Department of Nursing Home Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Med Ethics. 2011 May;37(5):303-10. doi: 10.1136/jme.2010.040774. Epub 2011 Feb 2.
As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date.
To explore how surveillance technology is viewed by care professionals and ethicists working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia.
Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritizing, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background.
The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart.
There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficult.
随着社会老龄化,养老院发现越来越难以应对痴呆症患者人数不断增加和劳动力减少的问题。这个问题的潜在解决方案可能在于技术的应用。然而,在痴呆症护理中使用监控技术引发了医护专业人员和伦理学家之间的大量伦理争议,迄今为止尚未达成明确共识。
通过调查监控技术在痴呆症患者居住护理中的理想应用,探讨护理专业人员和从事该领域的伦理学家对监控技术的看法。
使用概念映射方法,这是一种计算机辅助的五步程序:头脑风暴、优先级排序、聚类、计算机处理和分析。根据参与者的专业背景,邀请了各种专业人员(包括伦理学家、医生和护士)。
生成的观点分为六个类别,从自由和安全之间需要平衡、对居民有益且量身定制、明确适用于有能力和关怀的人员、主动监控和明确的规范指导等方面进行了分类。结果以图表形式呈现。
对于使用监控技术的观点似乎存在内在的双重性,这种双重性源于安全和自由之间的道德冲突。对这一伦理问题的阐述非常困难。