Anita Cava

Ethical, legal and social issues for personal health records and applications

Robert Wood Johnson Foundations Project HealthDesign included funding of an ethical, legal and social issues (ELSI) team, to serve in an advisory capacity to the nine design projects. In that capacity, the authors had the opportunity to analyze the personal health record (PHR) and personal health application (PHA) implementations for recurring themes. PHRs and PHAs invert the long-standing paradigm of health care institutions as the authoritative data-holders and data-processors in the system. With PHRs and PHAs, the individual is the center of his or her own health data universe, a position that brings new benefits but also entails new responsibilities for patients and other parties in the health information infrastructure. Implications for law, policy and practice follow from this shift. This article summarizes the issues raised by the first phase of Project HealthDesign projects, categorizing them into four topics: privacy and confidentiality, data security, decision support, and HIPAA and related legal-regulatory requirements. Discussion and resolution of these issues will be critical to successful PHR/PHA implementations in the years to come.

Marketing and the law

Marketing decisions are particularly vulnerable to legal rulings made in both the courts and the legislatures. The effective management of those legal implications challenges the modern marketing professional. Grasping marketing’s overall legal environment, including its governing case law, regulatory statutes and future trends, is essential. This review will provide analysis of recent court cases and legislation with particular emphasis on creatively assisting the marketer’s management of the legal factor.

Ethics and the gender equality dilemma for U.s. Multinationals

U.S. multinational enterprises must now follow the policies of Title VII of the Civil Rights Act of 1964 in their overseas operations, at least with respect to U.S. expatriate employees. Doing so in a culture which discourages gender equality in the workplace raises difficult issues, both practically and ethically. Vigorously importing U.S. attitudes toward gender-equality into a social culture such as Japan or Saudi Arabia may seem “ethnocentric,” a version of “ethical imperialism.” Yet adapting to host country norms risks a kind of “moral relativism.” This article supports the view that MNEs which promote workplace equality in a host country such as Japan, which is actively involved in the international economic and political community, is not “ethical imperialism” in any pejorative sense and is preferable to a moral relativism or social contract approach.We hold these truths to be self-evident: that all men are created equal, and endowed by their creator with certain rights — life, liberty, and the pursuit of happiness.U.S. Declaration of Independence, 1776 All human beings are born free and equal in dignity and rights.United Nations Universal Declaration of Human Rights, 1948

Bioethics, Business Ethics, and Science: Bioinformatics and the Future of Healthcare

The intersection of ethics, computing, and genetics plots a space not yet adequately mapped, despite its importance, indeed, its rapidly growing importance. Its subdomains are well-enough known: “Genethics,” or the study of ethical issues in genetics and genomics, is part of core curricula everywhere. Ethics and computing is an established subfield. Computing and genetics—bioinformatics—has in little more than a decade progressed from subsubspecialty to the sine qua non of contemporary biomedical research, and it bids fair to transform clinical practice. We must prepare for the complete digitization of the genomes of individual patients and the storage of millions of these genomes in very large databases.