Ethische Herausforderungen einer Telepsychiatrie

Zusammenfassung

Die Telepsychiatrie verlagert den Fokus von Psychiatrie und Psychotherapie von persönlicher Interaktion und Beziehungsaufbau auf eine Kommunikation mit technologischen Mediatoren in Form von Telekommunikation, virtueller Realität (VR), sozialen Robotern oder Künstlichen Intelligenzen (KI). Dieser Artikel diskutiert Chancen und Risiken neuer Technologien in der psychiatrischen Behandlung unter Berücksichtigung medizinethischer Aspekte. Telepsychiatrische Behandlungen können die Selbstbestimmung im häuslichen Umfeld entgegen einer Institutionalisierung fördern, bergen jedoch das Risiko unkontrollierter Datenweitergabe. Als potenzielle Nachteile können soziale Isolation, negative Auswirkungen auf die Arzt-Patienten-Beziehung und langfristige Veränderungen des Patientenverhaltens durch z. B. VR genannt werden. Bezüglich Gerechtigkeit könnten demografische und psychopathologische Faktoren einen ungleichen Zugang zur Telepsychiatrie bedingen, mit fraglichen Nachhaltigkeitseffekten. Durch die Anonymität der Telepsychiatrie droht eine Entfremdung, während moralische Abwägungen vorerst nicht durch KI ersetzt werden können. Die Fürsorgepflicht verpflichtet zur sorgfältigen Nutzen-Risiko-Abwägung neuer Technologien, besonders in ländlichen Regionen zur Versorgungsoptimierung.Gerade aufgrund ethischer Bedenken ist weitere intensive Forschung für eine Nutzen-Risiko-Abwägung notwendig. Die Entwicklung telepsychiatrischer Systeme erfordert transdisziplinäre Kooperationen. Auf gesellschaftlicher Ebene sollte der Stellenwert von Technologien als Ergänzung oder Ersatz für die Arzt-Patienten-Beziehung diskutiert werden.

Abstract

Telepsychiatry is shifting the focus of psychiatry and psychotherapy from personal interaction and relationship building to communication with technological mediators in the form of telecommunication, virtual reality (VR), social robots or artificial intelligence (AI). This article discusses the opportunities and risks of new technologies in psychiatric treatment, taking into account the principles of medical ethics. Telepsychiatric treatments can promote self-determination in the home environment as opposed to institutionalisation but carry the risk of uncontrolled data sharing. They harbour risks of potential harm such as social isolation, negative effects on the doctor-patient relationship and long-term changes in patient behaviour through, for example, VR. In terms of justice, demographic and psychopathological factors could result in unequal access to telepsychiatry, with questionable sustainability effects. The anonymity of telepsychiatry threatens alienation, while moral considerations cannot be replaced by AI for the time being. It is obligatory to carefully weigh up the benefits and risks of telepsychiatry, but especially in rural areas they could optimise care.Precisely because of ethical concerns, further intensive research is necessary to weigh up the risks and benefits. The development of telepsychiatric systems requires transdisciplinary co-operation. At a societal level, the significance of technologies as a supplement or replacement for the doctor-patient relationship needs to be discussed.

Schlüsselwörter

Künstliche Intelligenz - Arzt-Patienten-Beziehung - Telemedizin - Virtuelle Realität - Medizinethik

Keywords

Artificial Intelligence - doctor-patient relationship - telemedicine - virtual reality - medical ethics

Publication History

Received: 18 November 2023

Accepted after revision: 22 October 2024

Article published online:
13 November 2024

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