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/ Journal of Medical Internet Research /
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/ http://www.symposion.com/jmir/ /
/ International Scientific Journal for /
/ Medical Research, Information and /
/ Communication on the Internet /
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Table of Contents Issue 1, Volume 2 (Mar 2000)
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SPECIAL THEME ISSUE on e-Health Ethics
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All papers are available free of charge from our website.
http://www.symposion.com/jmir/2000/1/
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Editorials
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Towards ethical guidelines for e-health: JMIR Theme Issue on eHealth Ethics
Gunther Eysenbach
(JMIR 2000, Mar 31, 2 (1), e7)
http://www.symposion.com/jmir/2000/1/e7/
Ethical and Legal Issues in Interactive Health Communications:
A Call for International Cooperation
Roberto J. Rodrigues
(JMIR 2000, Mar 31, 2 (1), e8)
http://www.symposion.com/jmir/2000/1/e8/
Policy Proposal
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e-Health Ethics Draft Code (Feb 18)
e-Health Ethics Initiative
(JMIR 2000, Feb 29, 2 (1), e2)
http://www.symposion.com/jmir/2000/1/e2/
The Internet Healthcare Coalition
John Mack
(JMIR 2000, March 3, 2 (1), e3)
http://www.symposion.com/jmir/2000/1/e3/
Review Papers
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Towards ethical guidelines for dealing with unsolicited patient emails and
giving teleadvice in the absence of a pre-existing patient-physician
relationship - systematic review and expert survey
Gunther Eysenbach
(JMIR 2000, Feb 24, 2 (1), e1)
http://www.symposion.com/jmir/2000/1/e1/
Ethical guidlines for psychological interventions on the Internet
Craig Childress
(JMIR 2000, Mar 31, 2 (1), e5)
http://www.symposion.com/jmir/2000/1/e5/
Special Case Reports
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Report of a case of cyberplagiarism - and reflections on detecting and
preventing academic misconduct using the Internet
Gunther Eysenbach
(JMIR 2000, Mar 31, 2 (1), e4)
http://www.symposion.com/jmir/2000/1/e4/
Commentary: Digital plagiarism - The web giveth and the web shall taketh
John M. Barrie and David E. Presti
(JMIR 2000, Mar 31, 2 (1), e6)
http://www.symposion.com/jmir/2000/1/e6/
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Abstracts
Issue 1, Volume 2 (Mar 2000)
http://www.symposion.com/jmir/2000/1/
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Editorial
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Towards ethical guidelines for e-health: JMIR Theme Issue on eHealth Ethics
Gunther Eysenbach
(JMIR 2000, Mar 31, 2 (1), e7)
http://www.symposion.com/jmir/2000/1/e7/
The Internet is a vast resource for consumers, but to realize its full
potential it is necessary to ensure the quality of information, or at least
to help consumers to assess the quality of information. While the Internet
and interactive health communication clearly has the potential to make
patient-physician encounters more effective [1], a recent paper published in
the Journal of Medical Internet Research showed that only 19% of Scottish
GPs felt that they were "able to use the time more effectively" if patients
come with Internet printouts [2].
The principal dilemma of the Internet is that its anarchic nature is
desirable as it fosters open debate without censorship, but at the same time
it raises quality problems that could inhibit its potential [3]. However, a
single or centralized review process, institution, or agency to ensure
quality is neither desirable or realistic, since the Internet is a
decentralized, global medium: "Web 'publishers' of all stripes...should be
free to post whatever they like and live with the consequences" [4]. We can
call the resulting dilemma "the farmer's dilemma," as any farmer battling
with pests and weeds faces a similar problem: The more pesticides he uses,
the more he inhibits the healthy growth of useful plants. Likewise, any
"top-down" regulation on the Internet is prone to fail or to destroy
"healthy" communication [3].
(...read the full paper online....)
Editorial
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Ethical and Legal Issues in Interactive Health Communications:
A Call for International Cooperation
Roberto J. Rodrigues
(JMIR 2000, Mar 31, 2 (1), e8)
http://www.symposion.com/jmir/2000/1/e8/
Cyberspace is a fast-changing, globally-networked, multicultural, and
multilingual information environment with vast possibilities [1-9]. It calls
into question national and international borders, cultural and ethical
standards, regulations, and laws, which it bypasses and challenges [10-13].
In the health sector, self-care, drugs sold over the Internet, and providing
access to technical knowledge and alternative forms of healthcare to the
general public have destabilized drug regulatory mechanisms and the
traditional physician-patient relationship.
