Ethical, Legal and Social Implications in the Use of Digital Technology for Mental Health Applications

使用数字技术进行心理健康应用的伦理、法律和社会影响

• 批准号: 10478953
• 负责人: Nicole A Martinez-Martin
• 金额: $ 12.69万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2023-10-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478953
• 关键词: Accountability; Address; Adolescent; Adoption; Algorithms; Area; Attention; Behavior monitoring; Behavioral; Big Data; Caring; Categories; Cellular Phone; Clinical; Communication; Cultural Backgrounds; Data; Data Protection; Devices; Diagnostic; Dimensions; Empirical Research; Ethical Issues; Ethics; Family; Foundations; Future; Genetic; Genomics; Goals; Guidelines; Health; Health Services Accessibility; Health Technology; Healthcare; Improve Access; Informed Consent; Institution; Interview; Judgment; Knowledge; Location; Machine Learning; Mediating; Mental Health; Mental Health Services; Mental disorders; Methods; Minority Groups; Monitor; Mood Disorders; Motion; Patient Care; Patient Self-Report; Patients; Physicians; Privacy; Psychotic Disorders; Psychotic Mood Disorders; Qualitative Methods; Recommendation; Recording of previous events; Research; Research Personnel; Risk; Risk Assessment; Safety; Scholarship; Social Policies; Surveys; Technology; Therapeutic; Training; Translating; Translations; Trust; Voice; age group; behavioral health; chatbot; clinical care; community setting; computer science; dashboard; data management; digital; digital health; digital mental health; ethical legal social implication; expectation; experience; health application; health data; health information technology; improved; mHealth; neurotechnology; novel; patient subsets; programs; risk minimization; sensor; social implication; socioeconomics; tool; treatment adherence; uptake

Digital mental health technology (DMHT) –digital devices (smartphones, sensors) that can monitor and collect personal data from patients (tracking location/voice/motion, self-report), apply algorithms and machine learning (“ML”) to generate and integrate health and risk information (from genomics/family history), and even mediate care (monitoring treatment adherence or chatbot therapy)– is being integrated into mental health clinical care, with the goal of improving access, diagnostics and treatment for mental illness. DMHT poses novel ethical challenges because (1) use of DMHT disrupts traditional frameworks, such as the physician-patient dyad, for addressing ethical obligations and challenges in mental health care; (2) DMHT will contribute to the creation of novel and massive amount of behavioral data and risk categories, particularly when combined with other technologies, such as WGS, which may be difficult for clinicians and patients to evaluate and meaningfully use; and 3) behavioral health data will be created and used outside of frameworks for protecting the privacy of health data and may be experienced as surveillance by patients. The goals of the project are to: (1) examine how key stakeholders – DMHT developers, clinicians and patients – conceptualize and operationalize the ethical, legal and social implications of DMHT as it is translated into clinical care for the treatment of mood and psychotic disorders; and (2) use qualitative and quantitative methods to interview and survey clinicians, patients and consumers who use DMHT to examine the ethical, legal and social implications of the technology, particularly in relation to trust, privacy, data protection and management, and surveillance; and (3) provide improved understandings of how developers, patients, and clinicians perceive and manage ethical, legal and social implications of DMHT, that can be used as a foundation for further research and to provide guidance for ethical and safe use of digital technology in mental health care. he long-term goals of the project are to: 1) develop a research program exploring the ethical, legal and social implications of digital health technologies in mental health care and the potential impact on ethical frameworks in healthcare; 2) generate empirical research that improves understandings of the ethical, legal and social, implications of digital health technology; and 3) to improve understandings of the ethical issues involved in the use of DMHT to inform guidelines and social policy for the use of digital health technology in research, clinical, and community settings.

数字心理健康技术(DMHT)-可以 监控和收集患者的个人数据(跟踪位置/语音/动作、自我报告)，申请 用于生成和集成健康和风险信息的算法和机器学习 (来自基因组学/家族病史)，甚至中介护理(监测治疗依从性或 Chatbot治疗)-正在整合到心理健康临床护理中，目标是改善 精神疾病的获取、诊断和治疗。DMHT带来了新的伦理挑战 因为(1)DMHT的使用扰乱了传统的框架，例如医生-患者二联体，用于 解决精神卫生保健中的道德义务和挑战；(2)DMHT将有助于 创建新的和海量的行为数据和风险类别，特别是在 与其他技术相结合，如WGS，这可能对临床医生和患者来说很难 评估和有意义地使用；以及3)将创建行为健康数据并在外部使用 保护健康数据隐私的框架，并可能被视为监视 被病人。该项目的目标是：(1)检查关键利益攸关方-DMHT 开发人员、临床医生和患者-概念化和操作化伦理、法律和社会 DMHT转化为治疗心境和精神病的临床护理的意义 (2)采用定性和定量的方法对临床医生进行访谈和调查， 使用DMHT检查其伦理、法律和社会影响的患者和消费者 技术，特别是与信任、隐私、数据保护和管理有关的技术，以及 监测；以及(3)提供对开发人员、患者和临床医生如何 感知和管理DMHT的伦理、法律和社会影响，这可用作 为进一步研究奠定基础，并为合乎道德和安全地使用数字提供指导 精神卫生保健中的技术。贺龙-项目的短期目标是：1)开展研究 探索数字健康技术在精神疾病中的伦理、法律和社会影响的计划 医疗保健及其对医疗保健伦理框架的潜在影响；2)产生经验性 促进对数字的伦理、法律和社会影响的理解的研究 卫生技术；以及3)提高对使用 DMHT为在研究中使用数字卫生技术提供指导方针和社会政策， 临床和社区环境。

项目成果

Ethical Development of Digital Phenotyping Tools for Mental Health Applications: Delphi Study.

• DOI: 10.2196/27343
• 发表时间: 2021-07-28
• 期刊: JMIR mHealth and uHealth
• 影响因子: 5
• 作者: Martinez-Martin N;Greely HT;Cho MK
• 通讯作者: Cho MK

Bridging the AI Chasm: Can EBM Address Representation and Fairness in Clinical Machine Learning?

• DOI: 10.1080/15265161.2022.2055212
• 发表时间: 2022-05
• 期刊: AMERICAN JOURNAL OF BIOETHICS
• 影响因子: 13.4
• 作者: Martinez-Martin, Nicole;Cho, Mildred K.
• 通讯作者: Cho, Mildred K.

Ethical issues in using ambient intelligence in health-care settings.

• DOI: 10.1016/s2589-7500(20)30275-2
• 发表时间: 2021-03
• 期刊: The Lancet. Digital health
• 作者: Martinez-Martin N;Luo Z;Kaushal A;Adeli E;Haque A;Kelly SS;Wieten S;Cho MK;Magnus D;Fei-Fei L;Schulman K;Milstein A
• 通讯作者: Milstein A

Addressing COVID-19 Health Disparities & Latinidad.

• DOI: 10.1080/15265161.2020.1871115
• 发表时间: 2021-03
• 期刊: AMERICAN JOURNAL OF BIOETHICS
• 影响因子: 13.4
• 作者: Martinez-Martin, Nicole

Envisioning a Path toward Equitable and Effective Digital Mental Health.

• DOI: 10.1080/21507740.2022.2082597
• 发表时间: 2022-07
• 期刊: AJOB neuroscience