Resolving stakeholder tussles in healthcare systems: Ethical challenges to data protection

For cross-border collaborative healthcare delivery, data protection legislation seems to be increasingly obstructive. In extreme cases, this may compromise the quality of care a patient receives and at the same time prevent clinicians practicing and developing their medical skills to their full potential. A dilemma develops whereby the fundamental rights of patient and clinician are constrained by the very legal instruments designed to make delivery of healthcare easier. The contention between patient and clinician expectations, or tussles, may pose a threat to future healthcare delivery. Compromising healthcare delivery in this way has wider implications for community trust. The concept of tussles in technology infrastructures suggests an actor-network approach involving the patient and clinician relationship within the context of community response to their interactions to offer an innovative perspective on the problem of tussles in healthcare. In this paper, we develop such an approach and discuss an initial validation based on cross-border healthcare scenarios illustrating the contention between fundamental ethical rights and actor-network compliance.