Medicine, Health Care and Philosophy

, Volume 22, Issue 4, pp 623–630 | Cite as

Mobile health ethics and the expanding role of autonomy

  • Bettina SchmietowEmail author
  • Georg Marckmann
Scientific Contribution


Mhealth technology is mushrooming world-wide and, in a variety of forms, reaches increasing numbers of users in ever-widening contexts and virtually independent from standard medical evidence assessment. Yet, debate on the broader societal impact including in particular mapping and classification of ethical issues raised has been limited. This article, as part of an ongoing empirically informed ethical research project, provides an overview of ethical issues of mhealth applications with a specific focus on implications on autonomy as a key notion in the debate. A multi-stage model of references to the potential of mhealth use for strengthening some or other form of self-determination will be proposed as a descriptive tool. It illustrates an assumed continuum of enhanced autonomy via mhealth broadly conceived: from patient to user autonomy, to improved health literacy, and finally to the vision of supra-individual empowerment and democratised, participatory health and medicine as a whole. On closer examination, however, these references are frequently ambivalent or vague, perpetuating the at times uncritical use of established autonomy concepts in medical ethics. The article suggests zooming in on the range of autonomy-related aspects against the backdrop of digital innovation and datafied health more generally, and on this basis add to existing frameworks for the ethical evaluation of mhealth more specifically.


Mhealth Ethics Datafication Autonomy Empowerment Democratisation 



This article is part of the research project “Medicine 4.0—the ethical basis of digitalised healthcare” funded by the German Ministry of Health.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Institute of Ethics, History and Theory of MedicineLudwig-Maximilians-Universität MünchenMunichGermany

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