Health care organization is entering a new age. Focus is increasingly shifting from individual health care institutions to interorganizational collaboration and health care networks. Much hope is set on such networks which have been argued to improve economic efficiency and quality of care. However, this does not automatically mean they are always ethically justified. A relevant question that remains is what ethical obligations or duties one can ascribe to these networks especially because networks involve many risks. Due to their often (...) amorphous and complex structure, collective responsibility and accountability may increase while individual responsibility goes down. We argue that a business ethics approach to ethical obligations for health care networks, is problematic and we propose to opt for a patient perspective. Using the classic four principles of biomedical ethics it is possible to identify specific ethical duties. Based on the principle of justice, health care networks have an ethical duty to provide just and fair access for all patients and to be transparent to patients about how access is regulated. The principle of nonmaleficence implies an obligation to guarantee patient safety, whereas the principle of beneficence implies an obligation for health care networks to guarantee continuity of care in all its dimensions. Finally, the principle of autonomy is translated into a specific obligation to promote and respect patient choice. Networks that fail to meet any of these conditions are suspect and cannot be justified ethically. Faced with daunting challenges, the health care system is changing rapidly. Currently many hopes ride on integrated care and broad health care networks. Such networks are the topic of empirical debate, but more attention should be given to the ethical aspects. Health care networks raise new and pressing ethical issues and we are in need of a framework for assessing how and when such networks are justified. (shrink)

In informationally mature societies, almost all organisations record, generate, process, use, share and disseminate data. In particular, the rise of AI and autonomous systems has corresponded to an improvement in computational power and in solving complex problems. However, the resulting possibilities have been coupled with an upsurge of ethical risks. To avoid the misuse, underuse, and harmful use of data and data-based systems like AI, we should use an ethical framework appropriate to the object of its reasoning. Unfortunately, in recent (...) years, the space for data-related ethics has not been precisely defined in organisations. As a consequence, there has been an overlapping of responsibilities and a void of clear accountabilities. Ethical issues have, therefore, been dealt with using inadequate levels of abstraction (e.g. legal, technical). Yet, if building an ethical infrastructure requires the collaboration of each body, addressing ethical issues related to data requires leaving room for the appropriate level of abstraction. This paper first aims to show how the space of data ethics is already latent in organisations. It then highlights how to redefine roles (chief data ethics officer, data ethics committee, etc.) and codes (code of data ethics) to create and maintain an environment where ethical reasoning about data, information, and AI systems may flourish. (shrink)