Healthcare Ethics: Rebuttal Debate on My Health Record Access

This report presents a rebuttal debate script focusing on the ethical implications of allowing vulnerable populations, particularly those with mental health conditions, to have a choice regarding access to Australia's 'My Health Record' system. The argument posits that, despite the benefits of patient-centered care emphasized by the Australian Commission on Safety and Quality in Healthcare, individuals with mental health issues may lack the mental capacity to effectively manage their health records. The script highlights potential privacy violations, as outlined by the Office of the Public Advocate, and the risks associated with family members accessing records without patient consent, potentially hindering their right to confidentiality and causing emotional distress, as researched by Mann (2018). It further addresses concerns regarding data breaches, as reported by The News Daily (2018), and their impact on patient privacy and the ability of healthcare professionals to provide timely care. The script uses research by scholars such as Farrer (2016), Schwartz (2015), and Rezaeibagha, Win and Susilo (2015) to bolster its arguments, ultimately concluding that due to privacy, mental capacity, and family access inadequacies, vulnerable populations should not be granted a choice regarding 'My Health Records'.

Running head: HEALTHCARE ETHICS: REBUTTAL DEBATE
HEALTHCARE ETHICS: REBUTTAL DEBATE
Name of the Student:
Name of the University:
Author note:

1HEALTHCARE ETHICS
In Australia, ‘My Health Record’ is a digitalized version of records of individuals’ health
status which is accessible online for treatment as well as health monitoring by citizens and health
professionals alike. The facility of ‘My Health Record’ in Australia, allows citizens of the nation
to update details of their health, medications and disease conditions online in the form of a
personal health record (Office of the Australian Information Commissioner, 2019). ‘My Health
Record’ also allows health professionals to access, view and update health records and details of
their patients to ensure healthcare deliverance which is convenient, quick and patient-centered
(Schofield, Shaw & Pascoe, 2019). Despite the benefits of personalized health documentation,
‘My Health Record’ poses potential disadvantages for long term complications for vulnerable
populations, such as those with mental health issues. It is hence, desirable that such communities
are not granted the choice of accessing or availing ‘My Health Records’ (Hemsley et al., 2016).
Hence, this rebuttal is in support of the argument that vulnerable populations with mental illness
should not have a choice regarding ‘My Health Records’ Australia. Firstly, parties against this
motion advocate the key Recommendations postulated by the Australian Commission on Safety
and Quality in Healthcare (ACSQHC, 2019) which necessitates healthcare organizational leaders
to ensure availability of patient centered healthcare systems and facilities. Indeed, restricting the
rights of individuals’ with mental health issues to access ‘My Health Records’ is a serious
violation of national recommendations to provide patient centered care of optimum quality to
citizens (Delaney, 2018). However, it is worthwhile to note that ACSQHC (2019) also postulates
the necessity for individuals to possess the required capacity and skills to effectively interact
with health professionals in a patient centered manner. According to the Office of the Public
Advocate (2019) in Australia, ‘mental capacity’ implies the ability of individuals to understand
information provided to them, utilize the given information to take a decision, retain the given

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information for a time adequate enough to implement decisions and engage in communicating
such information to others. According to Farer (2016), essential skills of mental capacity such as
sound decision making are largely disrupted in mental health conditions like depression and
anxiety, the two most prevalent mental health conditions in Australia. In such situations, as
postulated in the research by Schwartz (2015), granting vulnerable individuals with mental
health issues a choice of accessing, manipulating and updating health details in ‘My Health
Records’ defeats the very purpose with which such healthcare documentation facilities have been
developed – that is, to appropriately and accurately communicate health needs and details and
relay the same to healthcare professionals for improved healthcare service deliverance. Secondly,
parties against this motion advocate that ‘My Health Records’ possess facilities arrange by the
Australian Digital Health Agency (2019), which allow individuals to grant accessibility of their
healthcare details to members of their families who can then upload or update necessary details
in circumstances of reduce mental capacity in such individuals. However, it must be noted from
the research by Rezaeibagha, Win and Susilo (2015), that granting such access to family
members without the consent of the patient with reduced mental health capacity is a serious
hindrance to an individual’s right to privacy and confidentiality. Further, as researched by Mann
(2018), breaches in privacy by granting free access of a patient’s healthcare records to their
families raises an ethical issue, especially in case of adolescents and young adults with mental
health issues or familial conflicts who may not wish their personal health information to be
viewed by their parents. Such easy accessibility may negatively impact the emotional and social
wellbeing of individuals with mental health issues who may now be reluctant to seek help or
mental healthcare services, hence increasing their progression of mental health symptoms, loss of
quality of life and increased disease burden in later life (Mann, 2018). Thirdly, parties against the

