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BMC Med Ethics. 2018 Mar 6;19(1):18. doi: 10.1186/s12910-018-0255-8.

Leaving patients to their own devices? Smart technology, safety and therapeutic relationships.

Ho A1,2,3, Quick O4.

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Centre for Applied Ethics, University of British Columbia, 227 - 6356 Agricultural Road, Vancouver, BC, V6T 1Z2, Canada.
Bioethics Program, University of California, San Francisco, San Francisco, USA.
Ethics Services, Providence Health Care, Vancouver, Canada.
University of Bristol Law School, Wills Memorial Building, Bristol, BS8 1RJ, UK.



This debate article explores how smart technologies may create a double-edged sword for patient safety and effective therapeutic relationships. Increasing utilization of health monitoring devices by patients will likely become an important aspect of self-care and preventive medicine. It may also help to enhance accurate symptom reports, diagnoses, and prompt referral to specialist care where appropriate. However, the development, marketing, and use of such technology raise significant ethical implications for therapeutic relationships and patient safety.


Drawing on lessons learned from other direct-to-consumer health products such as genetic testing, this article explores how smart technology can also pose regulatory challenges and encourage overutilization of healthcare services. In order for smart technology to promote safer care and effective therapeutic encounters, the technology and its utilization must be safe.


This article argues for unified regulatory guidelines and better education for both healthcare providers and patients regarding the benefits and risks of these devices.


Medical education; Medical ethics; Patient engagement; Patient safety; Professional regulation; Technology; Telemedicine

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