VA Puget Sound Health Care System, Tacoma, WA, USA.
Louisiana State University, Baton Rouge, LA, USA.
Suicide Life Threat Behav. 2019 Apr;49(2):382-392. doi: 10.1111/sltb.12431. Epub 2018 Jan 18.
Predictive models that utilize data from electronic healthcare records (EHR) have been developed, investigated, and appear to provide an important resource for suicide prevention in medical settings. Actuarial approaches to predicting suicide may be particularly important given the relative inability of clinicians to accurately predict suicide. Although research regarding predictive models that utilize EHR is certainly promising, ethical considerations for the use of these models to trigger suicide prevention interventions warrant careful consideration. The current manuscript discusses ethical considerations regarding the use of predictive models in suicide prevention clinical care. The unique characteristics of suicide are explored in terms of how they inform ethical and practical approaches. Additionally, biomedical ethical principles and utilitarian, Kantian, and personal rights ethical models are applied to the topic. Recommendations for navigating the ethical issues are provided as an initial framework for others who are considering the implementation of a predictive model to trigger suicide prevention initiatives.
利用电子健康记录 (EHR) 数据开发、研究并似乎为医疗环境中的预防自杀提供了重要资源的预测模型。鉴于临床医生难以准确预测自杀，对预测自杀的精算方法的重视可能尤为重要。尽管利用 EHR 的预测模型的研究前景确实很有希望，但使用这些模型触发预防自杀干预措施的伦理考虑因素值得仔细考虑。本文讨论了在预防自杀临床护理中使用预测模型的伦理考虑因素。探讨了自杀的独特特征，以及它们如何为伦理和实践方法提供信息。此外，还将生物医学伦理原则以及功利主义、康德主义和个人权利伦理模型应用于该主题。为解决这些伦理问题提供了建议，作为考虑实施预测模型以触发预防自杀计划的其他人的初始框架。
