Ethical Implications of eHealth Tools for Delivering STI/HIV Laboratory Results and Partner Notifications.

Ethical Implications of eHealth Tools for Delivering STI/HIV Laboratory Results and Partner Notifications.
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eHealth工具的道德意义,用于提供性传播疾病/艾滋病毒实验室结果和伴侣通知。

DOI:
10.1007/s11904-021-00549-y
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发表时间:
2021-06
影响因子:
4.6
通讯作者:
Jarrett BA
Jarrett BA
中科院分区:
医学2区
文献类型:
--
作者:
Godongwana M;Chewparsad J;Lebina L;Golub J;Martinson N;Jarrett BA

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电子保健工具越来越多地用于与患者沟通。尽管这些工具有效且具有成本效益,但它们面临着一些障碍,这些障碍对其在性健康中的道德使用提出了挑战。我们回顾了过去十年的文献,选择了电子健康工具的说明性研究,这些工具提供了性传播感染(包括人类免疫缺陷病毒)的实验室检测结果,以及伴侣通知。我们描述了这些技术的伦理影响。我们的审查发现,尽管对使用电子健康工具提供实验室结果和合作伙伴通知进行了广泛的研究,但这些研究很少测量或报告伦理影响。这些影响可以根据生命伦理学的四个主要原则来组织:善行,病人自主权,不伤害和正义。电子健康的益处通常是衡量与现有护理标准相比的疗效。患者自主权包括选择加入或退出电子健康工具的能力、基于权利的同意原则以及对医疗保健数据的主权。为了坚持不伤害原则,必须识别和衡量相关的伤害,例如无意中透露疾病、性取向或性活动。还必须考虑公正,以平等地容纳所有用户,无论其文化水平如何,并提供易于使用的平台,提供明确的信息。根据这次审查的案例研究,我们制定了一份电子健康平台的道德发展和评估建议清单,以向患者提供STI/HIV结果并通知合作伙伴。
eHealth tools are increasingly utilized for communication with patients. Although efficacious and cost-effective, these tools face several barriers that challenge their ethical use in sexual health. We reviewed literature from the past decade to pick illustrative studies of eHealth tools that deliver results of laboratory tests for sexually transmitted infections, including the human immunodeficiency virus, as well as partner notifications. We describe ethical implications for such technologies. Our review found that despite widespread research on the use of eHealth tools in delivering laboratory results and partner notifications, these studies rarely measured or reported on the ethical implications. Such implications can be organized according to the four major principles in bioethics: beneficence, patient autonomy, non-maleficence, and justice. The beneficence of eHealth typically measures efficacy in comparison to existing standards of care. Patient autonomy includes the ability to opt in or out of eHealth tools, right-based principles of consent, and sovereignty over healthcare data. To adhere to the principle of non-maleficence, relevant harms must be identified and measured—such as unintentional disclosure of illness, sexual orientation, or sexual activity. Justice must also be considered to accommodate all users equally, irrespective of their literacy level, with easy-to-use platforms that provide clear messages. Based on case studies from this review, we developed a list of recommendations for the ethical development and evaluation of eHealth platforms to deliver STI/HIV results to patients and notifications to partners.
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