Technology and ethical dilemmas in a medical setting: Privacy, professional autonomy, life and death

Abstract

A growing literature addresses the ethical implications of electronic surveillance at work, frequently assigning ethical priority to values such as the ‘right to privacy’. This paper suggests that, in practice, the issues are sociologically more complex than some accounts suggest. This is because many workplace electronic technologies not designed or deployed for surveillance purposes nevertheless embody surveillance capacity. This capacity may not be immediately obvious to participants or lend itself to simple deployment. Moreover, because of their primary functions, such systems embody a range of other features which are potentially beneficial for those utilising them. As a result, more complex ethical dilemmas emerge as different desired ‘goods’ compete for priority in the decision-making of individuals and groups. From a sociological point of view this raises interesting questions about the way ethical dilemmas arise in the context of the ongoing social relationships of work. The paper explores these issues using data from a study of the development and implementation of a computerised instructional package in a maternity setting. This medical setting illustrates clearly how seeking to assign ethical priority to a particular concern, such as the ‘right to privacy’, cannot but oversimplify the real day to day dilemmas encountered by participants. At the same time, the example of the instructional package demonstrates that it is difficult to predict in advance what ethical issues will be raised by technologies that almost always turn out to have a range of capabilities beyond those envisaged in their original design specification.