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 监视和收集患者的个人数据（跟踪位置/语音/运动，自我报告），申请 算法和机器学习（“ ML”）以生成和整合健康和风险信息 （源自基因组学/家族史），甚至调解护理（监测治疗依从性或 聊天机器人疗法） - 正在整合到心理健康临床护理中，目的是改善 访问，诊断和精神疾病治疗。 DMHT面临新颖的道德挑战 因为（1）使用DMHT会破坏传统框架，例如物理患者二元组 解决心理保健中的道德义务和挑战； （2）DMHT将为 创建新颖和大量的行为数据和风险类别，尤其是在 结合其他技术（例如WGS），对于临床医生和患者来说可能很难 评估和有意义地使用； 3）将创建和在外面创建和使用行为健康数据 保护健康数据隐私的框架，可能会作为监视经历 由患者。该项目的目标是：（1）检查主要利益相关者如何-DMHT 开发人员，临床医生和患者 - 概念化和运营道德，法律和社会 DMHT的含义将其转化为临床护理，以治疗情绪和精神病 疾病； （2）使用定性和定量方法面试和调查临床医生， 使用DMHT检查道德，法律和社会影响的患者和消费者 该技术，特别是与信任，隐私，数据保护和管理有关的技术，以及 监视; （3）对开发人员，患者和临床医生的方式提供了改进的理解 DMHT的感知和管理道德，法律和社会含义，可以用作 进一步研究的基础，并为数字化的道德和安全使用提供指导 心理保健技术。该项目的长期目标是：1） 计划探讨了数字健康技术在心理中的道德，法律和社会影响 医疗保健以及对医疗保健道德框架的潜在影响； 2）产生经验 提高对道德，法律和社会的理解的研究，数字的影响 卫生技术； 3）提高对使用中涉及的道德问题的理解 DMHT为在研究中使用数字卫生技术的指南和社会政策提供信息， 临床和社区环境。