El derecho de la libertad de conciencia ante el empleo de terapias digitales para el cuidado de la salud

Abstract

The lack of efficacy of therapeutic treatments may sometimes be due to incorrect adherence to the intake guidelines. The highest rates of poor adherence have been observed in chronic patients, such as the elderly or psychiatric patients. Until now, there has not been an effective way to objectively know the patient's adherence rates, however, with the advancement of new technologies, now it is already possible to accurately know patient's behavior patterns. In 2017, the FDA approved the entry into the US market of the first digital pill: Abilify MyCite, indicated for psychiatric uses. This medicine has a built-in sensor, whose function is to track the intake of the pill by the patient. When the patient swallows the pill, it sends a signal to the patch patient wears attached to her torso, indicating what medication has been ingested, in what dose, and at what time. The patch also collects other patient health information, such as heart rate, activity, and rest. All the information collected by the patch is encrypted and sent via bluetooth to the patient's smartphone app, and from there, to the doctor's health portal. In this way, the professional knows in real time if the patient is following correctly the treatment and the effects of it. Although this sort of digital therapy favors progress towards personalized precision medicine, the use of technological devices for patient monitoring poses serious legal and ethical concerns. Within an increasingly digitalized clinical paradigm, trust -the basic value on which the doctor-patient relationship is based- is directly affected, since the possibility of voluntarily disclosing their information to the health professional no longer rests with the patient, but rather the health professional already knows all his patient information without depending on his report. Additionally, the traditional informed consent form will no longer be the only requirement for the legitimization of the professional intervention, but now, the patient must also provide another type of consent -the one from his condition as a consumer- which is the terms and conditions of use of the medical device to be used throughout the treatment. The main goal of this research is to analyse how the patient's right to the freedom of conscience is affected, since this right is the necessary foundation for their rights to privacy, to health information and to decide freely about their own health. Likewise, an in this research is also conducted the study about how this new digital paradigm affects the rights and duties approximation is also made to the affectation of the rights and duties incumbent on health professionals.