Spahl Wanda, Rubeis Giovanni
Division Biomedical and Public Health Ethics, Karl Landsteiner University of Health Sciences, Krems, Austria.
Greifswald Medical School, Greifswald, Germany.
Med Health Care Philos. 2025 Sep;28(3):411-424. doi: 10.1007/s11019-025-10283-6. Epub 2025 Jul 30.
Digital mental healthcare technologies increasingly incorporate gamification, yet relevant ethical considerations remain underexamined. This paper introduces the Principle-Based Empirically Grounded Roadmap Approach (PERA), a methodological contribution to empirical bioethics. It has evolved from ethics research within the Horizon Europe project ASPbelong, which designs a collaboratively played augmented reality intervention for adolescents. PERA refines existing integrated empirical bioethics methodologies by responding to three key characteristics of the use case: a largely predetermined technology with a relatively low degree of openness in technological design, embedded co-development practices led by facilitators from within the project team, and planned future iterations beyond the ethics team's involvement. PERA integrates mapping of principles from the ethics literature, a scoping review of the moral intuitions of developers of comparable technologies, and the collection of original empirical data on the use case. Using abductive reasoning, these insights are synthesized into a tangible output: an ethics roadmap designed to guide and be adapted in future use case iterations. By advancing a methodology of combining normative reasoning with empirical insights on a concrete use case, this paper provides both practical tools for ethics researchers in technology projects and a means to generate empirically grounded conceptual contributions. Its outcomes, when brought into dialogue with findings from other integrated empirical bioethics research, can support the critical examination of broader assumptions and implications of gamified mental healthcare, including questions of good care and the broader social implications of such technologies.
数字精神卫生保健技术越来越多地融入游戏化元素，但相关的伦理考量仍未得到充分审视。本文介绍了基于原则的实证路线图方法（PERA），这是对实证生物伦理学的一项方法学贡献。它源自于欧洲地平线项目ASPbelong中的伦理学研究，该项目为青少年设计了一款协同玩的增强现实干预游戏。PERA通过回应该用例的三个关键特征，对现有的综合实证生物伦理学方法进行了完善：技术在很大程度上是预先确定的，技术设计的开放程度相对较低；由项目团队内部的协调员主导的嵌入式共同开发实践；以及在伦理团队参与之外计划的未来迭代。PERA整合了伦理文献中的原则映射、对类似技术开发者道德直觉的范围审查，以及关于该用例的原始实证数据收集。通过溯因推理，这些见解被综合成一个切实的产出：一个伦理路线图，旨在指导未来用例迭代并可在其中进行调整。通过推进一种将规范推理与具体用例的实证见解相结合的方法，本文既为技术项目中的伦理研究人员提供了实用工具，也提供了一种产生基于实证的概念贡献的方法。当将其成果与其他综合实证生物伦理学研究的结果进行对话时，它可以支持对游戏化精神卫生保健的更广泛假设和影响进行批判性审视，包括优质护理问题以及此类技术的更广泛社会影响。
