Ethical and practical concerns of heart rate monitoring: Enabling communication for patients with severe communication difficulties

Abstract

Monitoring technologies to aid communication in long-term patient care may enhance safety but infringe on privacy. While autonomy is a primary value in bioethics, definitions of autonomy often take for granted a minimum level of communicative ability. This paper explores how contemporary philosophical arguments for using long-term preventative monitoring apply to individuals without the ability to consent to such technologies. Specifically, how do the ethical principles of autonomy, justice, safety, and privacy manifest when implementing technologies such as long-term heart rate monitoring for individuals with severe communication difficulties? While monitoring someone without their consent is ethically problematic, providing heart rate monitoring for individuals with severe communication difficulties may be morally imperative as a necessary means of interaction. Heart rate monitoring enhances their autonomy by offering a form of communication, and it shows promise as safety-inducing through quicker detection of distress. Simultaneously, heart rate monitoring is a form of surveillance, thus potentially violating privacy; and misinterpretation or over-reliance on such data might undermine the patient's autonomy, lead to unnecessary interventions or result in reduced human interaction. Restricting monitoring based on consent capacity may deepen care disparities and violate the justice principle but so does selectively applying it to disabled individuals. We conclude that heart rate monitoring might greatly benefit this population, but we need to balance potential benefits for the individual with the risks, trained caregivers must integrate data with other cues, and we need data encryption, collaborative decision-making, and regular reassessment.