Vandemeulebroucke Tijs, Bolte Larissa
Bonn Sustainable AI Lab, Institut für Wissenschaft und Ethik, Universität Bonn, Bonner Talweg 57, 53113, Bonn, Germany.
Med Health Care Philos. 2025 Sep;28(3):639-665. doi: 10.1007/s11019-025-10269-4. Epub 2025 May 3.
Digital technologies, especially social media, have become everyday tools. In care settings, the use of social media is considered a possible guarantee to maintain quality practices. This trend is specifically relevant for social care, including social work, psychology, psychiatry, rehabilitation etc., due to their communicative nature. Nevertheless, this use is joined by ethical vulnerabilities. To get insight into these, a systematic review of relevant normative-ethical literature was carried out following a 4-step methodology: developing ethical-conceptual questions; a literature search in four electronic databases (CINAHL, Philosopher's Index, Web of Science, ProQuest Database Psychology); assessment and inclusion of articles based on predefined criteria; extracting, analysing, and synthesizing reported data. Thirty-three articles were included, showing that current ethical debates are governed by nine themes: Benefits of social media; Relations, limits, and boundaries; Searches; Privacy, confidentiality, and trust; Documentation and records; Competency and client suitability; Consultation and referral; Informed consent; and Identity and image. We found that most ethical literature on social media use in social care settings adheres to the principles of biomedical ethics (respect for autonomy, beneficence, non-maleficence, justice) and to an ethics of carefulness, i.e. an ethics which takes social media for granted and considers its impact only on the particular therapeutic relationship. It loses sight of those ethical issues which occur on organizational, societal, and global levels. A full account of the ethics of social media use can only be given by considering these different levels and by informing the ethics of carefulness by an ethics of desirability.
数字技术，尤其是社交媒体，已成为日常工具。在护理环境中，社交媒体的使用被视为维持优质实践的一种可能保障。由于其交流性质，这一趋势在社会护理领域尤为相关，包括社会工作、心理学、精神病学、康复等。然而，这种使用也伴随着伦理漏洞。为深入了解这些漏洞，我们按照以下四步方法对相关规范伦理文献进行了系统综述：提出伦理概念问题；在四个电子数据库（CINAHL、《哲学家索引》、《科学引文索引》、ProQuest心理学数据库）中进行文献检索；根据预定义标准评估并纳入文章；提取、分析和综合报告的数据。共纳入33篇文章，结果表明当前的伦理辩论受九个主题支配：社交媒体的益处；关系、限制和边界；搜索；隐私、保密和信任；文档记录；能力和服务对象适宜性；咨询和转诊；知情同意；以及身份和形象。我们发现，大多数关于社会护理环境中社交媒体使用的伦理文献都遵循生物医学伦理原则（尊重自主性、有益、无害、公正）以及谨慎伦理，即一种将社交媒体视为理所当然并仅考虑其对特定治疗关系影响的伦理。它忽视了在组织、社会和全球层面出现的那些伦理问题。只有考虑到这些不同层面，并以理想伦理为谨慎伦理提供信息，才能全面阐述社交媒体使用的伦理问题。
