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Articles
Published: 2025-10-12

Exploring lay ethics in e-health: Attitudes and moral values among the elderly in Poland

Uniwersytet Marii Curie Skłodowskiej, Institute of Sociology, Poland
Uniwersytet Marii Curie Skłodowskiej, Institute of Sociology, Poland
Katholieke Universiteit Leuven, Institute of Philosophy, Belgium
Uniwersytet Marii Curie Skłodowskiej, Institute of Sociology, Poland
Uniwersytet Marii Curie Skłodowskiej, Institute of Sociology, Poland
e-health moral values technology elderly Poland lay ethics

Abstract

This study aims to explore the ethical values and attitudes of elderly individuals in Poland toward e-health technologies, focusing on how lay ethics differ from professional ethical considerations. Methodology: The research employed individual in-depth interviews with 20 elderly participants and uses vignettes to present ethical dilemmas related to e-health tools. The vignettes were designed to contrast various moral values such as privacy vs. survival, normal behavior vs. health benefits, and autonomy vs. equal access. Results: The findings indicate that elderly participants often prioritize human contact over technology, distrust tools that replace personal interactions, and value effectiveness but not as the primary criterion for assessing e-health tools. Concerns about privacy, autonomy, and the erosion of natural social relationships were prominent. Theoretical contribution: This study contributes to the understanding of lay ethics in e-health, highlighting the importance of considering user perspectives and moral values in the development and implementation of e-health technologies. It underscores the need for a more nuanced approach to e-health that balances technological benefits with ethical concerns. Practical implications: The research suggests that e-health technologies should be designed with consideration for user privacy, autonomy, and social interaction needs to enhance acceptance and effectiveness among elderly populations.

