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加纳广泛使用非正式移动医疗方法的伦理问题。

Ethical implications of the widespread use of informal mHealth methods in Ghana.

机构信息

Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana

出版信息

J Med Ethics. 2024 Jul 23;50(8):563-568. doi: 10.1136/medethics-2021-107920.

DOI:10.1136/medethics-2021-107920
PMID:35396337
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9547032/
Abstract

BACKGROUND

Informal mHealth is widely used by community health nurses in Ghana to extend healthcare delivery services to clients who otherwise might have been excluded from formal health systems or would experience significant barriers in their quest to access formal health services. The nurses use their private mobile phones or devices to make calls to their clients, health volunteers, colleagues or superiors. These phone calls are also reciprocal in nature. Besides, the parties exchange or share other health data and information through text messages, pictures, videos or voice clips. There are some ethical dimensions that are inherent in these practices that ought to be critically scrutinised by bioethicists.

OBJECTIVE

The author has argued in this paper that informal mHealth at large scale adoption in Ghana is associated with some bioethical challenges.

METHODS

This essay was largely based on an analysis of an empirical study published by Hampshire in 2021 on the use of informal mHealth methods in Ghana.

RESULTS

Widespread adoption of Informal mHealth in Ghana is associated with privacy invasion of both the nurses and their clients, breaches confidentiality of the parties, discredits the validity of informed consent processes and may predispose the nurses to some other significant aggregated harms.

CONCLUSION

The author affirms his partial support for a formalised adoption process of informal mHealth in Ghana but has reiterated that the current ethical challenges associated with informal mHealth in Ghana cannot escape all the debilitating bioethical challenges, even if it is formalised.

摘要

背景

非正式移动医疗在加纳被社区卫生护士广泛使用,以向那些可能被正式医疗系统排除在外的客户,或在寻求正式医疗服务时面临重大障碍的客户提供医疗服务。护士使用私人手机或设备给客户、健康志愿者、同事或上级打电话。这些电话也是相互的。此外,各方还通过短信、图片、视频或语音片段交换或共享其他健康数据和信息。这些做法中存在一些固有的伦理问题,应该由生物伦理学家进行批判性审查。

目的

作者在本文中认为,非正式移动医疗在加纳的大规模采用与一些生物伦理挑战有关。

方法

本文主要基于汉普郡 2021 年发表的一项关于在加纳使用非正式移动医疗方法的实证研究的分析。

结果

非正式移动医疗在加纳的广泛采用与护士及其客户的隐私侵犯、各方保密性的破坏、损害知情同意过程的有效性以及可能使护士面临其他一些重大的累积伤害有关。

结论

作者肯定了他对加纳非正式移动医疗正式采用过程的部分支持,但重申,即使非正式移动医疗被正式化,加纳非正式移动医疗目前面临的伦理挑战也无法逃避所有的不良生物伦理挑战。