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Consent and engagement, security, and authentic living using wearable and mobile health technology

Nature Biotechnology volume 35, pages 617–620 (2017)Cite this article

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To the Editor:

Mobile health applications and wearable health technologies are becoming ubiquitous. Although such technology offers great promise for streamlining healthcare and empowering users in their pursuit of health and wellness, it also poses ethical challenges for clinical practice, research, and everyday living. Like any other biomedical technology, accuracy and reliability, informed consent, and privacy and confidentiality must be taken into account when designing and using mobile and wearable health and wellness technologies. But mobile health applications and wearables also pose additional ethical considerations that are important when implementing this technology. These are consent and engagement, security, and authentic living. Here, we identify these issues and provide recommendations for ameliorating any concerns that may arise with this technology. Overall, we argue that for an appropriately informed and engaged user, this technology can provide great benefits, and burdens can be mitigated.

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References

  1. Kelley, P.G. et al. in International Conference on Financial Cryptography and Data Security (68–79) (Springer Berlin Heidelberg, 2012).

    Book  Google Scholar 

  2. Joffe, S., Cook, E.F., Cleary, P.D., Clark, J.W. & Weeks, J.C. Lancet 358, 1772–1777 (2001).

    Article  CAS  Google Scholar 

  3. Krumholz, H.M. J. Am. Med. Assoc. 303, 1190–1191 (2010).

    Article  CAS  Google Scholar 

  4. Lavelle-Jones, C., Byrne, D.J., Rice, P. & Cuschieri, A. Br. Med. J. 306, 885–890 (1993).

    Article  CAS  Google Scholar 

  5. Felt, A.P. et al. in Proceedings of the Eighth Symposium on Usable Privacy and Security (3) (ACM 2012).

    Google Scholar 

  6. Department of Health & Human Services. http://privacyruleandresearch.nih.gov/pdf/HIPAA_Booklet_4-14-2003.pdf (2003).

  7. Cho, M.K. et al. Ann. Intern. Med. 162, 690–696 (2015).

    Article  Google Scholar 

  8. Rothstein, M.A. Am. J. Bioeth. 10, 3–11 (2010).

    Article  Google Scholar 

  9. Kraft, S.A. et al. Clin. Trials 14, 94–102 (2017).

    Article  Google Scholar 

  10. Kelly, S.E., Spector, T.D., Cherkas, L.F., Prainsack, B. & Harris, J.M. PLoS One 10, e0118027 (2015).

    Article  Google Scholar 

  11. Apple. https://www.apple.com/pr/library/2015/03/09Apple-Introduces-ResearchKit-Giving-Medical-Researchers-the-Tools-to-Revolutionize-Medical-Studies.html (9 March 2015).

  12. Kaye, J. et al. Eur. J. Hum. Genet. 23, 141–146 (2015).

    Article  Google Scholar 

  13. Spencer, K. et al. J. Med. Internet Res. 18, e66 (2016).

    Article  Google Scholar 

  14. Wilbanks, J. & Friend, S.H. Nat. Biotechnol. 34, 377–379 (2016).

    Article  CAS  Google Scholar 

  15. Swan, M. J. Med. Internet Res. 14, e46 (2012).

    Article  Google Scholar 

  16. Chan, Y.-F.Y. et al. Nat. Biotechnol. 35, 354–362 (2017).

    Article  CAS  Google Scholar 

  17. Smith, A., Rainie, L., McGeeney, K., Keeter, S. & Duggan, M. The Smartphone Difference http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/ (Pew Research Center, 2015).

    Google Scholar 

  18. Sepah, S., Luohua, J. & Peters, A.L. J. Med. Internet Res. 17, e92 (2015).

    Article  Google Scholar 

  19. Miller, A.S., Cafazzo, J.A. & Seto, E. Health Informatics J. 22, 184–193 (2016).

    Article  Google Scholar 

  20. Lister, C., West, J.H., Cannon, B., Sax, T. & Brodegard, D. JMIR Serious Games 2, e9 (2014).

    Article  Google Scholar 

  21. Manky, D. Fortinet https://blog.fortinet.com/2015/10/23/responsible-disclosure-and-iot (23 October 2015).

    Google Scholar 

  22. Storm, D. Computerworld http://www.computerworld.com/article/2981527/cybercrime-hacking/researchers-hack-a-pacemaker-kill-a-man-nequin.html (8 September 2015).

