines seemingly so obsessed with keeping humans alive for as long as possible. Containing a low-tech approach in the care practices the latest technology to be introduced into palliative care are telecommunication tools - ranging from the earliest video telephones to the tablet PC. Against this backdrop of a high-tech technology adaptation the thesis engages in a discourse analysis of relevant research projects and papers, specifically targeted at the ethical value constitution and technology attitudes in the relevant stakeholders. Emerging as central to the care trajectory is the single, dualistic relationship between doctor and patient, with the former being awarded a long lost position of authority. Subsequent secondary and tertiary stakeholders depend from this central "primary care relationship". The scientific approach in the literature, dubbed the "quantitative discourse", engages these stakeholder compositions as to quantify the human interactions with the devices as the technology mediates human engagement. In looking for the ethical impact of palliative care ethics in this discourse setting it becomes clear that for one, palliative care ethics has had not the expected transformative impact - as we find classic medical ethics strongly entrenched in the literature. Second, the scientific methodology of the quantitative discourse does rarely engages in discussing the ethical implications of the technology, as most of the researched projects are prototypical and hence their line of reasoning is very much aimed at generating objective, statistical relevant data sets. Thus emerges the meta-level topic of this thesis, in light of methodological shortcomings of the quantitative discourse in addressing the stakeholder ethics & values - in addition to shortcomings on its own terms when it comes to the veracity and accuracy of its statistical claims - there is a need for refinement of the approach to palliative care research. To contrast the quantitative discourse I engaged in a second discourse analysis of a quality-focused research project exemplified by the work of J. Pols. In her approach of researching telecare technology in palliative as well as therapeutic settings she consciously foregoes the scientific requirements like objective, statistical relevance and engages in context bound "uncontrolled field studies". This approach yields a closer and more idiosyncratic depiction of the practices and care routines that telecare technology modifies in the end. In her focus on the nurse and the role of care practices the ethical value assessment and realization of the contingent patient attitudes is expressed in a markedly improved manner, exemplifying a potential new approach to palliative care research.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:08 philosophy
Programme:Philosophy of Science, Technology and Society MSc (60024)
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