The Ethical Challenge of Conflicts of Interest in Healthcare

Conflicts of interest are prevalent across all walks of society, and unfortunately, the healthcare industry is not immune to these impediments. Conflicts of interest arise when the objective of upholding a patients’ interest collide with the physicians’ secondary goals and is mostly but not always related to monetary gain. To avoid conflict of interest, it is advisable for medical practitioners to weigh the pros and cons that their actions would inflict. Medical practices whose benefits outweigh the associated risks are ethically upright hence avoid conflict of interest. Each section proposes solutions for the conflicts of interest encountered at the disparate healthcare settings and contexts, and thus the dissertation’s immense contribution to the field. For instance, the study proved normative methods to be key to ethical decision making in healthcare as they establish rules, procedures, and regulations necessary to achieve informed consent. Moreover, they ensure the patient\u27s full autonomy as it puts them in a comprehensive position that they can voluntarily make their own decisions. This could comprise the most needed solutions in healthcare to ensure patient autonomy and informed consent hence solve the issue of conflict of interest in this context. The dissertation further illustrates how the importance of patient-physician relationship and involvement of family members in meaningful decision making can result in no conflicts of interest. The use of abortion and euthanasia as case studies availed meaningful statistics that are of significant impact in healthcare. These eye-openers raised important debates on the government involvement in such issues and how the current policies are only making the situation worse. In order to make certain legislation effective, the dissertation proved the need for gaining people’s consent in passing laws that affect them, and thus its contribution to society. The dissertation also elucidates the role of the government in shaping the moral fabric of the society hence its need to be involved in addressing conflict of interest issues in society. On the professional context, the dissertation emphasizes the need to prioritize the code of ethics as a guideline to prevent conflict of interest and proves how they benefit all stakeholders involved. The dissertation notes some proven finding to solutions to conflict of interest and commitment, such as higher reimbursements and payment for every service and highlights the need for policymakers to intervene. Finally, the analysis of organizational conflicts of interest sheds light on the importance of establishing a HEC as a strategy for countering conflicts of interest at the organizational level. Furthermore, the dissertation’s propositions on of the effective solutions to curb conflict of interest, especially regarding data privacy and confidentiality are widely applicable in both healthcare and other fields. Some of these entail data de-identification, reduction of patient-related variables, instilling strict regulations, continuous auditing, transparency, and adoption of user access controls and management system

Securing clouds using cryptography and traffic classification

Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources that can be rapidly provisioned and released with minimal management effort or service provider interaction. Over the last decade, cloud computing has gained popularity and wide acceptance, especially within the health sector where it offers several advantages such as low costs, flexible processes, and access from anywhere. Although cloud computing is widely used in the health sector, numerous issues remain unresolved. Several studies have attempted to review the state of the art in eHealth cloud privacy and security however, some of these studies are outdated or do not cover certain vital features of cloud security and privacy such as access control, revocation and data recovery plans. This study targets some of these problems and proposes protocols, algorithms and approaches to enhance the security and privacy of cloud computing with particular reference to eHealth clouds. Chapter 2 presents an overview and evaluation of the state of the art in eHealth security and privacy. Chapter 3 introduces different research methods and describes the research design methodology and processes used to carry out the research objectives. Of particular importance are authenticated key exchange and block cipher modes. In Chapter 4, a three-party password-based authenticated key exchange (TPAKE) protocol is presented and its security analysed. The proposed TPAKE protocol shares no plaintext data; all data shared between the parties are either hashed or encrypted. Using the random oracle model (ROM), the security of the proposed TPAKE protocol is formally proven based on the computational Diffie-Hellman (CDH) assumption. Furthermore, the analysis included in this chapter shows that the proposed protocol can ensure perfect forward secrecy and resist many kinds of common attacks such as man-in-the-middle attacks, online and offline dictionary attacks, replay attacks and known key attacks. Chapter 5 proposes a parallel block cipher (PBC) mode in which blocks of cipher are processed in parallel. The results of speed performance tests for this PBC mode in various settings are presented and compared with the standard CBC mode. Compared to the CBC mode, the PBC mode is shown to give execution time savings of 60%. Furthermore, in addition to encryption based on AES 128, the hash value of the data file can be utilised to provide an integrity check. As a result, the PBC mode has a better speed performance while retaining the confidentiality and security provided by the CBC mode. Chapter 6 applies TPAKE and PBC to eHealth clouds. Related work on security, privacy preservation and disaster recovery are reviewed. Next, two approaches focusing on security preservation and privacy preservation, and a disaster recovery plan are proposed. The security preservation approach is a robust means of ensuring the security and integrity of electronic health records and is based on the PBC mode, while the privacy preservation approach is an efficient authentication method which protects the privacy of personal health records and is based on the TPAKE protocol. A discussion about how these integrated approaches and the disaster recovery plan can ensure the reliability and security of cloud projects follows. Distributed denial of service (DDoS) attacks are the second most common cybercrime attacks after information theft. The timely detection and prevention of such attacks in cloud projects are therefore vital, especially for eHealth clouds. Chapter 7 presents a new classification system for detecting and preventing DDoS TCP flood attacks (CS_DDoS) for public clouds, particularly in an eHealth cloud environment. The proposed CS_DDoS system offers a solution for securing stored records by classifying incoming packets and making a decision based on these classification results. During the detection phase, CS_DDOS identifies and determines whether a packet is normal or from an attacker. During the prevention phase, packets classified as malicious are denied access to the cloud service, and the source IP is blacklisted. The performance of the CS_DDoS system is compared using four different classifiers: a least-squares support vector machine (LS-SVM), naïve Bayes, K-nearest-neighbour, and multilayer perceptron. The results show that CS_DDoS yields the best performance when the LS-SVM classifier is used. This combination can detect DDoS TCP flood attacks with an accuracy of approximately 97% and a Kappa coefficient of 0.89 when under attack from a single source, and 94% accuracy and a Kappa coefficient of 0.9 when under attack from multiple attackers. These results are then discussed in terms of the accuracy and time complexity, and are validated using a k-fold cross-validation model. Finally, a method to mitigate DoS attacks in the cloud and reduce excessive energy consumption through managing and limiting certain flows of packets is proposed. Instead of a system shutdown, the proposed method ensures the availability of service. The proposed method manages the incoming packets more effectively by dropping packets from the most frequent requesting sources. This method can process 98.4% of the accepted packets during an attack. Practicality and effectiveness are essential requirements of methods for preserving the privacy and security of data in clouds. The proposed methods successfully secure cloud projects and ensure the availability of services in an efficient way