Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls

Building climate justice : an analysis of how the nexus between climate change and human rights shapes public policy agendas and alternatives

This thesis provides an analysis of how the nexus between climate change and human rights shapes public policy agendas and alternatives. It draws upon seminal work conducted by John Kingdon, whose landmark publication “Agendas, alternatives, and public policy” described how separate streams of problems, solutions, and politics converge to move an issue onto the public policy agenda toward potential government action. Building on Kingdon’s framework, this research explores how human rights contribute to surfacing the problem of climate change; developing alternative approaches to tackling climate change; and improving the political environment necessary for addressing climate change with sufficient ambition. The study reveals that climate change undermines the realization of human rights and that human rights can be effective tools in building climate resilience. This analysis was developed using a mixed methods approach and drawing upon substantial literature review, the researcher’s own participation in international climate policy design; elite interviews with thought leaders dealing with climate change and human rights; and regular inputs from focus groups comprised of practitioners drawn from the fields of climate change, development and human rights. This is a journal based thesis with a total of six articles submitted for evaluation, published in peer‐reviewed publications, over a five year period. Denna avhandling analyserar hur klimatfrågan och mänskliga rättigheter i samverkan formar den politiska agendan och det politiskt möjliga. Den bygger på banbrytande forskning av John Kingdon, vars publikation “Agendas, alternatives, and public policy” beskriver hur en fråga blir politiskt viktig och lyfts upp på den politiska agendan. Med utgångspunkt i Kingdons ramverk, utforskar avhandlingen hur mänskliga rättigheter bidrar till att blottlägga klimatfrågan som problem; utveckla alternativa metoder för att angripa och hantera klimatfrågan; samt skapa ett politiskt klimat nödvändigt för att på ett ambitiöst sätt kunna angripa klimatfrågan. Studien visar att klimatförändringar undergräver mänskliga rättigheterna men att arbete med mänskliga rättigheter kan vara ett effektivt verktyg för att stå emot och hantera effekterna av klimatförändringar. Analysen har genomförts med hjälp av en rad olika metoder vilka inkluderar litteraturstudier, författarens egna observationer under klimatförhandlingar; intervjuer med ledande tänkare inom klimatfrågan och mänskliga rättigheter; samt data insamlad genom fokusgrupper bestående av yrkesverksamma inom klimat, utveckling och mänskliga rättigheter. Avhandlingen är baserad på totalt sex artiklar som publicerats i fackgranskade tidskrifter under en femårsperiod.

Exploring knowledge worker motivation in autonomous and interdependent problem solving tasks on virtual platforms

The objective of this study is to understand why virtual knowledge workers conduct autonomous tasks and interdependent problem solving tasks on virtual platforms. The study is qualitative case study including three case organizations that tap the knowledge of expert networks, and utilize virtual platforms in the work processes. Research data includes 15 interviews, that is, five experts from each case company. According to the findings there are some specific characteristics in motivation to work on tasks on online platforms. Autonomy, self-improvement, meaningful tasks, knowledge sharing, time management, variety of contacts, and variety of tasks, and projects motivate virtual knowledge workers. Factors that may enhance individuals’ engagement to work on tasks are trust, security of continuous task flow and income, feedback, meaningful tasks and tasks that contribute to self-improvement, flexibility and effectiveness in time management, and virtual tools that support social interaction. The results also indicate that there are some differences in individuals’ motivation based on the tasks’ nature. That is, knowledge sharing and variety of contacts motivated experts who worked on interdependent problem solving tasks. Then again, autonomy and variety of tasks motivated experts who worked on autonomous tasks.

Viability of part cargoes in tramp shipping company’s routing and scheduling decisions

Operational excellence of individual tramp shipping companies is important in today’s market, where competition is intense, freight revenues are modest and capital costs high due to global financial crisis, and tighter regulatory framework is generating additional costs and challenges to the industry. This thesis concentrates on tramp shipping, where a tramp operator in a form of an individual case company, specialized in short-sea shipping activities in the Baltic Sea region, is searching ways to map their current fleet operations and better understand potential ways to improve the overall routing and scheduling decisions. The research problem is related to tramp fleet planning where several cargoes are carried on board at the same time, which are here systematically referred to as part cargoes. The purpose is to determine the pivotal dimensions and characteristics of these part cargo operations in tramp shipping, and offer both the individual case company and wider research community better understanding of potential risks and benefits related to utilization of part cargo operations. A mixed method research approach is utilized in this research, as the objectives are related to complex, real-life business practices in the field of supply chain management and more specifically, maritime logistics. A quantitative analysis of different voyage scenarios is executed, including alternative voyage legs with varying cost structure and customer involvement. An on-line-based questionnaire designed and prepared by case company’s decision group again provides desired data of predominant attitudes and views of most important industrial customers regarding the part cargo-related operations and potential future utilization of this business model. The results gained from these quantitative methods are complied with qualitative data collection tools, along with suitable secondary data sources. Based on results and logical analysis of different data sources, a framework for characterizing the different aspects of part cargo operations is developed, utilizing both existing research and empirical investigation of the phenomenon. As conclusions, part cargoes have the ability to be part of viable fleet operations, and even increase flexibility among the fleet to a certain extent. Naturally, several hinderers for this development is recognized as well, such as potential issues with information gathering and sharing, inefficient port activities, and increased transit times.