The process of democratization of information had been going at full speed for the past few decades thus making information more and more available to people regardless of their level of expertise in the subject. Now one can not only know well what the US forces do across the globe, the government expenditures, or the number of casualties in New Orleans, but also how to make a dirty bomb, or how to poison your neighbor without getting caught. In the following essay I will speak about the advantages and disadvantages of having health and wellness information freely available on the web with some of the major issues being considered. I will use my personal educated judgment as well as publicly available sources to comment on the democratization of information.
In order to better illustrate the necessity of freely accessible and available medical information in the modern world, I will define medical information as all the information pertinent to detection of sickness and disease as well as all the information related to ameliorating the health condition or preventing some diseases from starting.
Speaking about whether or not the medical information should be as freely available as it is, I would certainly say yes without any reservation simply because in my personal view the more information is freely available the broader are the individual horizons of people and the more informed decisions they can make.
Here is a snapshot of pro-liberalization of the medical information:
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1. Freely available medical information alerts people about their current and imminent health condition and prompts them to take further action. In other words by knowing that one has a some health problem, she/he can seek medical help and assistance and thus avoid these problems at early stages rather than wait till the time when the physical health visibly deteriorates. In the Middle Ages, syphilis (common sexually transmitted disease) in Europe would be cured only at the Secondary Syphilis stage, i.e. when the skin rash would make the life of patients rather unpleasant, to put it mildly. Having the information about primary syphilis stage freely available at that time would have not only saved lives but make these lives happier. The teeth would also not be cared for and when a patient had some major toothache the only decision the doctors at that time could make was to remove the tooth, thus contributing to the fact that in middle ages only a slim percentage of population after reaching the age of 40 would have any teeth left. It was not until the development of medical technology, that sicknesses like cancer (except for maybe skin cancer that is visible without special technology), gallstones, let alone ‘stones’ in kidneys or liver, ulcer etc were identified at that stages when they already hurt the patient and were noticeable because of causing physical pain and discomfort (Forget 2002). Now the governments of all countries encourage females to check their breasts and males to check their testicles on a biweekly basis in search of knots which could be the initial signs of tumors or cancer. The semiannual dental examination we have today assures that our teeth do not get rotten completely with cavities as it had been in the past. The ultrasound body scan assures that if a person has some other problems at the stages unseen with eyes or at stages that do not cause any pain they are still identified. Annual medical examination assures that people know about their health and are free to act accordingly and knowledgeably.
2. Freely available medical information allows people to take precautionary actions and lead a healthy lifestyle. In the past the lack of information about medicine meant that people did not know how to lead a healthy lifestyle. There was no available information about the danger of smoking or drinking. As a matter of fact smoking was encouraged in Europe as a modern fad. One did not know what products one needs to avoid when having high blood pressure or heart problems. One did not know what to eat and how to exercise during pregnancy. The professors of medicine in the Great Britain and Europe would encourage people to take cocaine and morphine (an opiate, derivative of heroin) to combat depression and melancholy. And as we remember Sherlock Holmes (the famous literary detective personage who lived in London) oftentimes would smoke morphine with Doctor Watson providing him that ‘medicine’. Even Coca-Cola at some point of time contained cocaine in small amounts (Bend 2004).
At present we know about unsaturated and saturated fats, cholesterol, red meat, and the things like vitamins, fibers and microelements. We know what sports we can play with what health conditions and what things we should not do (take drugs, smoke, drink excessively, expose oneself to potential danger/sicknesses as can be when drinking water from the river, having unprotected sex or eating raw meat). It was only with the liberalization of medical information that we know how to avoid exposure to AIDS or other sexually transmitted diseases, the bird flu, the SARS. It is only with the freely accessible medical information we can know that fast food is bad for you health just like junk food or lack of exercise.
3. Freely available medical information allows people to compare the healthcare practitioners and healthcare institutions, let alone the services they provide in order to pick the best available for them and for their families. In other words, by having access to information about what medical services are performed by what specialists, people can then, freely choose what hospital they want to attend and what procedures they agree to accept. The public access to medical information will allow people select only the best medical institutions and have the best services performed to them for their money. It is with the free access to medical information we can know that it is better to receive treatment in the USA or Japan than in Mexico or Poland.
4. Freely available information lets people compare prices of medical services and doctors in order to select the best ones. By the same token, having a free access to medical information as enabled by computer technology allows people to effectively compare the prices for identical services in different hospitals around the world and pick the one that they could afford.
