Cosgrove Victoria, Gliddon Emma, Berk Lesley, Grimm David, Lauder Sue, Dodd Seetal, Berk Michael, Suppes Trisha
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA.
Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, USA.
Int J Bipolar Disord. 2017 Dec;5(1):26. doi: 10.1186/s40345-017-0095-3. Epub 2017 Aug 6.
While e-health initiatives are poised to revolutionize delivery and access to mental health care, conducting clinical research online involves specific contextual and ethical considerations. Face-to-face psychosocial interventions can at times entail risk and have adverse psychoactive effects, something true for online mental health programs too. Risks associated with and specific to internet psychosocial interventions include potential breaches of confidentiality related to online communications (such as unencrypted email), data privacy and security, risks of self-selection and self-diagnosis as well as the shortcomings of receiving psychoeducation and treatment at distance from an impersonal website. Such ethical issues need to be recognized and proactively managed in website and study design as well as treatment implementation. In order for online interventions to succeed, risks and expectations of all involved need to be carefully considered with a focus on ethical integrity.
虽然电子健康计划有望彻底改变心理健康护理的提供方式和可及性，但在线开展临床研究涉及特定的背景和伦理考量。面对面的心理社会干预有时会带来风险并产生不良精神活性效应，在线心理健康项目也是如此。与互联网心理社会干预相关的特定风险包括与在线通信（如未加密电子邮件）相关的潜在保密性泄露、数据隐私和安全、自我选择和自我诊断的风险，以及在远离非个人化网站的情况下接受心理教育和治疗的缺点。此类伦理问题需要在网站和研究设计以及治疗实施中得到认识并积极管理。为了使在线干预取得成功，需要仔细考虑所有相关方的风险和期望，重点是伦理完整性。
