Inhaltszusammenfassung

Advancements in digitalization with cardiac implantable electronic devices (CIEDs) allow patients opportunities for improved autonomy, quality of life and potential increase in longevity. However, with the digital and functional practicalities of CIEDs, there exists also cyber safety issues with transferring wireless information. Informed consent is a key component of both ethical care and promoting therapeutic relationships through chosen patient-centred treatment plan(s). To date, there are...Advancements in digitalization with cardiac implantable electronic devices (CIEDs) allow patients opportunities for improved autonomy, quality of life and potential increase in longevity. However, with the digital and functional practicalities of CIEDs, there exists also cyber safety issues with transferring wireless information. Informed consent is a key component of both ethical care and promoting therapeutic relationships through chosen patient-centred treatment plan(s). To date, there are no standardised guidelines for listing cyber security risks within the informed consent or for discussing during the consent process. With these cyber risk concerns, further challenges arise due to: 1) cyber risk scenarios are difficult for health care institutions to plan for (considered as an ambiguous threat) and result in ineffective and inconsistent protective measures, 2) cyber threats can impair trust in the device, the treatment plan and the patient provider relationship; and 3) the perceived threat to CIED patients is elevated because CIEDs are mobile in the patient and the stress to the patients about cyber attacks could be higher than from a technical malfunction. In addition, institutions who have not informed their CIED patients about cyber security risk(s), are involuntarily shifting patients’ risk perceptions and treatment choices. If a health care network were to be hacked, a CIED patient could experience both the loss sensitive data and the possible loss of control of the CIED by an unwelcome party. Furthermore, if a CIED patient were to become victim of a cyber attack that resulted in a serious or lethal event, and this information were to become public, the trust in healthcare would be impacted and legal consequences could result. A cyber attack therefore poses not only a direct threat to the patient’s health but also the confidentiality, integrity and availability of the CIED, and these cyber threats should be considered patient targeted threats. Providers are responsible for adhering to ethical principles of autonomy, beneficence, non-maleficence and justice, both in medical practice and the informed consent process. At present, the decision to include cyber security risks is mainly left to the provider’s discretion, who may also have limited cyber risk information. Without effective and in-depth communication about all possible cybersecurity risks during the consent process, CIED patients can be left unaware of the privacy and physical risks they possess by wearing such a device. Cyber risk factors should be covered within the patients’ informed consent and reviewed on an ongoing basis as new risk information becomes available. By including cyber risk information in the informed consent process, patients are given the autonomy to make the best-informed decision.» weiterlesen» einklappen

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DDC Sachgruppe:
Allgemeines, Wissenschaft