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References

  1. Ahmed, M. A. E., Zakaria, M. F., Abd Elaziz, A. A. E., Fouad, M. M., Elbokl, A. M., & Swelam, M. S. (2023). Assessment of the role of telemedicine in the outcome of multiple sclerosis patients. Egyptian Journal of Neurology, Psychiatry & Neurosurgery, 59, 1–9. https://doi.org/10.1186/s41983-023-00690-y DOI: https://doi.org/10.1186/s41983-023-00690-y
  2. Akenine, U., Barbera, M., Beishuizen, C. R., Pour, M. F., Guillemont, J., Rosenberg, A., Coley, N., Mangialasche, F., Salo, L., Savy, S., Pols, A. J., Andrieu, S., Richard, E., Soininen, H., Charante, E. M. van, & Kivipelto, M. (2020). Attitudes of at-risk older adults about prevention of cardiovascular disease and dementia using eHealth: A qualitative study in a European context. BMJ Open, 10(8), e037050. https://doi.org/10.1136/bmjopen-2020-037050 DOI: https://doi.org/10.1136/bmjopen-2020-037050
  3. Almasi, S., Shahbodaghi, A., & Asadi, F. (2022). Efficacy of Telemedicine for the Management of Asthma: A Systematic Review. Tanaffos, 21(2), 132–145.
  4. AlQudah, A. A., Al-Emran, M., & Shaalan, K. (2021). Technology Acceptance in Healthcare: A Systematic Review. Applied Sciences, 11(22), Article 22. https://doi.org/10.3390/app112210537 DOI: https://doi.org/10.3390/app112210537
  5. Alter, N., Arif, H., Wright, D.-D., Martinez, B., & Elkbuli, A. (2023). Telehealth Utilization in Trauma Care: The Effects on Emergency Department Length of Stay and Associated Outcomes. American Surgeon, 89(11), 4826–4834. https://doi.org/10.1177/00031348231173944 DOI: https://doi.org/10.1177/00031348231173944
  6. Amiri, F. S. A. S. E., Bohlouly, F., Khoshkangin, A., Razmi, N., Ghaddaripouri, K., & Habibi, M. R. M. (2021). The effect of telemedicine and social media on cancer patients’ self-care: A systematic review. Frontiers in Health Informatics, 10(1), 1–5. https://doi.org/10.30699/fhi.v10i1.316 DOI: https://doi.org/10.30699/fhi.v10i1.316
  7. Aslan, A., Mold, F., van Marwijk, H., & Armes J. (2024). What are the determinants of older people adopting communicative e-health services: a meta-ethnography. BMC Health Service Research, 24(60), 1-6. https://doi.org/10.1186/s12913-023-10372-3 DOI: https://doi.org/10.1186/s12913-023-10372-3
  8. Banbury, A., Roots, A., & Nancarrow, S. (2014). Rapid review of applications of e-health and remote monitoring for rural residents. Australian Journal of Rural Health, 22(5), 211–222. https://doi.org/10.1111/ajr.12127 DOI: https://doi.org/10.1111/ajr.12127
  9. Barter, Ch., Renold, E. (2000). ‘I wanna tell you a story’: exploring the application of vignettes in qualitative research with children and young people. Social Research Methodology, 3(4), 307-323. DOI: https://doi.org/10.1080/13645570050178594
  10. Bentham, J. (1907). An Introduction to the Principles of Morals and Legislation. Oxford: Clarendon Press.
  11. Bujnowska-Fedak, M.M., Mastalerz-Migas, A. (2014). Usage of Medical Internet and E-Health Services by the Elderly. In: Pokorski, M. (eds) Environment Exposure to Pollutants. Advances in Experimental Medicine and Biology, vol 834. Springer, Cham. https://doi.org/10.1007/5584_2014_74 DOI: https://doi.org/10.1007/5584_2014_74
  12. Bujnowska-Fedak, M., Pirogowicz I. (2014). Support for e-health services among elderly primary care patients. Telemed J E Health, 20(8), 696-704. https://doi.org/10.1089/tmj.2013.0318. Epub 2013 Dec 20. PMID: 24359252; PMCID: PMC4106384. DOI: https://doi.org/10.1089/tmj.2013.0318
  13. Cohen, J. L. (2002). Regulating Intimacy. A New Legal Paradigm. Princeton: Princeton University Press.
  14. Drapalik, K. N., Grodberg, D., & Ventola, P. (2022). Feasibility and Acceptability of Delivering Pivotal Response Treatment for Autism Spectrum Disorder via Telehealth: Pilot Pre-Post Study. JMIR Pediatrics & Parenting, 5(3), 1–10. https://doi.org/10.2196/32520 DOI: https://doi.org/10.2196/32520
  15. Faber, J. S., Al-Dhahir, I., Reijnders, T., Chavannes, N. H., Evers, A. W. M., Kraal, J. J., van den Berg-Emons, H. J. G., & Visch, V. T. (2021). Attitudes Toward Health, Healthcare, and eHealth of People With a Low Socioeconomic Status: A Community-Based Participatory Approach. Frontiers in Digital Health, 3, 690182. https://doi.org/10.3389/fdgth.2021.690182 DOI: https://doi.org/10.3389/fdgth.2021.690182
