Bioethics of Built Space

Decisions made in health care architecture have myriad effects on patients, families, and staff. Design is being employed increasingly often to alter specific behaviors, mediate the interactions of those within the health care spaces, and affect patient outcomes.

We propose that advances in design science and understanding of its powerful effects are now such that, in some instances, the built environment in health care should be considered analogous to a medical intervention. As with medical interventions, the intentional use of the built environment to effect perceptual and behavioral changes in patients or residents should be appropriately disclosed, as should harms caused by a building itself. But while some of these effects bear on individuals such that an informed consent process may be sufficient, others have population-level impacts that can persist for generations.

This presentation explores issues related to transparency, informed consent, surrogate authority, and describes the need for further empirical research into the implementation, efficacy, and ethics of these interventions.

Learning Objectives
• Understand how the built environment can help resolve the conflicting obligations of isolation for disease mitigation and the need for socialization and autonomy.
• Demonstrate the increasing impact the healthcare built environment is having on health and as a dimension of duty of care.