a DePaul University.
b Stanford University.
Am J Bioeth. 2018 Sep;18(9):38-47. doi: 10.1080/15265161.2018.1498933.
Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care.
数字医疗是一种将技术与药物输送相结合的医疗方法。这种结合的承诺包括持续和远程监测、更好的疾病管理、自我跟踪、疾病的自我管理以及提高治疗依从性。这些设备给患者、提供者和医学的社会实践带来了伦理挑战。对于患者来说，既要有知情同意书又要有用户协议，这就提出了对自主性和知情同意、治疗误解、决策中外在影响、保密性和隐私以及设备可靠性的理解问题。对于提供者来说，数字医疗改变了信任可以被验证、临床医生可以被监测、期望必须被管理以及可能承担新的责任风险的关系。其他伦理问题包括第三方对健康治疗的直接监测、可负担性以及在设备故障情况下对不良事件的规划。本文旨在为这些设备在患者护理中的应用勾勒出伦理领域。
