Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Sint-Rafael, Kapucijnenvoer 33, Bus 7001 (Blok H), 3000, Leuven, Belgium.
Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Mental Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK.
Soc Sci Med. 2020 Oct;262:112691. doi: 10.1016/j.socscimed.2019.112691. Epub 2020 Jan 18.
The internet has become a key frontier for large-scale, public health efforts in suicide prevention. Market-leading technology companies, such as Google, are developing interventions to deliver support information to those experiencing suicidal distress, but the precise technology, i.e. algorithms, behind this are proprietary. This raises important ethical questions regarding whether such large-scale public health interventions for suicide prevention should be happening behind closed corporate doors when this makes the evaluation of such interventions extremely difficult. Furthermore, as illustrated by Arendt et al. (2019), initiatives such as Google's Suicide Prevention Result (SPR) appear not to work in circumstances in which they could be of significant potential benefit, such as when individuals are searching for details of celebrity suicides. In the current commentary, we discuss ways in which the SPR can be optimized, based on existing evidence regarding suicide-related internet use. We go on to discuss the ethical issues of large technology companies becoming key players in suicide prevention and critically consider how online public health initiatives of this kind are able to be evaluated.
互联网已成为预防自杀的大规模公共卫生工作的重要前沿领域。谷歌等市场领先的科技公司正在开发干预措施，向有自杀困扰的人提供支持信息，但背后的精确技术（即算法）是专有的。这引发了一些重要的伦理问题，即当这种情况使得对这种干预措施的评估变得极其困难时，是否应该在封闭的公司大门内进行这种大规模的预防自杀的公共卫生干预。此外，正如阿伦特等人（2019 年）所表明的那样，谷歌的自杀预防结果（SPR）等举措在可能具有重大潜在益处的情况下似乎不起作用，例如当个人在搜索名人自杀的详细信息时。在当前的评论中，我们根据与互联网使用相关的自杀行为的现有证据，讨论了优化 SPR 的方法。我们接着讨论了大型科技公司成为预防自杀的关键参与者所带来的伦理问题，并批判性地考虑了如何评估这类在线公共卫生倡议。
