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远程医疗中的患者自主性与医疗质量。

Patient Autonomy and Quality of Care in Telehealthcare.

机构信息

Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany.

出版信息

Sci Eng Ethics. 2018 Feb;24(1):93-107. doi: 10.1007/s11948-017-9885-3. Epub 2017 Mar 9.

Abstract

Telemedicine is a complex field including various applications and target groups. Especially telehealthcare is seen by many as a means to revolutionize medicine. It gives patients the opportunity to take charge of their own health by using self-tracking devices and allows health professionals to treat patients from a distance. To some, this means an empowerment of patient autonomy as well as an improvement in the quality of care. Others state the dangers of depersonalization of medicine and the pathologization of daily life. This paper examines the ethical implications of telehealthcare, focusing on patient autonomy and quality of care by analyzing metareviews, randomized controlled trials and narrative ethical analyses on the topic. As a result, we conclude that the technically enhanced encounter between patients and health professionals may mean an empowerment of patient autonomy when it goes along with a personal relationship based on trust, assistance and support. When it comes to the quality of care, telehealthcare may lead to an improvement as long it is adopted to the patient's individual needs.

摘要

远程医疗是一个包含各种应用和目标群体的复杂领域。特别是远程医疗被许多人视为医学革命的手段。它使患者有机会通过使用自我跟踪设备来管理自己的健康,并使医疗保健专业人员能够远程治疗患者。对一些人来说,这意味着增强患者自主权和提高护理质量。另一些人则表示担心医学去人性化和日常生活病理化的危险。本文通过分析关于该主题的元综述、随机对照试验和叙述性伦理分析,探讨了远程医疗的伦理含义,重点是患者自主权和护理质量。结果表明,当患者与医疗保健专业人员之间的技术增强型互动伴随着基于信任、帮助和支持的个人关系时,可能意味着患者自主权的增强。就护理质量而言,只要远程医疗能够满足患者的个体需求,就可能会有所改善。

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