Ethics in Machine - Telehealth in Vulnerable Communities
Author
Clasen, Ikuala Navagiaq
Term
4. term
Education
Publication year
2025
Submitted on
2025-06-30
Pages
52
Abstract
Denne afhandling undersøger, hvordan telesundhedsteknologier anvendes og opleves i sårbare, geografisk fjerntliggende grønlandske lokalsamfund, og hvilke etiske spørgsmål der opstår i mødet mellem lokale klinikere, specialister ved Dronning Ingrids Hospital og de digitale løsninger. Med udgangspunkt i et techno‑antropologisk feltstudie under et praktikforløb ved Steno Diabetes Center Greenland kombinerer studiet sygeplejefaglig deltagelse, deltagerobservation, daglige og jottings-noter samt uformelle og semistrukturerede interviews med klinikere i yderområder; materialet er transskriberet og kodet og teoretisk forankret i hermeneutisk fænomenologi og post‑fænomenologi samt litteratur om bioetik, empowerment, digital ulighed og deltagerdrevet design. Analysen tager afsæt i udrulningen af et nyt telesundheds-setup (forudinstallerede tablets og en patientapp) i det grønlandske sundhedsvæsen og belyser, hvordan tekniske fejl, ustabil infrastruktur og manglende kompetence i brugen af systemerne påvirker etiske beslutninger og omsorgspraksis. Resultaterne peger på, at ulige adgang og en digital kløft medfører substandard telesundhedstilbud i nogle bygder, at begrænset inddragelse og organisatoriske forhold hæmmer anvendelsen, og at utilstrækkelig koordinering mellem specialister, klinikere og teknologi kan skabe eksklusion og forringe kvaliteten af behandlingen—herunder i mentale helbredsforløb. Afhandlingen konkluderer, at ansvarlig implementering i Grønland kræver mere robust infrastruktur, målrettet oplæring, bedre tværfaglig koordinering og kulturelt sensitive, deltagende og lighedsorienterede tilgange, så telesundhed reelt styrker adgang og kvalitet for patienter og klinikere i yderområder.
This thesis examines how telehealth technologies are used and experienced in vulnerable, geographically remote communities in Greenland and the ethical issues that emerge at the intersection of local clinicians, specialists at Queen Ingrid’s Hospital, and digital tools. Drawing on a techno‑anthropological field study conducted during an internship at the Steno Diabetes Center of Greenland, the research combines nursing participation, participant observation, daily and jotting notes, and informal and semi‑structured interviews with remote clinicians; materials were transcribed and coded and interpreted through hermeneutic phenomenology and post‑phenomenology, alongside literature on bioethics, empowerment, the digital divide, and participatory design. Anchored in the rollout of a new telehealth setup (pre‑installed tablets and a patient app) across the Greenlandic health system, the analysis shows how technical malfunctions, unstable infrastructure, and limited user training shape ethical decision‑making and care practices. Findings indicate that unequal access and a digital divide lead to substandard telehealth services in some settlements, that limited involvement and organizational shortcomings constrain use, and that poor coordination among specialists, clinicians, and technology can cause exclusion and undermine care quality—including in mental health consultations. The thesis concludes that responsible telehealth in Greenland requires more reliable infrastructure, targeted training, stronger cross‑professional coordination, and culturally sensitive, participatory, equity‑oriented approaches so telehealth can genuinely improve access and quality for patients and providers in remote areas.
[This abstract was generated with the help of AI]
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