Towards an ethics for telehealth

Botrugno, Carlo

doi:10.1177/0969733017705004

Cited by 34 publications

(32 citation statements)

References 30 publications

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“…In addition, it may be more challenging to create a trusting relationship remotely than in person [8], and a caring touch, which patients in need of palliative care may appreciate [2], is impossible with remote contact. Some found that it may not be appropriate to discuss serious diagnoses or end-of-life issues via video because of the lack of physical closeness [60,61], whereas others found that the lack of physical closeness helped them address difficult issues with health care professionals. Consequently, health care professionals need to distinguish the appropriateness of using telehealth for communication and, in turn, individually tailor patient care [56,57].…”

Section: Principal Findingsmentioning

confidence: 99%

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Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review

Steindal¹,

Nes²,

Godskesen³

et al. 2020

J Med Internet Res

153

192

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Background Telehealth is increasingly being used in home care and could be one measure to support the needs of home-based patients receiving palliative care. However, no previous scoping review has mapped existing studies on the use of telehealth for patients in palliative home care. Objective The aim of this study was to map and assess published studies on the use of telehealth for patients in palliative home care. Methods A scoping review was conducted using the methodological framework of Arksey and O’Malley. Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic and comprehensive search of Medical Literature Analysis and Retrieval System Online, EMBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health was performed for studies published between January 2000 and October 2018. Two authors independently assessed eligibility and extracted data. Results The review included 22 papers from 19 studies. Four thematic groupings were identified among the included papers: easy and effortless use of telehealth regardless of the current health condition, visual features that enhance communication and care via telehealth, symptom management and self-management promotion by telehealth, and perceptions of improved palliative care at home. Conclusions The use of telehealth in palliative home care seems to be feasible, improving access to health care professionals at home and enhancing feelings of security and safety. The visual features of telehealth seem to allow a genuine relationship with health care professionals. However, there are contradicting results on whether the use of telehealth improves burdensome symptoms and quality of life. Future research should investigate the experiences of using telehealth among patients with life-limiting illness other than cancer and patients aged 85 years or older. More research is needed to increase the body of knowledge regarding the effectiveness of telehealth on symptoms and quality of life.

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Section: Principal Findingsmentioning

confidence: 99%

“…Notably, few studies included the oldest-old patients, although this population increases continuously and also lives longer with life-limiting illness because of improvement in treatments [61,73]. There may be challenges to including the oldest-old patients in telehealth research.…”

Section: Principal Findingsmentioning

confidence: 99%

Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review

Steindal¹,

Nes²,

Godskesen³

et al. 2020

J Med Internet Res

153

192

View full text Add to dashboard Cite

show abstract

“…Its applications include, but are not restricted to, real-time health consultations from a distance, remote health data collection, analysis, interpretation, and monitoring, and digital interactions with health assistants, including virtual ones (7). Accordingly, these subjects have deserved particular ethical, legal and scholar attention in recent years (7,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Digital Technologies and Data Science as Health Enablers: An Outline of Appealing Promises and Compelling Ethical, Legal, and Social Challenges

Cordeiro

2021

Front. Med.

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Digital technologies and data science have laid down the promise to revolutionize healthcare by transforming the way health and disease are analyzed and managed in the future. Digital health applications in healthcare include telemedicine, electronic health records, wearable, implantable, injectable and ingestible digital medical devices, health mobile apps as well as the application of artificial intelligence and machine learning algorithms to medical and public health prognosis and decision-making. As is often the case with technological advancement, progress in digital health raises compelling ethical, legal, and social implications (ELSI). This article aims to succinctly map relevant ELSI of the digital health field. The issues of patient autonomy; assessment, value attribution, and validation of health innovation; equity and trustworthiness in healthcare; professional roles and skills and data protection and security are highlighted against the backdrop of the risks of dehumanization of care, the limitations of machine learning-based decision-making and, ultimately, the future contours of human interaction in medicine and public health. The running theme to this article is the underlying tension between the promises of digital health and its many challenges, which is heightened by the contrasting pace of scientific progress and the timed responses provided by law and ethics. Digital applications can prove to be valuable allies for human skills in medicine and public health. Similarly, ethics and the law can be interpreted and perceived as more than obstacles, but also promoters of fairness, inclusiveness, creativity and innovation in health.

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“…Models should be evaluated, not just in terms of resource allocation but also in relation to "the principle of human value" as well as any current legislation against discrimination [19]. Botrugno [44], in discussing the argument for telehealth to underpin greater distributive justice in health care, advises against accepting "technological determinism," arguing instead for a "plan of analysis through which to critically assess the implications of telehealth" [44].…”

Section: Justicementioning

confidence: 99%

The Value of Applying Ethical Principles in Telehealth Practices: Systematic Review

Keenan¹,

Tsourtos²,

Tieman³

2021

J Med Internet Res

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Background As the use of technology to deliver health services is increasing rapidly and has further intensified during the COVID-19 pandemic, these initiatives may fail if ethical impacts are not fully identified and acted upon by practitioners. Ignoring the ethical impacts of information and communication technology health service delivery creates an unintended risk for patients and can lead to reduced effectiveness, noncompliance, and harm, undermining the best intentions of governments and clinicians. Objective Our aim was to explore how ethical considerations or impacts may be different, greater, or more variable in information and communication technology methods versus face-to-face health care delivery models, and how they may be applied in practice. Methods We undertook a systemic literature review to provide a critical overview of existing research into the incorporation of ethical principles into telehealth practice. Six databases were searched between March 2016 to May 2016 and again in December 2020 to provide the benefit of currency. A combination of broad terms (“ethics,” “ethical,” “health,” and “care”) with the restrictive terms of “telehealth” and “telemedicine” was used in keyword searches. Thematic analysis and synthesis of each paper was conducted, aligned to the framework developed by Beauchamp and Childress. Results From the 49 papers reviewed, authors identified or discussed the following ethical principles in relation to telehealth practice: autonomy (69% of authors, 34/49), professional–patient relationship (53% of authors, 26/49), nonmaleficence (41% of authors, 20/49), beneficence (39%, of authors, 19/49), and justice (39% of authors, 19/49). Conclusions Although a small number of studies identified ethical issues associated with telehealth practice and discussed their potential impact on service quality and effectiveness, there is limited research on how ethical principles are incorporated into clinical practice. Several studies proposed frameworks, codes of conduct, or guidelines, but there was little discussion or evidence of how these recommendations are being used to improve ethical telehealth practice.

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Towards an ethics for telehealth

Cited by 34 publications

References 30 publications

Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review

Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review

Digital Technologies and Data Science as Health Enablers: An Outline of Appealing Promises and Compelling Ethical, Legal, and Social Challenges

The Value of Applying Ethical Principles in Telehealth Practices: Systematic Review

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