院外心脏骤停是一个主要的健康问题,立即治疗对于提高生存机会至关重要。检测院外心脏骤停和警报紧急响应者的技术解决方案的发展正在获得动力;多个研究联盟目前正在为此目的开发可穿戴技术。对于这项技术的负责设计和实现,有必要注意道德含义。这篇综述根据医学伦理学的4项关键原则,确定了基于可穿戴式院外心脏骤停检测的相关伦理方面。首先,与受益相关的方面与技术的有效性有关。第二,非恶意治疗需要防止与佩戴该装置相关的心理困扰,并引发对筛查是否可取的质疑。第三,以自治为基础的是赋权,从连续收集的数据中进行潜在的重新识别,数据访问问题,旁观者隐私,知情同意。最后,正义问题包括算法偏见和不平等技术获取的风险。基于此概述和相关立法,我们制定设计建议。我们建议关键要素是设备的准确性和可靠性,动态同意,目的限制,和个性化。需要对利益相关者的观点进行进一步的实证研究,包括有院外心脏骤停风险的人和他们的近亲,实现这项技术在社会中的成功和道德平衡的整合。
Out-of-hospital cardiac arrest is a major health problem, and immediate treatment is essential for improving the chances of survival. The development of technological solutions to detect out-of-hospital cardiac arrest and alert emergency responders is gaining momentum; multiple research consortia are currently developing wearable technology for this purpose. For the responsible design and implementation of this technology, it is necessary to attend to the ethical implications. This review identifies relevant ethical aspects of wearable-based out-of-hospital cardiac arrest detection according to 4 key principles of medical ethics. First, aspects related to
beneficence are related to the effectiveness of the technology. Second, nonmaleficence requires preventing psychological distress associated with wearing the device and raises questions about the desirability of screening. Third, grounded in autonomy are empowerment, the potential reidentification from continuously collected data, issues of data access, bystander privacy, and informed consent. Finally, justice concerns include the risks of algorithmic bias and unequal technology access. Based on this overview and relevant legislation, we formulate design recommendations. We suggest that key elements are device accuracy and reliability, dynamic consent, purpose limitation, and personalization. Further empirical research is needed into the perspectives of stakeholders, including people at risk of out-of-hospital cardiac arrest and their next-of-kin, to achieve a successful and ethically balanced integration of this technology in society.