    Google Scholar 

  23. Zetter, K. Wired https://www.wired.com/2015/06/hackers-can-send-fatal-doses-hospital-drug-pumps/ (8 June 2015).

    Google Scholar 

  24. US Food & Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm456832.htm (31 July 2015).

  25. De Freytas-Tamura, K. The New York Times https://www.nytimes.com/2017/02/17/technology/cayla-talking-doll-hackers.html?_r=0 (17 February 2017).

  26. Smith, D. Radware Blog https://blog.radware.com/security/2016/07/malware-and-botnet-attack-services-found-on-the-darknet/ (13 July 2016).

    Google Scholar 

  27. Mahmoud, R., Yousuf, T., Aloul, F. & Zualkernan, I. in 2015 10th International Conference for Internet Technology and Secured Transactions, 336–341 (2015).

  28. Lohr, S. New York Times https://www.nytimes.com/2017/04/03/technology/trump-repeal-online-privacy-protections.html?_r=0 (3 April 2017).

  29. Boudway, I. Bloomberg Business https://www.bloomberg.com/news/articles/2014-06-05/is-chris-dancy-the-most-quantified-self-in-america (5 June 2014).

    Google Scholar 

  30. Wolf, G. https://www.wired.com/2009/06/lbnp-knowthyself/ Wired (22 June 2009).

    Google Scholar 

  31. De-Sola Gutiérrez, J., Rodríguez de Fonseca, F. & Rubio, G. Front. Psychiatry 7, 175 (2016).

    Article  Google Scholar 

  32. Liu, C., Lin, S., Pan, Y. & Lin, Y. Medicine 95, e4068 (2016).

    Article  Google Scholar 

  33. Montag, C., Duke, E. & Reuter, M. in Internet Addiction (Eds., Montag, C & Reuter, M). 131–139 (Springer International Publishing, 2015).

    Google Scholar 

  34. Demirci, K., Akgönül, M. & Akpinar, A. J. Behav. Addict. 4, 85–92 (2015).

    Article  Google Scholar 

  35. Lanaj, K., Johnson, R.E. & Barnes, C.M. Organ. Behav. Hum. Decis. Process 124, 11–23 (2014).

    Article  Google Scholar 

  36. Stothart, C., Mitchum, A. & Yehnert, C. J. Exp. Psychol. Human 41, 893–897 (2015).

    Article  Google Scholar 

  37. Kushlev, K. & Dunn, E.W. Comput. Human Behav. 43, 220–228 (2015).

    Article  Google Scholar 

  38. Montag, C. et al. BMC Res. Notes 8, 331 (2015).

    Article  Google Scholar 

  39. Etkin, J. J. Consum. Res. 42, 967–984 (2016).

    Article  Google Scholar 

  40. Javadi, A.H. et al. Nat. Commun. 8, 14652 (2017).

    Article  CAS  Google Scholar 

  41. Czikszentmihalyi, M. Flow: The Psychology of Optimal Experience (Harper & Row, New York, 1990).

    Google Scholar 

  42. Centers for Medicare and Medicaid Services. http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EHR_Medicare_Stg1_BegGuide.pdf (April 2014).

Download references

Author information

Authors and Affiliations

  1. Stanford Center for Biomedical Ethics, Stanford, California, USA

    Karola V Kreitmair

  2. Department of Pediatrics, Stanford Center for Biomedical Ethics, Stanford University, Stanford, California, USA

    Mildred K Cho

  3. Department of Medicine, Stanford Center for Biomedical Ethics, Stanford University, Stanford, California, USA

    David C Magnus

Authors
  1. Karola V Kreitmair
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  2. Mildred K Cho
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  3. David C Magnus
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Correspondence to David C Magnus.

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Kreitmair, K., Cho, M. & Magnus, D. Consent and engagement, security, and authentic living using wearable and mobile health technology. Nat Biotechnol 35, 617–620 (2017). https://doi.org/10.1038/nbt.3887

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