5. Freely available medical information lets people prioritize their goals and decide whether they need to visit a doctor now or later. By knowing as much as possible about the prevention and detection of various sicknesses and health conditions, people can manage their time more effectively and save resources. On one hand, knowing about dangers of certain sicknesses will prevent us from immediately going to a doctor after having a minor paper-cut, or a running nose. On the other hand, detecting a small knot during self-examination in the breast area (females) or testicle area (males) will immediately prompt us for formal medical diagnostics and examination to assure that our health in a right condition (Keeler J & Newman, 2001).
6. Freely available medical information allows people to save money, time and other resources by engaging in self-cure. By knowing what cures or prevents what people could effectively cure themselves as they had already done in the past. The presence of various over-the-counter medicine to treat various health problems is not enough if a person does not know well how to use it. By knowing what to take to reduce the cholesterol level, mitigate pain or alter mood, we could effectively help ourselves to lead a healthy lifestyle and enjoy our lives to the fullest. Once again, prior to engaging in some self-cure we need to know all the side effects of given drugs as well as our health problems we try to remedy (Martin 310).
Just like the presence of medical information can help people in the ways discussed earlier in the essay, so can the presence of medical information hurt people by misleading them. First of all, medicine involves a lot of grey areas where some drugs can cure one thing while negatively impact other organs (typically liver and kidneys). In order to cure a person well, one needs to know his/her other problems or general health condition to prescribe the drug that would cure the most and damage the human health the least. The so called golden mean needs to be found. The other thing is that different medical schools view the same health problems differently and thus insist on using different ways of cures which may not be equally beneficial for an individual. While it is a proven fact that alcohol reduces the bad cholesterol level, nicotine positively impacts neurotransmitters in Alzheimer’s disease or can possibly reduce the appetite (a coveted thing for those who want to lose weight), and sex boost self-esteem and happiness, drinking Vodka excessively, smoking to lose weight, or having promiscuous sex is likely to damage the human health more than it would benefit it (Stead 1999). The last but not least thing is that the freely accessible medical information will mean that companies can market their drugs in an unrestricted manner artificially boosting the demand for drugs as people would believe the commercials that a pill will do wonders to their health. By the same token, without having control over doctors, one would have a situation where a medical institution would find non-existent health problems in patients in order to generate additional profits. The patients who certainly are less competent than doctors will believe that they do have some sort of disease and will certainly pay the hospital any price to combat that disease.
The only thing to protect people from misleading information that is very likely to appear with the liberalization of medical information is to develop the system of controls/checks and balances with some of the following characteristics:
- Independent rating agency. This could be the Food and Drug Administration, or any other independent agency that would rate and endorse the information provided by the medical institutions or drug manufacturers. So the statements about some medicine and its impact on human health needs to be verified by someone not interested in marketing this medicine. By the same token the services marketed by an organization need to be endorsed by a competent agency which does not market these services. In other words, in order to avoid the conflict of interests which appears when medical institutions and drug manufacturers besides wanting to help the patient also want to make the largest profit possible, the independent party will check the statements of healthcare providers (Vogel 2003).
- Official terminology free of disambiguation. One needs to come up with the terminology used in medical texts that would be easy to understand for those who want to have free access to medical information. The statements such as “this drug will cause..” or “this drug may cause..” or “this drug is likely to cause…” need to be explained in a greater detail, such as what percentage of people is affected by which statement. In other words, the users of freely available medical information need to understand well what is meant by statements such as “this medicine helps to combat diabetes”. The terminology will explain what percentage of patients in what age groups had what improvements. Did they fully combat diabetes or did their blood sugar fell only by 1 zillionth of a percent, a puny step in a way to combat diabetes? As one can understand, having official terminology understood clearly by the users of medical information will reduce misinformation.
- Stringent standards. In order to make the medical information easy to interpret stringent standards need to be established regarding the positive and negative effects of drugs. Some generally acceptable equilibrium would mean that a given medical service or product indeed is worth to be called beneficial for human health. While cocaine indeed will remove your depression, it will make you addicted and will cause other harm to your health. Thus it cannot be called a medicine. Other drugs that can cure some disease yet can cause cancer should also be restricted and these side effects need to be pointed out to the users of medical information to reduce the amount of misleading information. The standards should also be said to the users of freely accessible medical information. For instance, the information should be made easy to understand for people with a high school diploma or a university diploma, all those who can read and understand well the benefits and harms of that medicine. Therefore, the standards should restrict the access minors or those who are unable to properly interpret that information to the freely available medical information since they are likely to incur more harm than benefit from its use.
