ABSTRACT
We and our patients are immersed in a mediascape that is unparalleled in history. It is a force of monumental proportion that for many youth competes with and has replaced parental, social, and cultural influences on their development. The ethical questions regarding this dynamic are frequently answered by little else than the application of vague and dated moral dictums based on "old media." To engender a comprehensive understanding of how "new media" interacts with our patients, we suggest a new perspective on the differentiation of old media from new media. Then, using our conceptual model of new media, we break down the ethical questions into the several overlapping ethical areas, these being media, professional, and bioethical. To aid in the application of the system of thought we provide a structured system of ethical analysis. Through these, we hope that this issue can be looked at with increased clarity and guidance within a framework for future thought.
Subject(s)
Adolescent Psychiatry/ethics , Child Psychiatry/ethics , Ethics, Medical , Internet/ethics , Mass Media/ethics , Adolescent , Child , Codes of Ethics , Confidentiality , Humans , Physician's Role , Professional-Family Relations , Psychotherapy/ethics , Social Change , United StatesABSTRACT
The following is a case report of a 15-year-old adolescent who was evaluated and treated via telepsychiatry as part of an ongoing project at the University of Michigan Health System and the Hiawatha Community Mental Health Center in Michigan. In addition to clinical information, prospective quantitative data was collected at baseline, 6 weeks, and 3 months. Measures included the Youth Self Report (YSR), Child Behavior Checklist (CBCL), Suicide Probability Scale (SPS), Reynold's Adolescent Depression Scale (RADS), Connor's Global Index-Parent Version (CGI-P), and the Children's Global Assessment Scale (CGAS). Prior to the telepsychiatry intervention, the patient was diagnosed as having bipolar disorder with psychosis. During the telepsychiatry intervention, the diagnosis was altered to a posttraumatic stress disorder; medications were discontinued and the patient improved. All scales showed reductions in severity of symptoms after the telepsychiatry interventions. This case represents the first application of adolescent telepsychiatry for the diagnosis, treatment, and tracking of clinical symptoms.
