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: 10004167
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004167
• 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 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; 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）-数字设备（智能手机，传感器），可以 监测和收集患者的个人数据（跟踪位置/语音/运动，自我报告）， 算法和机器学习（“ML”），以生成和整合健康和风险信息 (from基因组学/家族史），甚至中介护理（监测治疗依从性或 聊天机器人疗法）-正在被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提出了新的伦理挑战 因为（1）DMHT的使用破坏了传统的框架，如医生-患者二元关系， 解决精神卫生保健中的道德义务和挑战;（2）DMHT将有助于 创造新的和大量的行为数据和风险类别，特别是当 结合其他技术，如WGS，这可能是困难的临床医生和患者 评估和有意义地使用; 3）行为健康数据将在外部创建和使用 保护健康数据隐私的框架，并可能被视为监督 被病人。该项目的目标是：（1）研究关键利益相关者- DMHT 开发人员、临床医生和患者-概念化和操作化伦理的、法律的和社会的 DMHT的含义，因为它被转化为治疗情绪和精神病的临床护理 疾病;和（2）使用定性和定量方法采访和调查临床医生， 使用DMHT的患者和消费者，以检查以下方面的伦理、法律的和社会影响： 技术，特别是与信任、隐私、数据保护和管理有关的技术，以及 监督;（3）提供更好的理解，开发人员，患者和临床医生如何 理解和管理DMHT的伦理、法律的和社会影响，可用作 为进一步研究奠定基础，并为道德和安全使用数字技术提供指导。 精神卫生保健技术。该项目的长期目标是：1）开展研究 探索数字健康技术在精神疾病中的伦理，法律的和社会影响的计划 医疗保健和对医疗保健伦理框架的潜在影响; 2）产生经验 提高对数字化的伦理、法律的和社会影响的理解的研究 卫生技术;和3）提高对使用中涉及的伦理问题的理解 DMHT为在研究中使用数字健康技术提供指导方针和社会政策， 临床和社区环境。