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---
title: "Wiki Entry Template"
subtitle: "BA New Media / Online Communication KF/BF A: Spring Term 2023"
author: "Maren Ehret"
categories:
- "Media Psychology"
- "Digital Media"
- "Well Being"
- "Digital Healthcare"
- Paper: Schmietow, B. & Marckmann, G. (2019). Mobile health ethics and the expanding role of autonomy. Medicine, health care, and philosophy, 22(4), 623–630.
---

Key Quote: "Autonomous, empowered individuals taking care proactively of their health are pictured as the creators of this vision for future
healthcare, and may at the same time redefne their role in relation to the traditional, expert-driven healthcare system." (Schmietow & Marckmann, 2019)

Main Argument: The article by Schmietow and Marckmann is part of a larger project in the debate about ethical issues of digital healthcare and focuses
on the role of autonomy regarding new digital health applications. With the growing of various mobile health (mhealth) technologies, a lot of ethical questions as well as questions about the user/patient's autonomy continue to arise. Schmietow and Marckmann argue that mhealth strengthens and empowers
their independancy in making decisions about their own health. They continue to explain how more autonomy and self-determination can benefit and support
self-care and finally create a form of democratised medecine. However, they do highlight the imortance of digital and health literacy.

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Do you think the aspects mentioned here can have an influence on individuals' autonomy need experiences? If yes, how so? If no, why not?

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Based on the definition of autonomy need experience by Vansteenkiste, I think that more independance concerning one's health decisions has an influence on their autonomy need experience. People start acting by themselves without having to follow direct directions by doctors in real life. They get to participate in their own treatment and can discuss it with health caretakers. This form of democratised medecine could certainly satisfy their volition and willingness in their actions. However if they fail or their knowledge ends at some point, they might in fact need speicif help from more experienced individuals and can therefore experience pressure and inner conflict which emerge from unsatisfied autonomy need experiences.

Relationship: Unfortunatley this research area, espacially the role of autonomy in mheath, is still very vague. However Meskó et al. explain the importance
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What do you mean when you say that it is vague? How could it be made more explicit?

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With all the research I have found on the topic digital healthcare and autonomy, most of the papers based their main arguments on the ideas of other research papers. I saw very few studies that have developped and tried out actual methods to explain the role of autonomy in mhealth. There is still need of a lot more studying with larger samples.

of physicians charing knowledge and responsibility with patients (Meskó et al., 2017). Digital health is a team work because it involves patients more and allows them to participate in their own healthcare. The paper reflects the afore mentioned idea of democratised medecine.
Another important work which relates to the chosen article is that about autonomy in self-determination theory by Arvanitis and Kalliris. It is a good base
to understand the importance of the role of autonomy in digital healthcare as it gives a lot of theoratical and ethical background on autonomy and self-determination. (Arvanitis and Kalliris, 2023).

Questions:
1. Further research should explore if a full democratisation of healthcare is possible and whether it is a benefit to give patients that much autonomy.
2. How can the patient's understanding about risks, benefits and limitations of mhealth be ensured?

Summary:
In their article, Schmietow and Marckmann focus on the correlation between digital healthcare (mhealth) and autonomy. Mhealth is the growing use of technological devices such as smartphones for healthcare purposes. Some applications are already on the market and as individuals become increasingly interested in the idea of monitoring their health and making their own decisions about it, many questions concerning ethics and the role of autonomy arise. The authors state that using digital media as a way of healthcare increases digital autonomy as the user/patients become more independent and actively take part in the “traditional, expert-driven healthcare system” (Schmietow & Marckmann, 2019). Through communication with physicians and other patients, they get empowered and encouraged in their decision-making.
However Schmietow and Marckmann emphasize the issues concerning digital health. They point out that people may not possess enough health-related knowledge to reasonably use digital health technologies and make the right decisions. Indeed promoting and respecting the patient autonomy is difficult as the individuals will have to be well informed about all information and give consent to share private information. Transparency is a key part in mhealth and the related digital autonomy.
To connect mhealth use and autonomy need experiences, a theoretical mechanism is not directly mentioned. Nonetheless, Schmietow and Marckmann highlight the fact, that getting more autonomy in the own health-decisions results in more self-control and self-determination which are part of the IM3UNE-model by Schneider et al. This assumes that positive effects of the SOC facets lead to a satisfaction of needs and therefore well-being, the main goal of digital healthcare.
As the research in this area is still ongoing and with the article being part of an ongoing empirically informed ethical research project, it is not yet clear how exactly the relationship between digital autonomy and digital healthcare is studied empirically.