Council reviews IT that removes physicians from care
The Nuffield Council on Bioethics has launched a consultation on the ethics of services and technologies that serve to remove the general practitioner from healthcare, such as commercial DNA testing and body imaging, and online healthcare.
"Cutting out the GP may sometimes be a good thing, providing us with convenience, privacy and control over our health," said Christopher Hood, chair of the study and professor of government at the University of Oxford. "But, there is not much regulation of these new services and we may be getting information that causes more harm than good."
In the UK, DNA tests for disorders such as Huntington's disease have been available on the NHS for some years. But now there are companies offering to analyze DNA for a range of health risks on a commercial basis. The tests are marketed as a way of reassuring people, encouraging them to change lifestyles or seek appropriate treatment. But the disease risks associated with some of the genes being tested have not been well researched, potentially leaving people with misleading or inaccurate results - either giving them false reassurance or sending them in alarm to their GPs when there may be nothing wrong.
"We need to think carefully about the value of these services and we would like to hear about people's experiences of using them," Hood said.
People can also now bypass GPs and go to private healthcare companies for MRI or CT scans, which claim to look for abnormalities that indicate disease. These "body MOTs" can cost several thousand pounds, but tend to throw up large numbers of false positives, where the test wrongly indicates a problem. CT scans also come with significant radiation risks. There is currently no overarching regulation of commercial DNA testing or body imaging.
The internet provides numerous other opportunities to avoid going to GPs. Websites that offer diagnoses have existed for several years, and in the US individuals can also now store all their health records on the internet, on websites that aim to put them "in charge of your health information." People can choose who they share information with, but there are concerns about the privacy of these sites and who else might gain access.
After receiving health advice on the internet, people are then able to buy prescription medicines from online pharmacies.
"The questionable quality of some medicines bought over the internet is a cause for concern, as is the possible link to increases in prescription drug abuse," Hood said. "But such concerns may be outweighed by the convenience offered to those with long-term conditions. We want to hear what people think."
The Council wants to hear the views of a wide range of people, including those using or contemplating using these services, those involved in providing them in the public and private context, researchers, academics, regulators, policy makers and others.
Responses to the consultation will be carefully considered, and a report setting out the Council's findings will be published in spring 2010.