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姑息治疗与新技术。智能传感器技术的应用及其对全面关怀原则的影响。

Palliative care and new technologies. The use of smart sensor technologies and its impact on the Total Care principle.

机构信息

Chair of Systematic Theology II (Ethics), Faculty of Humanities, Social Sciences, and Theology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kochstraße 6, Erlangen, 91054, Germany.

Department of Palliative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Werner-von-Siemens-Straße 34, Erlangen, 91052, Germany.

出版信息

BMC Palliat Care. 2023 Apr 26;22(1):50. doi: 10.1186/s12904-023-01174-9.

Abstract

BACKGROUND

Palliative care is an integral part of health care, which in term has become increasingly technologized in recent decades. Lately, innovative smart sensors combined with artificial intelligence promise better diagnosis and treatment. But to date, it is unclear: how are palliative care concepts and their underlying assumptions about humans challenged by smart sensor technologies (SST) and how can care benefit from SST?

AIMS

The paper aims to identify changes and challenges in palliative care due to the use of SST. In addition, normative guiding criteria for the use of SST are developed.

METHODS

The principle of Total Care used by the European Association for Palliative Care (EAPC) forms the basis for the ethical analysis. Drawing on this, its underlying conceptions of the human and its socio-ethical aspects are examined with a phenomenological focus. In the second step, the advantages, limitations, and socio-ethical challenges of using SST with respect to the Total Care principle are explored. Finally, ethical-normative requirements for the application of SST are derived.

RESULTS AND CONCLUSION

First, SST are limited in their measurement capabilities. Second, SST have an impact on human agency and autonomy. This concerns both the patient and the caregiver. Third, some aspects of the Total Care principle are likely to be marginalized due to the use of SST. The paper formulates normative requirements for using SST to serve human flourishing. It unfolds three criteria according to which SST must be aligned: (1) evidence and purposefulness, (2) autonomy, and (3) Total Care.

摘要

背景

缓和医疗是医疗保健的一个组成部分,近几十年来,医疗保健已经越来越多地实现了技术化。最近,创新的智能传感器与人工智能相结合,有望实现更好的诊断和治疗。但迄今为止,仍不清楚智能传感器技术(SST)如何挑战缓和医疗的概念及其对人类的基本假设,以及 SST 如何使医疗受益。

目的

本文旨在确定由于使用 SST 而导致的缓和医疗的变化和挑战。此外,还制定了使用 SST 的规范指导标准。

方法

欧洲缓和医疗协会(EAPC)使用的“全面关怀”原则为伦理分析提供了基础。在此基础上,以现象学为重点,对其对人类及其社会伦理方面的基本概念进行了考察。在第二步中,探讨了使用 SST 相对于“全面关怀”原则的优势、局限性和社会伦理挑战。最后,得出了应用 SST 的伦理规范要求。

结果与结论

首先,SST 在测量能力上存在局限性。其次,SST 对人类的能动性和自主性有影响。这既涉及患者,也涉及护理人员。第三,由于使用 SST,“全面关怀”原则的某些方面可能被边缘化。本文为使用 SST 服务于人类繁荣制定了规范要求。它根据必须符合的标准展开了三个标准:(1)证据和目的性,(2)自主性,(3)全面关怀。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a4d/10131446/adb134bde178/12904_2023_1174_Fig1_HTML.jpg

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