Software offers key to ethical dilemmas

By ANGELA GREGORY health reporter

Big Brother may soon not just be watching you but helping solve ethical dilemmas involving you, like those faced daily by health workers.

An Auckland medical ethics expert believes the computer can be a key tool in resolving difficult decisions in the health sector.

Professor David Seedhouse, at the Auckland University of Technology, is developing ground-breaking software to help medical staff decide on issues which invariably involve value systems and subjective judgments.

Professor Seedhouse, who is director of the National Centre for Health and Social Ethics, says the program helps by presenting the problem both visually and in simple, well-defined language.

"Language can often camouflage or obscure what people really mean ... Over the years I've been trying to develop decision-making tools which blow away the smoke."

Professor Seedhouse, who is trained in philosophy, has designed an "ethical grid" where individuals can use a computer to clarify their position in situations where choices and compromises have to be made.

The resulting image produced by the computer can then be compared with others involved in the decision-making process.

Professor Seedhouse said people processed information more effectively when they used pictures.

They could more easily see how they differed in their perceptions or approaches to a problem, and get straight to the core of it.

He saw the system being used in clinical decision making where there were difficulties or disagreements.

Professor Seedhouse said hospital staff usually held meetings to consider difficult cases, but that could waste time and achieve little.

"In healthcare people often overstate," he said. "Rather than sit around chewing the cud they could use this system to quickly and efficiently cut through a lot or rubbish ...

"Ethical dilemmas can be created by people not being clear about what they are doing."

Professor Seedhouse said the system made its users define what they meant and could highlight conflicts and self-contradictions, as well as areas of compatibility with other users.

"It saves time, confusion and heartache so people can get on with the job."

He has tested the system with doctors and nurses who were amazed at how differently they reached a point of view.

They did not realise just how differently they approached problems, he said.

Professor Seedhouse said the system would also be a useful tool for patients frustrated that they had not been able to get the health system to work for them.

"At least by using the ethical grid they can have an equal voice."

He said the system took away personal pressures and allowed people to reflect calmly.

There could be resistance from those who thought they did all right already.

"But only the most ultra-defensive will object."

The software was still in prototype form but there had already been interest from Britain.

Professor Seedhouse said he planned to market the software with AUT for use in hospital departments, health management and medical schools.

He also foresaw its use in many non-health markets such as the justice system.

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