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Wednesday, September 28, 2016

The Ethics of Behavioral Health Information Technology

Michelle Joy, Timothy Clement, and Dominic Sisti
JAMA. Published online September 08, 2016.

Here is an excerpt:

Individuals with mental illness and addiction experience negative stereotyping, prejudice, discrimination, distancing, and marginalization—social dynamics commonly called stigma. These dynamics are also often internalized and accepted by individuals with mental health conditions, amplifying their negative effect. Somewhat counterintuitively, stigmatizing beliefs about these patients are common among health care workers and often more common among mental health care professionals. Given these facts, the reinforcement of any stigmatizing concept within the medical record system or health information infrastructure is ethically problematic.

Stigmatizing iconography presents the potential for problematic clinical consequences. Patients with dual psychiatric and medical conditions often receive low-quality medical care and experience worse outcomes. One factor in this disparity is the phenomenon of diagnostic overshadowing. For example, diagnostic overshadowing can occur in patients with co-occurring mental illness and conditions such as cardiovascular disease or diabetes. These patients are less likely to receive appropriate medical care than patients without a mental health condition—their psychiatric conditions overshadow their other conditions, potentially biasing the clinician’s judgment about diagnosis and treatment such that the clinician may misattribute physical symptoms to mental health problems.

The article is here.