[Digital transformation in healthcare to strengthen patient autonomy]

Patient autonomy is regarded as a central ethical and health policy principle of modern healthcare delivery. Its practical implementation is gaining increasing importance in light of the rapidly advancing digital transformation of the healthcare system. Digital technologies are changing the conditions under which autonomy can be exercised and safeguarded. They alter access to information and orientation within healthcare settings, thereby influencing individual decision-making processes. Against this backdrop, a purely individualistic concept of autonomy proves insufficient. For the digitalization of healthcare to meaningfully strengthen patient autonomy, it must go beyond technical and organisational implementation and include a conceptual and structural engagement with autonomy. This gives rise to a political and socio-structural design mandate that goes far beyond the introduction of individual applications. A consistent commitment to an expanded understanding of autonomy places substantial demands on the development and integration of digital infrastructures. Digital solutions must function reliably, reflect societal diversity, enable participation and support orientation. Safeguarding informational and participatory self-determination additionally requires an interplay of targeted political governance, coherent regulation, technically robust interoperability and socially responsive structural conditions. The aim of this article is to examine these requirements in detail and to profile them, with regard to a patient-oriented design of digital infrastructures, as an emancipatory mandate for a patient-centered health care system.