The Internet offers unprecedented power to provide users of healthcare
information -- patients, professionals, families, caregivers, educators,
researchers, insurers, regulators, and policymakers -- with data of
unprecedented timeliness, accuracy, depth, and diversity. The very qualities
that make the Internet such a rich marketplace of ideas -- its decentralized
structure, global reach, leveling of access to the tools of publication,
immediacy of response, and ability to facilitate free-ranging interchange --
also make it an exceptional channel for potential misinformation, unethical
use, concealed bias, covert self-dealing, fraudulent practices, and evasion
of legitimate regulation.
(...read the full paper online....)
Policy Proposal
---------------
e-Health Ethics Draft Code (Feb 18)
e-Health Ethics Initiative
(JMIR 2000, Feb 29, 2 (1), e2)
http://www.symposion.com/jmir/2000/1/e2/
ABSTRACT
The Internet is changing how people receive health information and health
care. All who use the Internet for health-related purposes must join
together to create an environment of trusted relationships to assure high
quality information and services; protect privacy; and enhance the value of
the Internet for both consumers and providers of health information,
products, and services. The goal of the "e-Health Code of Ethics" is to
ensure that all people worldwide can confidently, and without risk, realize
the full benefits of the Internet to improve their health. The draft code,
presented in this paper, has been prepared as a result of the "eHealth
Ethics Summit," which convened in Washington DC on 31 January 2000 - 2
February 2000, organized by the Internet Healthcare Coalition and hosted by
the World Health Organisation/Pan-American Health Organisation (WHO/PAHO),
and attended by a panel of about 50 invited experts from all over the world.
Policy Proposal
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The Internet Healthcare Coalition
John Mack
(JMIR 2000, March 3, 2 (1), e3)
http://www.symposion.com/jmir/2000/1/e3/
As individuals take a larger role in managing their own healthcare, more
consumers are independently seeking out health information via the Internet.
Health professionals are also turning to the Internet to keep informed and
interact with their patients. Given the vast amount of healthcare data
available on the Internet, the Internet Healthcare Coalition was created to
promote quality health resources online and to ensure that consumers and
professionals are able to find reliable, quality information online.
Review Paper
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Towards ethical guidelines for dealing with unsolicited patient emails and
giving teleadvice in the absence of a pre-existing patient-physician
relationship - systematic review and expert survey
Gunther Eysenbach
(JMIR 2000, Feb 24, 2 (1), e1)
http://www.symposion.com/jmir/2000/1/e1/
ABSTRACT
Background: Many health information providers on the Internet and doctors
with email accounts are confronted with the phenomenon of receiving
unsolicited emails from patients asking for medical advice. Also, a growing
number of websites offer "ask-the-doctor" services, where patients can ask
questions to health professionals via email or other means of
telecommunication. It is unclear whether these types of interactions
constitute medical practice, and whether physicians have the ethical
obligation to respond to unsolicited patient emails.
Objective: To improve the quality of online communication between patients
and health professionals (physicians, experts) in the absence of a
pre-existing patient-physician relationship or face-to-face communication,
by preparing a set of guiding ethical principles applicable to this kind of
interaction.
Methods: Systematic review of the literature, professional, and ethical
codes; and consultation with experts.
Results: Two different types of patient-physician encounters have to be
distinguished. "Traditional" clinical encounters or telemedicine
applications are called "Type B" interactions here (Bona fide relationship).
In comparison, online interactions lack many of the characteristics of bona
fide interactions; most notably there is no pre-existing relationship and
the information available to the physician is limited if, for example, a
physician responds to the email of a patient who he has never seen before. I
call these "Type A" consultations (Absence of pre-existing patient-physician
relationship). While guidelines for Type B interactions on the Internet
exist (Kane, 1998), this is not the case for Type A interactions. The
following principles are suggested: Physicians responding to patients'
requests on the Internet should act within the limitations of
telecommunication services and keep the global nature of the Internet in
mind; not every aspect of medicine requires face-to-face communication;
requests for help, including unsolicited patient questions, should not be
ignored, but dealt with in some appropriate manner; informed consent
requires fair and honest labeling; health professionals and information
providers must maintain confidentiality; health professionals should define
internal procedures and perform quality control measures.
Conclusions: Different media are appropriate at each point on the continuum
between dispensing general health information and handling patient problems
that would require the practice of medicine to solve. For example, email is
a sufficiently capable medium for giving out general health information,
while diagnosis and treatment usually requires at least advanced telemedical
technology. Patients have to be educated that it is unethical to diagnose
and treat over the Internet in the absence of a pre-existing
patient-physician relationship, and if the interaction is limited to a
single email. More research is needed to establish more evidence regarding
situations in which teleadvice is beneficial and efficient.