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motion advocate that ‘My Health Records’ possess adequate privacy-associated facilities which
allow individuals to restrict the access of their health records to their family members if needed
(Australian Digital Health Agency, 2019). However, in response to the same, our argument will
shed light upon a recent article published by The News Daily (2018), which reported recent
breaches in privacy due to technical mishaps in ‘My Health Records’ resulting in the leakage of
private health details of numerous individuals. Such breaches are not only a serious violation of
the citizens’ right to privacy as per the Privacy Act 1988, but also adversely increases the risk of
individuals’ with mental illness of being discriminated and exploited against by cyber bullies or
abusers within the family through leakage, infiltration and manipulation of their personal mental
health data (Rezaeibagha, Win & Susilo, 2015). The news report (The News Daily, 2018), also
denoted that the technical disturbances also resulted in an inability of healthcare professionals to
update their patient’s healthcare records with diagnostic reports and results. The health and
wellbeing of vulnerable patients with mental health issues are largely dependent on
multidisciplinary care where unavailability of timely information to the patient as well as
associated healthcare professionals delays treatment, care and achievement of positive mental
health outcomes to such individuals (Ben-Assuli et al., 2015). Thus, considering inadequacies in
terms of privacy, mental health capacity and family accessibility, vulnerable populations with
mental health issues should not be granted a choice regarding ‘My Health Records’.

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References
ACSQHC. (2019). Patient Centered Care: Improving quality and safety through partnerships
with patients and consumers. Retrieved 30 August 2019, from
https://www.safetyandquality.gov.au/sites/default/files/migrated/PCC_Paper_August.pdf.
Australian Digital Health Agency. (2019). What is My Health Record?. Retrieved 30 August
2019, from https://www.myhealthrecord.gov.au/for-you-your-family/what-is-my-health-
record.
Ben-Assuli, O. (2015). Electronic health records, adoption, quality of care, legal and privacy
issues and their implementation in emergency departments. Health policy, 119(3), 287-
297.
Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in
Australia. Collegian, 25(1), 119-123.
Farrer, L. M., Gulliver, A., Bennett, K., Fassnacht, D. B., & Griffiths, K. M. (2016).
Demographic and psychosocial predictors of major depression and generalised anxiety
disorder in Australian university students. BMC psychiatry, 16(1), 241.
Hemsley, B., Georgiou, A., Carter, R., Hill, S., Higgins, I., van Vliet, P., & Balandin, S. (2016).
Use of the My Health Record by people with communication disability in Australia: A
review to inform the design and direction of future research. Health Information
Management Journal, 45(3), 107-115.
Mann, M. (2018). Privacy in Australia: Brief to UN Special Rapporteur on Right to Privacy.

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Office of the Australian Information Commissioner. (2019). My Health Record. Retrieved 30
August 2019, from https://www.oaic.gov.au/privacy/other-legislation/my-health-record/.
Office of the Public Advocate. (2019). About Mental Capacity | Office of the Public Advocate.
Retrieved 30 August 2019, from http://www.opa.sa.gov.au/page/view_by_id/21.
Rezaeibagha, F., Win, K. T., & Susilo, W. (2015). A systematic literature review on security and
privacy of electronic health record systems: technical perspectives. Health Information
Management Journal, 44(3), 23-38.
Schofield, P., Shaw, T., & Pascoe, M. (2019). Toward Comprehensive Patient-Centric Care by
Integrating Digital Health Technology With Direct Clinical Contact in Australia. Journal
of medical Internet research, 21(6), e12382.
Schwartz, P. H., Caine, K., Alpert, S. A., Meslin, E. M., Carroll, A. E., & Tierney, W. M. (2015).
Patient preferences in controlling access to their electronic health records: a prospective
cohort study in primary care. Journal of general internal medicine, 30(1), 25-30.