  16. Hoenig, H. M., Amis, K., Edmonds, C., Morgan, M. S., Landerman, L., & Caves, K. (2018). Testing fine motor coordination via telehealth: Effects of video characteristics on reliability and validity. Journal of Telemedicine & Telecare, 24(5), 365–372. https://doi.org/10.1177/1357633X17700032 DOI: https://doi.org/10.1177/1357633X17700032
  17. Höppner, G., Urban, M. (2019). Editorial: Materialities of Age and Ageing. Frontiers in Sociology, 4(14), 10.3389/fsoc.2019.00014 DOI: https://doi.org/10.3389/fsoc.2019.00014
  18. Jokinen, A., Stolt, M., & Suhonen, R. (2021). Ethical issues related to eHealth: An integrative review. Nursing Ethics, 28(2), 253–271. https://doi.org/10.1177/0969733020945765 DOI: https://doi.org/10.1177/0969733020945765
  19. Jung, M.-L., & Loria, K. (2010). Acceptance of Swedish e-health services. Journal of Multidisciplinary Healthcare, 3, 55–63. https://doi.org/10.2147/JMDH.S9159 DOI: https://doi.org/10.2147/JMDH.S9159
  20. Kamal, S. A., Shafiq, M., & Kakria, P. (2020). Investigating acceptance of telemedicine services through an extended technology acceptance model (TAM). Technology in Society, 60, 101212. https://doi.org/10.1016/j.techsoc.2019.101212 DOI: https://doi.org/10.1016/j.techsoc.2019.101212
  21. Kymlicka, W. (2002), Contemporary Political Philosophy. An Introduction. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/hepl/9780198782742.003.0001
  22. Lee, M. G. Y., Russo, J. J., Ward, J., Wilson, W. M., & Grigg, L. E. (2023). Impact of Telehealth on Failure to Attend Rates and Patient Re-Engagement in Adult Congenital Heart Disease Clinic. Heart, Lung & Circulation, 32(11), 1354–1360. https://doi.org/10.1016/j.hlc.2023.08.010 DOI: https://doi.org/10.1016/j.hlc.2023.08.010
  23. Lindberg, J., & Lundgren, A. S. (2022). The affective atmosphere of rural life and digital healthcare: Understanding older persons’ engagement in eHealth services. Journal of Rural Studies, 95, 77–85. https://doi.org/10.1016/j.jrurstud.2022.07.020 DOI: https://doi.org/10.1016/j.jrurstud.2022.07.020
  24. Maciejewska-Mroczek, E., Witeska-Młynarczyk, A. (2021). Managing the Past in the Context of (Dis)Closed Adoption in Poland. Revue des sciences sociales, 66, 78-87. DOI: https://doi.org/10.4000/revss.7377
  25. Ngassa Piotie, P., Wood, P., Muchiri, J. W., Webb, E. M., & Rheeder, P. (2022). Using a nurse-driven and home-based telehealth intervention to improve insulin therapy for people with type 2 diabetes in primary care: a feasibility study. Journal of Endocrinology, Metabolism & Diabetes of South Africa, 27(3), 108–116. https://doi.org/10.1080/16089677.2022.2074122 DOI: https://doi.org/10.1080/16089677.2022.2074122
  26. Nymberg, V. M., Bolmsjö, B. B., Wolff, M., Calling, S., Gerward, S., & Sandberg, M. (2019). 'Having to learn this so late in our lives…' Swedish elderly patients' beliefs, experiences, attitudes and expectations of e-health in primary health care. Scandinavian journal of primary health care, 37(1), 41–52. https://doi.org/10.1080/02813432.2019.1570612 DOI: https://doi.org/10.1080/02813432.2019.1570612
  27. Pah, N. D., Motin, M. A., & Kumar, D. K. (2022). Phonemes based detection of parkinson’s disease for telehealth applications. Scientific Reports, 12(1), 1–9. https://doi.org/10.1038/s41598-022-13865-z DOI: https://doi.org/10.1038/s41598-022-13865-z
  28. Pink, S. (2015). Doing Sensory Ethnography. Los Angeles, London, new Dehli, Singapore, Washington DC: Sage Publications Ltd. DOI: https://doi.org/10.4135/9781473917057
  29. Pinker, S. (2008, May 28). The Stupidity of Dignity. The New Republic. https://newrepublic.com/article/64674/the-stupidity-dignity
  30. Rajkumar, E., Gopi, A., Joshi, A., Thomas, A. E., Arunima, N. M., Ramya, G. S., Kulkarni, P., Rahul, P., George, A. J., Romate, J., & Abraham, J. (2023). Applications, benefits and challenges of telehealth in India during COVID-19 pandemic and beyond: a systematic review. BMC Health Services Research, 23(1), 1–15. https://doi.org/10.1186/s12913-022-08970-8 DOI: https://doi.org/10.1186/s12913-022-08970-8
  31. Rasi-Heikkinen, P., & Airola, E. (2023). Health services and eHealth from the perspective of older rural residents of Finnish Lapland. Journal of Rural Studies, 97, 177–185. https://doi.org/10.1016/j.jrurstud.2022.12.016 DOI: https://doi.org/10.1016/j.jrurstud.2022.12.016
  32. Rochester, C. L. (2022). Does Telemedicine Promote Physical Activity? Life (2075-1729), 12(3), 425–N.PAG. https://doi.org/10.3390/life12030425 DOI: https://doi.org/10.3390/life12030425
