Strech Daniel
Institut für Geschichte, Ethik & Philosophie der Medizin, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625 Hannover.
Z Evid Fortbild Qual Gesundhwes. 2010;104(8-9):674-81. doi: 10.1016/j.zefq.2010.09.019. Epub 2010 Oct 8.
Hardly any academic research has been conducted on physician rating sites (PRS) with regard to their medical and ethical implications. In the public media, however, representatives of health care providers and payers have been involved in a controversial debate on the, at least, possible implications and practical consequences resulting from PRS.
The present article provides a conclusive explanation of why PRS can take on a significant role in future health care. Furthermore, using a framework of ethical principles, ethical and medical implications that can be related to PRS are systematically presented.
Considering the so far rapid spread of Web 2.0 services, it seems plausible to assume that PRS will become a highly used source of information on selecting a physician. There are good reasons to believe that PRS may have a positive impact on health outcomes of physician-seekers as well as on the promotion of health literacy and equality of opportunity. However, considering the lack of evidence for these assumptions, the possibility of an opposite development should not be ruled out. The potential of damage for physician-seekers, for example, through misinformation, and for evaluated doctors, for example, caused by defamation, requires adequate prevention. On the other hand, preventive measures should not restrict the attempts at optimising transparency of medical practice too strongly.
Further specification of the ethical principles outlined in the present article will significantly influence the upcoming decisions on the development and regulation (certification) of PRS. This raises complex normative considerations, the legitimacy of which can be enhanced by, among other things, adequate transparency, justification, participation and conflict of interest policies.
关于医生评分网站(PRS)的医学和伦理影响,几乎没有进行过学术研究。然而,在公共媒体上,医疗服务提供者和支付方的代表参与了一场至少关于PRS可能产生的影响和实际后果的争议性辩论。
本文对PRS为何能在未来医疗保健中发挥重要作用给出了结论性解释。此外,运用伦理原则框架,系统地阐述了与PRS相关的伦理和医学影响。
考虑到目前Web 2.0服务的迅速普及,似乎有理由认为PRS将成为选择医生时广泛使用的信息来源。有充分理由相信,PRS可能对寻求医生帮助的人的健康结果以及健康素养的提升和机会平等产生积极影响。然而,鉴于这些假设缺乏证据,也不能排除相反发展的可能性。例如,寻求医生帮助的人可能因错误信息而受到损害,被评估的医生可能因诽谤而受到损害,这就需要采取适当的预防措施。另一方面,预防措施不应过度限制优化医疗实践透明度的努力。
本文概述的伦理原则的进一步细化将对即将到来的关于PRS发展和监管(认证)的决策产生重大影响。这引发了复杂的规范性考量,通过充分的透明度、正当理由、参与和利益冲突政策等,可以增强其合法性。