Overview

As we followed the actual events or were entertained by the movie Apollo 13 (Howard, R., 1995), we all watched the astronauts trying against all odds to bring their crippled spaceship back to earth.  The speed of their travel was incomprehensible to most of us, and the task of bringing that spaceship back to earth seemed nearly impossible.  They were experiencing a crisis never imagined by the experts at NASA; and they were making up their survival plan moment by moment.  What brought them back to earth safely? Surely we must give credit to the technology and the space ship's ability to withstand the trauma it experienced. But what amazed us most was the traditional non-technological tools, skills, and supplies that were used in new and different ways to stabilize the spacecraft’s environment and keep the astronauts safe while traveling toward their uncertain future.

           This sense of constancy in the midst of change serves to stabilize our experience in many different life events and contributes to our survival of crisis and change.  This rhythmic process is also vital to the healthcare system’s stability and survival in the presence of the rapidly changing events of the Information Age.

Nobody can dispute the fact that the Information Age is changing healthcare in ways that will not be fully recognized and understood for years.   The change is paradigmatic and every expert who addresses this change reminds health care professionals of the need to  “go with the flow” of rapid change or be left behind. 

           As with any paradigm shift, a new way of viewing the world brings with it some of the enduring values of the previous worldview. As healthcare journeys into the brave new world of digital communications, it will bring along some familiar tools and skills recognized in the form of values, such as privacy, confidentiality, autonomy, and nonmaleficence. While these basic values remain unchanged, the standards for living out these values will take on new meaning as health professionals are confronted with new and different moral dilemmas.  Ethical decision-making frameworks will remain constant, but the context for examining these moral issues will become increasingly complex.

           This brief overview will provide you with some familiar ethical concepts to take with you on your challenging journey into the increasingly complex future of healthcare informatics. We will briefly define ethics and bioethics and examine the evolution of ethical approaches from the “Hippocratic ethic” era through “principlism” and to the current “antiprinciplism” movement of ethical decision-making. We encourage you to read more about these approaches as you review the cases presented in this course and as you journey further into the unfolding era of healthcare informatics.