The concept of Datenherrschaft of patient information from a Heideggerian perspective
| Date | 12 August 2019 |
| Pages | 336-353 |
| Published date | 12 August 2019 |
| DOI | https://doi.org/10.1108/JICES-04-2018-0031 |
| Author | Jani Simo Sakari Koskinen |
| Subject Matter | Information & knowledge management,Information management & governance,Information & communications technology |
The concept of Datenherrschaft of
patient information from a
Heideggerian perspective
Jani Simo Sakari Koskinen
Department of Management and Entrepreneurship, Information Systems Science,
University of Turku, Turku, Finland
Abstract
Purpose –In this paper, patient information is approached from a Heideggerian perspective with the
intention to gather an understandingabout the personal nature of the information. The purpose of this paper
is to analyse the ownership of patient information and then present Datenherrschaft (German for “mastery
over information”)as a suitable model for patient ownership of patientinformation.
Design/methodology/approach –This paper is theoretical in approach. It is based on arguments
derived fromHeidegger’s work in the Being and Time.
Findings –Based on this Heideggerian approcah, a proposal for using the special definition of
ownership of patient information –Datenherrschaft –given to a patient is suggested. From a
Heideggerian perspective, it can be stated that the patient has the strongest rights towards patient
information because this information is crucial for a patient to have an understanding about their
Dasein (being-in-the-world).
Research limitations/implications –Datenherrschaft is used as an example of an ethically justified
way of regulating thepatient information ownership and should be analysed further.Especially the practical
implicationsof implementing Datenherrschaft need moreresearch.
Originality/value –Patient information ownership is an issue that is neither unambiguously solved in
many countries, nor has it, in our view, been ethically justified. The potential solution –Datenherrschaft–
presentedin this paper is clear and has strong philosophical justifications.
Keywords Ownership, Privacy, Heidegger, Datenherrschaft, Patient information
Paper type Conceptual paper
1. Introduction
Nowadays, the ownership of patient information is lacking in the jurisprudences of
different countries or it is based on era of paper-based records (Kish and Topol, 2015;
Koskinen et al., 2016;Rodwin, 2010). This is a problematic phenomenon because the
lack of a clearly articulated regulation has led to the emergence of different laws and
other regulations considering patient information use (Koskinen et al.,2016). In this
paper, the situation of undefined ownership is critisised, and a justified alternative
solution is offered.
Phenomenology as a method has a strong tradition in modern healthcare, especially
in nursing sciences and research on healthcare ethics (Tuohy et al., 2013). It is the
second most used methodology after grounded theory, and usually phenomenology is
based either on Heidegger’s or Husserl’s ontological view (Petrovskaya, 2014). Thus,
Heidegerian approach for ownership of patient information is plausible as Heidegger
has such recognised position in and his writings are a rich and suitable source for
research in healthcare context.
JICES
17,3
336
Received4 April 2018
Revised3 September 2018
Accepted8 November 2018
Journalof Information,
Communicationand Ethics in
Society
Vol.17 No. 3, 2019
pp. 336-353
© Emerald Publishing Limited
1477-996X
DOI 10.1108/JICES-04-2018-0031
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/1477-996X.htm
The research question for this article is: How ownership of patient information
should be arranged? To answer this, Heidegger was used to reveal the two different
aspects of patient information –Notions of information as tool and information as part
of person it is derived from. These two notions shows the difference between disease as
biomedical condition and illness as personal lived experience of such condition (Morris,
2008).
The issue of this articlehas already been analysed from a Lockean (Koskinen et al.,2016)
and Kantian perspective (Koskinen and Kimppa, 2016): but the Heideggerian approach
offers deeper insight for the personal meaning of that information for an individual and
underlines the individual’s own inner and inseparableexperience in one’s life. Thus, above-
mentioned two notions for patient information are based on analysis of Heidegger’s (1927)
work in Being and Time.
The structure of this article is as follows. In Chapter 2, the background of patient
information ownership is presented, and some special characters of the problem are
brought forth. In Chapter 3, the first notion, that information can be seen as a tool
because it appears as a tool does, is presented. For every tool, there is a task (here:
caring for people) for which it is made and used. The second notion in Chapter 4
portrays the view that information is an inseparable part of one’s being and cannot be
seen merely as a tool. In Chapter 5, new personal view on patient information (systems)
is presented. In Chapter 6, a solution for the question of what kind of ownership would
be justified is presented. Ownership should be seen as Datenherrschaft (mastery over
data/information) that is given to the patients. Finally, in Chapter 7, conclusions are
presented.
2. Background
Patient information ‘ownership’is the main issue of this paper, but some questions
inevitably must be answered before we can go deeper into the issue: what actually are
patient information and patient information system (PIS)? Currently, variable names exist
for records that containinformation about patients such as: electronic health records(EHRs),
electronic medicalrecords (EMRs), electronic patient records (EPRs), personal healthrecords
(PHRs), healthcare information systems (HISs), etc. (Tang et al., 2006;Hayrinen et al., 2008;
Rantanen and Heimo, 2014).
Thus, in this paper, patient information is seen as official information about the
patient that is stored and usually entered by (public or private) healthcare
organisations. By that definition, the PIS is an ‘official’system used to gather and store
patient information, created and maintained by healthcare organisations. Personal
records held and collected solely by individuals are not considered because there is no
problem with the ownership as long as these records are kept by the patients
themselves. Even above-mentioned definition for patient information (system) is not
inclusive; it is sufficient for analysing the ownership of patient information (system)
from a Heideggerian perspective in this article.
Thus, the problem is that currentlegislation in many countries does not state who owns
the patient information clearlyenough (Koskinen et al.,2016;Rodwin,2009, 2010). The main
reason for this omission seems to be that only a few academic contributions have directly
addressed the issue of patient information ownership (Evans, 2011,2012;Rodwin, 2009,
2010;Hall and Schulman, 2009;Kish and Topol, 2015). This lack of research and clear
legislation for patient information ownership leaves room fordifferent interpretations about
how patient informationis used and why.
The concept of
Datenherrschaft
337
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