Sira Nataliya, Groß Dominik, Wilhelmy Saskia
Institute for History, Theory and Ethics of Medicine, University Hospital, RWTH Aachen University, Aachen, Germany.
Digit Health. 2024 Oct 18;10:20552076241288368. doi: 10.1177/20552076241288368. eCollection 2024 Jan-Dec.
The use of telemedicine in health care has recently expanded, and with it the need to evaluate its use from an ethical perspective. Studies investigating the ethical acceptability of telemedical consultations (TC) in nursing homes are lacking, and in particular, the perspectives and experiences of older adults with TC are underrepresented. The objective of this study is to identify ethically relevant parameters in the acute care of nursing home residents using TC and to derive recommendations.
A combination of qualitative research methods was employed to gain a comprehensive understanding of the research topic. These included semi-structured face-to-face interviews and participant observations. Due to the phased design of the cluster-randomized controlled intervention trial in the overarching study project, our investigations were carried out in phases before and after the implementation of the telemedical systems in the nursing homes.
We identified various ethical challenges associated with the use of TC, including those related to autonomy, participation, privacy, self-conception, beneficence, security and justice. Our analysis indicates that the use of TC for nursing home residents is ethically acceptable, provided that several recommendations to promote acceptability are considered.
Our findings provide insights into the variety of ethical challenges that can arise when using TC in nursing homes to provide care for older adults while also providing information on how these challenges can be addressed. Furthermore, these findings provide guidance for further research to improve the care of residents in nursing homes from an ethical perspective.
远程医疗在医疗保健中的应用近来有所扩展，随之而来的是需要从伦理角度评估其使用情况。缺乏对养老院中远程医疗咨询（TC）伦理可接受性的研究，尤其是老年人对远程医疗咨询的观点和体验未得到充分体现。本研究的目的是确定在养老院居民急性护理中使用远程医疗咨询时与伦理相关的参数，并得出建议。
采用定性研究方法的组合，以全面理解研究主题。这些方法包括半结构化面对面访谈和参与观察。由于总体研究项目中集群随机对照干预试验的分阶段设计，我们的调查在养老院实施远程医疗系统之前和之后分阶段进行。
我们确定了与使用远程医疗咨询相关的各种伦理挑战，包括与自主性、参与性、隐私、自我认知、行善、安全性和公正性相关的挑战。我们的分析表明，只要考虑一些促进可接受性的建议，为养老院居民使用远程医疗咨询在伦理上是可接受的。
我们的研究结果揭示了在养老院使用远程医疗咨询为老年人提供护理时可能出现的各种伦理挑战，同时也提供了有关如何应对这些挑战的信息。此外，这些结果为从伦理角度改善养老院居民护理的进一步研究提供了指导。
