Ethical Aspects of Internet- and Mobile-Based Interventions (IMIs) for Substance Abuse Disorders

Purpose Internet- and mobile-based interventions (IMIs) are widely used for substance abuse disorders. There is extensive evidence for the efficiency of IMIs. However, there is a lack of research concerning the specific ethical aspects of using IMIs for substance abuse disorders. To the best of our knowledge, our paper is the first detailed ethical analysis of IMIs in addiction treatment. Our analysis is based on normative aspects specific for the treatment of substance abuse disorders, especially stigmatization of patients, the blaming of patients and assumptions of guilt as well as self-responsibility, the lack of acceptance of the concept of addiction as illness and the resulting deprectiation of patients as well as their discrimination. Methods Our methodological instrument is the 3 ACEs-approach by Thornicroft and Tansella. This instrument facilitates a detailed ethical analysis of using IMIs in individual cases as well as implementing IMIs in the mental health sector. Results Our analysis shows that IMIs may empower patient autonomy, avoid stigmatization, and facilitate a low-threshold access to mental health services. Critical aspects are the fit of IMIs for specific patient groups and individual patients regarding their needs, the therapeutic responsibilities of service providers, data security, safety, and privacy, and the possibilities of connecting different service providers. Conclusions: A further implementation of IMIs in addiction treatment is preferable only when binding quality standards are created and the patient-oriented application based on individual patient characteristics is secured.