Software clears up ethical dilemmas

By MARTIN JOHNSTON

A New Zealand company has made its first sale of computer software designed to help health workers with ethical dilemmas such as whether to permit a medically unnecessary caesarean birth.

Lawyers have advised public hospitals not to perform such caesareans, but some private specialists are willing to do them.

The company, VIDe, has sold its health ethics programme to a National Health Service trust in Britain, which will use it in areas including mental health and treating prisoners.

Healthcare practitioners, like other people, tended to obscure value judgments by excessive reliance on technical details, said the company's research and development head, Professor David Seedhouse.

The software would inject science into subjective decision-making, to provide tangible evidence about health workers' feelings, preferences and moral reasoning,

"When deciding whether ... patient Y should have her first baby delivered by caesarean section, when her obstetrician thinks this would be unnecessary surgery, evidence and clinical skill are not enough to make the decision."

Healthcare decisions also involved personal judgments, human values and instincts, said Professor Seedhouse, the director of Auckland University of Technology's health and social ethics centre.

Decision-making quickly became more transparent using the software, which asked everyone involved in a decision, from nurses to managers, to rank the importance of its components, including clinical risks to the patient, legal ramifications, communication with the patient, technical competence of the staff and the use of resources.

It would also give more people the freedom to have their say, something often unwittingly restricted by the pressure to make a decision.

Another benefit would be in responding in court to complaints. The programme would provide evidence of both an "audit trail" of decisions in which it was used and that the organisation had dwelt on the matter carefully.