  33. Rosen, M. (2008). Dignity. Its history and meaning. Cambridge: Harvard University Press.
  34. Rój, J. (2022). What Determines the Acceptance and Use of eHealth by Older Adults in Poland?. Int. J. Environ. Res. Public Health, 19, 15643. https://doi.org/10.3390/ijerph192315643 DOI: https://doi.org/10.3390/ijerph192315643
  35. Sekhon, H., Sekhon, K., Launay, C., Afililo, M., Innocente, N., Vahia, I., Rej, S., & Beauchet, O. (2021). Telemedicine and the rural dementia population: A systematic review. Maturitas, 143, 105–114. https://doi.org/10.1016/j.maturitas.2020.09.001 DOI: https://doi.org/10.1016/j.maturitas.2020.09.001
  36. Schomakers, E.-M., Lidynia, C., & Ziefle, M. (2019). Listen to My Heart? How Privacy Concerns Shape Users’ Acceptance of e-Health Technologies. 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob), 306–311. https://doi.org/10.1109/WiMOB.2019.8923448 DOI: https://doi.org/10.1109/WiMOB.2019.8923448
  37. Shemesh, T., & Barnoy, S. (2020). Assessment of the intention to use mobile health applications using a technology acceptance model in an Israeli adult population. Telemedicine and e-Health, 26(9), 1141-1149. DOI: https://doi.org/10.1089/tmj.2019.0144
  38. Singer, P. (1993). Practical Ethics. Cambridge: Cambridge University Press.
  39. Sommer, A. C., & Blumenthal, E. Z. (2020). Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak. Graefe’s Archive of Clinical & Experimental Ophthalmology, 258(11), 2341–2352. https://doi.org/10.1007/s00417-020-04879-2 DOI: https://doi.org/10.1007/s00417-020-04879-2
  40. Stavropoulos, K. K.-M., Bolourian, Y., & Blacher, J. (2022). A scoping review of telehealth diagnosis of autism spectrum disorder. PLoS ONE, 17(2), 1–22. https://doi.org/10.1371/journal.pone.0263062 DOI: https://doi.org/10.1371/journal.pone.0263062
  41. Stroetmann, V. N., Hüsing, T., Kubitschke, L., & Stroetmann, K. A. (2002). The Attitudes, Expectations and Needs of Elderly People in Relation to E-Health Applications: Results from a European Survey. Journal of Telemedicine and Telecare, 8(2_suppl), 82–84. https://doi.org/10.1177/1357633X020080S238 DOI: https://doi.org/10.1177/1357633X020080S238
  42. Tarhan, G., Örsal, Ö., & Duru, P. (2023). The effect of telehealth interventions on anxiety management in the COVID-19 pandemic: a systematic review. Journal of Psychiatric Nursing / Psikiyatri Hemsireleri Dernegi, 14(1), 59–69. https://doi.org/10.14744/phd.2022.00378 DOI: https://doi.org/10.14744/phd.2022.00378
  43. Taylor, C. (1979). Philosophy and the Human Sciences. Philosophical Papers 2. Cambridge: Cambridge University Press.
  44. Terp, R., Kayser, L., & Lindhardt, T. (2021). Older Patients’ Competence, Preferences, and Attitudes Toward Digital Technology Use: Explorative Study. JMIR Human Factors, 8(2), e27005. https://doi.org/10.2196/27005 DOI: https://doi.org/10.2196/27005
  45. Uppal, S. K., Beer, J., Hadeler, E., Gitlow, H., & Nouri, K. (2021). The clinical utility of teledermoscopy in the era of telemedicine. Dermatologic Therapy, 34(2), 1–5. https://doi.org/10.1111/dth.14766 DOI: https://doi.org/10.1111/dth.14766
  46. Wang, X., Wang, J., Du, X., Yu, L., Zhou, Y., Zhou, S., Wang, Y., & Ding, Y. (2023). Telemedicine during the COVID‐19 epidemic improves outcomes in children with tuberous sclerosis complex: A 1206 visits retrospective cohort study. CNS Neuroscience & Therapeutics, 1. https://doi.org/10.1111/cns.14549 DOI: https://doi.org/10.1111/cns.14549
  47. Witeska-Młynarczyk, A. (2019). Dziecięce doświadczenia ADHD. Etnografia spornej jednostki diagnostycznej. [Children's experiences of ADHD. An ethnography of a contentious diagnostic entity.] Warszawa, Oficyna Naukowa.
  48. Zubair, M., Liang, G., Jawad, M., Dilawar, S., & Ilyas, B. (2021). Fear of COVID-19 and intentions towards adopting e-health services: exploring the technology acceptance model in the scenario of pandemic. International Journal of Business, Economics and Management, 8(4), 270-291. DOI: https://doi.org/10.18488/journal.62.2021.84.270.291

How to Cite

Nowakowski, M., Witeska-Młynarczyk, A. ., De Schutter, H., Juros, A., & Piątkowski, W. (2025). Exploring lay ethics in e-health: Attitudes and moral values among the elderly in Poland. Human Technology, 21(2), 293–316. https://doi.org/10.14254/1795-6889.2025.21-2.3