The Digital Transformation in Healthcare as a Challenge for Autonomy and Trust in the Physician-Patient Interaction

Abstract

Medical care is generally carried out between two agents: the patient in need and the helping physician. However, this relationship and its values are permanently changing: paternalism emphasized the patient’s well-being; the contractualism and the shared decision-making model are based on their principles of patient autonomy. The digital transformation directly and radically influences the physician-patient relationship and its values. Very important issues of data protection and data autonomy are discussed. However, due to the radical and dramatic consequences of digitalization on the doctor-patient relationship, the principle of patient autonomy should not be forgotten as the overriding principle in professional ethics. In this context, evident deficits are overcome by recourse to concepts of trust and trustworthiness. First, the article discusses the chances and risks of digitalization for the physician-patient relationship. Second, it examines different successive waves that transformed the physician-patient relationship and its values. The insights of the research on trust illustrate how enormous and complex the challenge is to foster trust and autonomy in medical practice. The application of digital ICT also offers the opportunity to address this challenge more intensively again. Trust-based patient autonomy is the fundamental normative criterion for the use of digital technology.