- Corporate requirements and responsibility. Companies that provide healthcare products and service should be the ultimately bearers of responsibility for their products/services as well as the information they make available to the public. Companies need to assure that all the tests are made and the ultimate user of information will reasonably know what to expect from a service or goods. The use of independent party to rate and endorse the corporate statements will mitigate the impact of conflict of interests where the companies would be tempted to make as much profit as possible at the expense of human health. The best policy for these corporations should be the Hippocrates’ oath “Thou shall not hurt” that every doctor prior to engaging in medical practice should keep in mind. The violators (companies) need to be punished with fines and criminal responsibility.
Indeed the nature of medical information is different from that of other kinds of information since it directly impacts the human health. Improper dosage or diagnosis could cause deaths of patients and the chaos in the society. While improper economic, financial, military or government information could cause poverty, famine, wars and degradation of the society and thus indirectly contribute to the deaths of millions, medical information directly relates to the issue of life and death. It is for this reason, this very type of information needs to be as accurate and precise as possible to guarantee the maximum benefit to the society (Metzger JB et al. 1995).
The internet is a global network of computers which cannot be effectively restricted or controlled even by the mightiest nations on earth. The users of the internet indeed can be called cyber citizens as they surpass national borders with the help of the internet and can benefit from the information hosted in absolutely every country on earth. With the help of the internet they can avoid censorship and access or spread the information that can be prohibited in their homeland. Since there is little control over the internet and the identity of internet users one can only vaguely argue for or against the rights and responsibilities of cyber citizenship. In other words, even if there are some rights and responsibilities online they cannot be effectively enforced or controlled. Ideally, the rights and responsibilities of cyber citizenship should resemble those of normal first world nations, assuming that the rights and responsibilities of these nations are superior in quality to the rights and responsibilities of the third world countries. A cyber citizen has the rights to the free speech and information just like a free (informed) choice. Their responsibilities include those related to common ethics: honesty, integrity, and following Kant’s Categorical Imperative/”Golden rule” (Vogel 2003).
Misleading or dangerous information on the internet should be handled in a way misleading medical information should be handled. In other words, there should be independent rating agencies that would endorse the information available online and guarantee that it is true, accurate and correct. Those who access it can be certain that it comes from the decent source and does not pose potential danger to the society as a whole and individuals in particular. The terminology and standards should also be developed and explained to the users of online information so that they can be certain about what is said or shown to them online. It should be made known to cyber citizens that one can trust only that information that comes from the endorsed website which has known physical headquarters anywhere on earth. By knowing exactly who publishes what information and where that person or an organization is located, one can effectively hold them responsible for that information. Any other information coming from pretty, attractive yet not endorsed by third parties and without known physical location of the publisher should be handled with great suspicion as there is a possibility that the only reason why the website is not endorsed or that the information about physical presence of the publisher is not disclosed is because that individual or an organization wants to provide misleading information to global citizens.
Bibliography:
Bend J. 2004, In Pursuit of the Elusive Public Value of E-Health. Institute for Public Policy Research. London. Pp 201-203.
Forget C. Former Quebec Minster of Health. Proceedings of the Standing Senate Committee on Social Affairs, Science and Technology. Issue 53 – Evidence. Ottawa, May 6, 2002.
Keeler J & Newman J. Paperless Success: The Value of E-Medical Records. HIMSS Proceedings. Vol. 2, Session 45. 2001.
Martin JB. Effectiveness, Efficiency, and the Value of IT. Journal of Healthcare Information Management. Vol. 17, No. 2. 2003
Metzger JB et al. Lessons learned from the Davies Program: The first four years. In Steen EB (ed): Proceedings of the First Annual Nicholas E Davies CPR Recognition Symposium, April 4–6, 1995.
Stead W& Lorenzi N. Health Informatics: Linking Investment to Value. JAMIA. 6:341–348. 1999.
Vogel L. Finding Value from IT Investments: Exploring the Elusive ROI in Healthcare. Journal of Healthcare Information Management. Vol. 17, No. 4. 2003
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