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Hintergrund/Zielsetzung
Der Beitrag befasst sich mit dem Wissenstand und der Einstellung der Bevölkerung. Betrachtet werden die Übermittlung und Verfügbarkeit von Gesundheitsdaten, Gesundheitsregister, die elektronische Patientenakte, Einwilligungsverfahren für die Übermittlung von Daten und der Zugriff auf Gesundheitsdaten zu Forschungszwecken.
Methoden
Die Studie basiert auf einer computergestützten Telefonbefragung (Dual-Frame) bei einer Zufallsstichprobe der Bevölkerung in Deutschland im Zeitraum 01.-27.06.2022 (n = 1.308).
Ergebnisse
Der Wissensstand zur Übermittlung von Gesundheitsdaten an Krankenkassen ist hoch, wohingegen das Vorhandensein zentraler Sterbe-, Impf- und Gesundheitsregister sowie der Zugriff auf Gesundheitsdaten durch behandelnde Ärztinnen und Ärzte überschätzt werden. Die Akzeptanz medizinischer Register ist sehr hoch. Die elektronische Patientenakte ist bei der Hälfte der Bevölkerung unbekannt, die Nutzungsbereitschaft ist eher gering ausgeprägt; bei der Übertragung von Daten wird eine Zustimmungsoption bevorzugt, und über achtzig Prozent würden die Daten der elektronischen Patientenakte zur Forschung freigeben. Drei Viertel würden ihre Gesundheitsdaten allgemein zur Forschung freigeben, insbesondere an Universitäten in Deutschland, wobei meist Anonymität Bedingung ist. Die Bereitschaft zur Datenfreigabe steigt mit der Höhe des Vertrauens in die Presse sowie in Universitäten und Hochschulen, und sie sinkt, wenn ein Datenleck als schwerwiegend erachtet wird.
Diskussion und Schlussfolgerung
In Deutschland besteht, wie in anderen europäischen Ländern, eine große Bereitschaft zur Freigabe von Gesundheitsdaten zu Forschungszwecken. Dagegen ist der Wunsch zur Nutzung der elektronischen Patientenakte eher gering. Ebenso niedrig ist die Akzeptanz einer Widerspruchsoption, die jedoch als Voraussetzung für eine erfolgreiche Einführung einer elektronischen Patientenakte gilt. Vertrauen in die Forschung und staatliche Stellen, die Gesundheitsdaten verarbeiten, sind zentrale Faktoren.
The study is based on a German single-topic population survey on vaccination willingness against COVID-19 (VWC) by the authors (2020, n = 2014). The single-topic survey allowed us to test several competing explanations for VWC, as discussed in the literature. The VWC in the sample was 67.3%. Logistic regression was used to identify factors affecting VWC. Being at high risk from COVID-19 and having received flu vaccination have a positive impact on VWC. Perceived VWC of friends has a strong positive effect on respondents’ VWC. Bivariate relationships of gender, age, and level of education with VWC were no longer significant in a multivariate analysis. Trust in alternative medicine and belief in conspiracy theories have a negative effect on VWC.
Der Beitrag befasst sich mit dem Spannungsfeld der politischen Beteiligung im Migrationskontext vor dem Hintergrund der Partizipation von unterrepräsentierten Gruppen. Empirisch untersucht werden die politische Partizipation von Geflüchteten in Bayern sowie ihre Einstellungen zur Demokratie. Die Ergebnisse werden vor dem Stand der Forschung diskutiert und es werden Empfehlungen abgeleitet.
Cybersecurity in health care
(2022)
Psychiatry" by Ligthart et al. (2021) Ligthart et al. (2021) introduce the idea that "Extended Reality (XR) systems, such as Virtual Reality (VR) and Augmented Reality (AR)," could be used for forensic psychiatry, and then go into detail about considerations that advocate for and against the use of XR systems in forensic psychiatry. Yet, in doing so, they implicitly make presuppositions about the functionality and performance of such systems, which first already seem to be questionable from a technical point of view, understood in a broad sense, but moreover, subsequently have far-reaching significance for a normative assessment of the use of such systems. The following remarks will therefore first describe what Ligthart et al. do not explicitly say about the required technology but must presuppose, and then outline the normative consequences of this omission. In the following, the focus will be placed on virtual reality since the use cases initially mentioned by Ligthart et al. suggest that the authors have also such systems in mind. Presumably, however, the remarks made here can also be applied to Augmented and Extended Reality systems.
Cybersecurity and Ethics
(2022)
The text aims to demonstrate that establishing cybersecurity is not only a technical challenge, but that legal, economic, or organizational aspects also play at least as important a role. The provision of cybersecurity raises ethical questions, since cybersecurity can affect moral values such as autonomy, freedom, or privacy. If measurements necessary for the provision of cybersecurity shall be accepted, it is essential to find a balance between the different claims of all stakeholders involved. This aim is achieved through a detailed ethical analysis accompanied by an extensive literature study. As the most important result of this analysis, it becomes obvious that cybersecurity is in competition or even conflict with other values and interests, and that establishing cybersecurity always involves a trade-off. Not only can there be no 100 percent cybersecurity for technical reasons, but if other values and interests are to be considered, this inevitably leads to compromises in cybersecurity.
On closer examination, the concept of civil society becomes blurred, for instance, on the crucial question of who belongs to civil society. The different answers to this question show how controversial the concept of civil society is, since it cannot be assumed that members of civil society would be morally particularly preferable actors. If, however, the conceptual foundations of and the question of membership in civil society already raise doubts about this concept, the recourse to civil society as a means against fake news and hate speech itself, which is often heard in public debates, becomes doubtful.
At risk of reproductive disadvantage? Exploring fertility awareness among migrant women in Germany
(2022)
This study examined awareness about fertility among immigrant women and non-migrants in Germany. The social relevance of infertility and fertility treatment is increasing in Western countries due to continually low overall birth rates, a high rate of childlessness, and a gap between the desired and actual numbers of children. While there is growing interest in infertility and reproductive medicine in general, previous studies have rarely included immigrant or ethnic minorities in Europe. This study investigated whether knowledge on the age-related fertility decline (ARFD) varies between migrant groups and the majority group, and the role of education. Working hypotheses were drawn from theoretical considerations on frameworks of migrant assimilation. The analysis was based on data collected in a social science pilot study on reproductive medicine, representative of the general population (‘NeWiRe’ 2014–2015). The sample included 962 women aged 18–50 years living in Germany. Approximately 81% of the sample were immigrants who originated from Turkey, Poland, the Balkan countries or countries of the (post-Soviet) Commonwealth of Independent States. While rather poor overall, knowledge on ARFD was found to be significantly lower in the migrant groups compared with the majority group. This minority-group disadvantage cannot be explained by sociodemographic or cultural variables. Future research should include minority groups in empirical studies on awareness about fertility in order to better understand the causes of this disadvantage, and the potential reproductive needs of migrants.