Dilemmas and Challenges of Professional Practice in a Digital Age


Tracey L. Adams, Western University

The work of health professionals is changing; the pace of change has been accelerated by the COVID-19 pandemic, technological and workplace developments, shifting consumer demands, and workforce shortages. This context creates challenges for healthcare professionals, who can face demands for which their training has not entirely prepared them. Regulatory bodies find it difficult to keep codes of ethics and practice guidance sufficiently up-to-date in order to guide practitioners as they navigate this shifting terrain. Changing technology, including expanding applications of artificial intelligence, the growth of virtual practice, and recent disciplinary decisions highlighting professionals’ (mis)use of social media reveal new ethical considerations for healthcare professionals practising today. The persistence of healthcare shortages have prompted organizational and governmental policy shifts that further alter professionals’ work, not only redrawing who does what, but changing the conditions under which professional work is performed. These changes not only bring challenges for professional workers, but also demand new regulatory solutions. This paper explores the practice challenges and ethical dilemmas experienced by health professionals working in Ontario, Canada in a climate of changing workplace demands and new technology. Study data come from three sources. First, we conducted a content analysis of codes of ethics and practice guidance provided by health profession regulators in the province of Ontario to determine the extent to which regulators can support professional workers as they navigate this shifting terrain. Recent case law in this field was also examined. Second, we conducted interviews with a small sample of Ontario health profession regulators to discuss the extent to which recent technological and workplace change is impacting the regulation of professional work, and to identify emergent trends in practice (mis)conduct. Third, we conducted focus groups with health professionals to understand their experiences in the workplace, and hear first-hand about the challenges workplace change is bringing. We conducted thematic analysis across the datasets to develop an understanding of the nature of changes experienced, their impact on professional workers, and their implications for the regulation of professional work. Findings indicate that many regulators have made changes to their codes of ethics and practice guidance to foster ethical professional conduct in a context of change; however, some provide more support than others. Many feel ill-equipped to stay up-to-date with developments in the professional fields they regulate, and/or believe that it is not their role to support practitioners as they navigate the changing terrain. The impact of technological change is altering many aspects of professional practice – but it impacts professionals differently, depending on their work setting and employment status. The extent to which the implementation and application of technology is controlled by the workers or by others (like their employers), is crucially important. Impacts are also variable depending on region and urban-rural locale. In hospital settings the push to do more, and take on new roles that have the potential to increase safety risks to the public is particularly intense. Technological change creates new challenges for professional regulators too as it opens different avenues for professional misconduct, and may facilitate illegal practice. The implications of some workplace and technological changes -- for example, expanding use of artificial intelligence -- are multiple and difficult to predict. The implications of technological change for professional workers and regulatory bodies are considered.

This paper will be presented at the following session: