4.3 Article

Ethical implications of the widespread use of informal mHealth methods in Ghana

Journal

JOURNAL OF MEDICAL ETHICS
Volume -, Issue -, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/medethics-2021-107920

Keywords

Confidentiality; Ethics; Health Personnel; Information Technology; Informed Consent

Funding

  1. Fogarty International Center - NIH [R25 TW010886]

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Informal mHealth in Ghana is widely used to extend healthcare services to those who cannot access formal health systems. However, it poses bioethical challenges such as privacy invasion, breaches of confidentiality, and inadequacies in informed consent processes.
Background Informal mHealth is widely used by community health nurses in Ghana to extend healthcare delivery services to clients who otherwise might have been excluded from formal health systems or would experience significant barriers in their quest to access formal health services. The nurses use their private mobile phones or devices to make calls to their clients, health volunteers, colleagues or superiors. These phone calls are also reciprocal in nature. Besides, the parties exchange or share other health data and information through text messages, pictures, videos or voice clips. There are some ethical dimensions that are inherent in these practices that ought to be critically scrutinised by bioethicists. Objective The author has argued in this paper that informal mHealth at large scale adoption in Ghana is associated with some bioethical challenges. Methods This essay was largely based on an analysis of an empirical study published by Hampshire et al in 2021 on the use of informal mHealth methods in Ghana. Results Widespread adoption of Informal mHealth in Ghana is associated with privacy invasion of both the nurses and their clients, breaches confidentiality of the parties, discredits the validity of informed consent processes and may predispose the nurses to some other significant aggregated harms. Conclusion The author affirms his partial support for a formalised adoption process of informal mHealth in Ghana but has reiterated that the current ethical challenges associated with informal mHealth in Ghana cannot escape all the debilitating bioethical challenges, even if it is formalised.

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