Rubeis Giovanni
Institut für Geschichte und Ethik der Medizin, Medizinische Fakultät, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 327, 69120 Heidelberg, Deutschland.
Ethik Med. 2021;33(3):335-352. doi: 10.1007/s00481-021-00621-6. Epub 2021 Mar 26.
Refugees show a high prevalence of mental health burden. Catering to the need for mental health services is made difficult by access barriers. These barriers consist of structural factors as well as culturally different attitudes towards mental health, mental illness, and therapeutic interventions. One option to overcome these access barriers and to provide mental healthcare services in an appropriate manner is seen in digital interventions. In the form of interactive websites or smartphone apps, these interventions have proven to be effective in mental healthcare. There are also promising examples of successful use of these technologies with refugees. However, the ethical aspects of digital interventions for refugees have scarcely been studied yet.
Aim of this paper is to tackle this research desiderate. The instrument of the ethical analysis to be conducted is the concept of agency. According to the concept of agency, persons have to be seen as actors capable of acting based on their own resources and competencies. Agency is the guiding principle here for analyzing the opportunities and risks of digital interventions for refugees. In addition, I will attempt to point out prospects for an agency-based application of digital interventions.
The ethical analysis could be used as the blueprint for developing therapeutic concepts that contribute to the improvement of mental healthcare services for refugees from an ethical perspective.
难民心理健康负担的患病率很高。获取障碍使得满足心理健康服务需求变得困难。这些障碍包括结构因素以及对心理健康、精神疾病和治疗干预在文化上的不同态度。克服这些获取障碍并以适当方式提供心理保健服务的一个选择是数字干预。以交互式网站或智能手机应用程序的形式,这些干预已被证明在心理保健方面是有效的。也有一些成功地为难民使用这些技术的例子。然而,针对难民的数字干预的伦理方面几乎尚未得到研究。
本文的目的是解决这一研究需求。进行伦理分析的工具是能动性概念。根据能动性概念,人必须被视为能够基于自身资源和能力采取行动的行为者。能动性是这里分析针对难民的数字干预的机遇和风险的指导原则。此外,我将试图指出基于能动性应用数字干预的前景。
伦理分析可作为制定治疗概念的蓝图,从伦理角度有助于改善为难民提供的心理保健服务。