The Ethics of Smart Pills and Self-Acting Devices: Autonomy,Truth-Telling,and Trust at the Dawn of Digital Medicine

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care.     

Moral counselling: a method in development

This article describes a method of moral counselling developed in the Radboud University Medical Centre Nijmegen (The Netherlands). The authors apply insights of Paul Ricoeur to the non-directive counselling method of Carl Rogers in their work of coaching patients with moral problems in health care. The developed method was shared with other health care professionals in a training course. Experiences in the course and further practice led to further improvement of the method.     

A free, easy-to-use, computer-based simple and four-choice reaction time programme: the Deary-Liewald reaction time task

Reaction time tasks are used widely in basic and applied psychology. There is a need for an easy-to-use, freely available programme that can run simple and choice reaction time tasks with no special software. We report the development of, and make available, the Deary-Liewald reaction time task. It is initially tested here on 150 participants, aged from 18 to 80, alongside another widely used reaction time device and tests of fluid and crystallised intelligence and processing speed. The new task’s parameters perform as expected with respect to age and intelligence differences. The new task’s parameters are reliable, and have very high correlations with the existing task. We also provide instructions for downloading and using the new reaction time programme, and we encourage other researchers to use it.     

Correspondence

The American Journal of Psychoanalysis -     

Does energy expenditure affect the perception of egocentric distance? A failure to replicate experiment 1 of Proffitt, Stefanucci, Banton, and Epstein (2003)

In a series of recent studies, Proffitt and his colleagues have reported that the perceived distance to a target is influenced by the energy expenditure associated with any action, such as walking or throwing, for spanning the distance to the target. In particular, Proffitt, Stefanucci, Banton, and Epstein (2003) reported that wearing a heavy backpack caused verbal reports of distance to increase. We conducted a study to determine whether three responses dependent on perceived distance (verbal report of distance, blind walking, and estimates of object size) are influenced by the backpack manipulation. In two experiments, one involving a between-participants design and the other involving a within-participants design, we found that none of the three responses were influenced by the wearing of a heavy backpack.