Repositioning Bioethics in Digital Health Innovation Ecosystems : A Human-Rights Grounded Educational Architecture for Ethical Learning
Date Issued
June 30, 2026
Author(s)
Livieri, Georgia E.
Advisor
Abstract
This dissertation addresses a central challenge in digital health: the translation of abstract ethical principles into practical, usable tools that can support ethical learning across di-verse professional contexts. The study aimed to develop an operational, user-centred ethics navigator capable of embedding ethical reflection into real-world digital health practices.
A multi-phase, design-oriented mixed methodology was employed. First, published ev-idence on ethical gaps and challenges experienced by patients and healthcare profession-als was systematically collected, synthesized and translated into structured, design-relevant problem dimensions. Second, these insights informed the development of an initial (Alpha) architecture, which was iteratively refined through expert validation, lead-ing to the BETA architecture and its educational (BETA-EDU) version. Third, end-user engagement across six relevant sectors enabled the identification of context-specific needs and cross-sector requirements, culminating in the final (Gamma) architecture.
The findings demonstrate that ethical challenges in digital health are context-dependent and require adaptive, user-centred solutions. The resulting architecture provides a scala-ble, modular, and layered system that integrates ethical reasoning, usability, and cross-sector applicability. This work contributes to digital health ethics by reframing ethics as a process of guided reflection and by offering a concrete, implementation-oriented ethics navigator to support ethical practice in complex socio-technical environments.
A multi-phase, design-oriented mixed methodology was employed. First, published ev-idence on ethical gaps and challenges experienced by patients and healthcare profession-als was systematically collected, synthesized and translated into structured, design-relevant problem dimensions. Second, these insights informed the development of an initial (Alpha) architecture, which was iteratively refined through expert validation, lead-ing to the BETA architecture and its educational (BETA-EDU) version. Third, end-user engagement across six relevant sectors enabled the identification of context-specific needs and cross-sector requirements, culminating in the final (Gamma) architecture.
The findings demonstrate that ethical challenges in digital health are context-dependent and require adaptive, user-centred solutions. The resulting architecture provides a scala-ble, modular, and layered system that integrates ethical reasoning, usability, and cross-sector applicability. This work contributes to digital health ethics by reframing ethics as a process of guided reflection and by offering a concrete, implementation-oriented ethics navigator to support ethical practice in complex socio-technical environments.
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Georgia E. Livieri-PHD-2026-ABSTRACT.pdf
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