Review Paper
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Ethical guidlines for psychological interventions on the Internet
Craig Childress
(JMIR 2000, Mar 31, 2 (1), e5)
http://www.symposion.com/jmir/2000/1/e5/
ABSTRACT
The Internet offers psychotherapists a new communication medium through
which they can deliver psychotherapeutic interventions that are appropriate
to the medium.
Yet online psychotherapy also offers new ethical challenges for therapists
interested
in providing online psychotherapeutic services. The differences between
interactive text-based
communication and in-person verbal communication create new ethical
challenges not previously
encountered in face-to-face therapy. This article will examine the
Internet's potential
for providing online psychotherapeutic interventions and will review the
ethical issues involved
with providing interactive text-based psychotherapy.
Special Case Report
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Report of a case of cyberplagiarism - and reflections on detecting and
preventing academic misconduct using the Internet
Gunther Eysenbach
(JMIR 2000, Mar 31, 2 (1), e4)
http://www.symposion.com/jmir/2000/1/e4/
ABSTRACT
Background: The Internet is an invaluable tool for researchers and certainly
also a source of inspiration. However, never before has it been so easy to
plagiarise the work of others by clipping together (copy & paste) an
apparently original paper or review paper from paragraphs on several
websites. Moreover, the threshold of stealing ideas, whether lifting
paragraphs or perhaps even whole articles from the Internet, seems to be
much lower than copying sections from books or articles. In this article, we
shall use the term "cyberplagiarism" to describe the case where someone,
intentionally or inadvertently, is taking information, phrases, or thoughts
from the World Wide Web (WWW) and using it in a scholarly article without
attributing the origin.
Objective: To illustrate a case of cyberplagiarism and to discuss potential
methods using the Internet to detect scientific misconduct. This report was
also written to stimulate debate and thought among journal editors about the
use of state of the art technology to fight cyberplagiarism.
Methods: A case of a recent incident of cyberplagiarism, which occurred in
the Journal of the Royal College of Surgeons of Edinburgh (JRCSEd), is
reported. A systematic search of the Internet for informatics tools that
help to identify plagiarism and duplicate publication was conducted.
Results: This is the first in-depth report of an incident where significant
portions of a web article were lifted into a scholarly article without
attribution. In detecting and demonstrating this incident, a tool at
www.plagiarism.org, has proven to be particularly useful. The plagiarism
report generated by this tool stated that more than one third (36%) of the
JRCSEd article consisted of phrases that were directly copied from multiple
websites, without giving attribution to this fact.
Conclusions: Cyberplagiarism may be a widespread and increasing problem.
Plagiarism could be easily detected by journal editors and peer-reviewers if
informatics tools would be applied. There is a striking gap between what is
technically possible and what is in widespread use. As a consequence of the
case described in this report, JMIR has taken the lead in applying
information technology to prevent and fight plagiarism by routinely checking
new submissions for evidence of cyberplagiarism.
Special Case Report
-----------
Digital plagiarism - The web giveth and the web shall taketh
John M. Barrie and David E. Presti
(JMIR 2000, Mar 31, 2 (1), e6)
http://www.symposion.com/jmir/2000/1/e6/
ABSTRACT
Publishing students' and researchers' papers on the World Wide Web
(WWW) facilitates the sharing of information within and between academic
communities. However, the ease of copying and transporting digital
information leaves these authors' ideas open to plagiarism. Using tools such
as the Plagiarism.org database, which compares submissions to reports and
papers available on the Internet, could discover instances of plagiarism,
revolutionize the peer review process, and raise the quality of published
research everywhere.
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The next issue of JMIR will appear end of June, 2000.
Papers accepted for forthcoming issues of JMIR include
- Utilization Of Internet Resources By Patients with Inflammatory Bowel
Disease: Questionnaire Survey
- Benchmark Searches for Testing Search Capabilities and Medical Coverage of
Internet Discovery Tools
- Co-operative Health Information Networks: Experiences from Greece and
Scotland
- Design and Implementation of a Portal for the Market of the Medical
Equipment (MEDICOM)
- Organizing The Present, Looking To The Future: An Online Knowledge
Repository To Facilitate Collaboration
- Review: The SGML Standardization Framework and the Introduction of XML
If you want to contribute - our "Instructions for authors" can be found at
http://www.symposion.com/jmir/instruction.htm
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