What Ethics for Telemedicine?

Loute, Alain; Cobbaut, Jean-Philippe

doi:10.1057/978-1-349-95173-4_22

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…The potential for harm is more prevalent, however, and include telehealth equipment such as videophones situated in the home causing shame or embarrassment; the possibility that professional carers may choose telehealth over delivering care in person in difficult or high needs cases may put clients at risk; or an ‘undue burden’ may be imposed on unwell or frail patients who find the technology intrusive or do not fully understand it's use. 6 , 13 – 28 Beneficence is discussed in relation to telehealth having the potential to benefit people by providing assurance, increasing an individual's confidence in managing their health and reducing the dependence on professional carers or family. 13 – 15 , 19 , 22 , 23 , 25 , 26 , 29 , 30 …”

Section: Introductionmentioning

confidence: 99%

Promise and peril-defining ethical telehealth practice from the clinician and patient perspective: A qualitative study

2022

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Objectives We undertook a qualitative study to examine and compare the experience of ethical principles by telehealth practitioners and patients in relation to service delivery theory. The study was conducted prior to and during the recent global increase in the use of telehealth services due to the COVID-19 pandemic, Methods We conducted semi-structured interviews with 20 telehealth practitioners and patients using constructionist grounded theory methods to collect and analyse data. Twenty-five axial coded data categories were then unified and aligned through selective coding with the Beauchamp and Childress (2013) framework of biomedical ethics. The groups were then compared. Results Thirteen categories aligned to the ethical framework were identified for practitioners and 12 for patients. Variance existed between the groups. Practitioner results were non-maleficence 4/13 or (31%), beneficence 4/13 (31%), professional–patient relationships 3/12 (22%), autonomy 1/13 (8%) and justice 1/13 (8%). Patient data results were non-maleficence 4/12 (33%), professional–patient relationships 3/12 (33%), autonomy 2/12 (18%), beneficence 1/12 (8%) and justice 1/12 (8%). Conclusions Ethical principles are experienced differently between telehealth practitioners and patients. These differences can impact the quality and safety of care. Practitioners feel telehealth provides better care overall than patients do. Patients felt telehealth may force a greater share of costs and burdens onto them and reduce equity. Both patients and practitioners felt telehealth can be more harmful than face-to-face service delivery when it creates new or increased risk of harms. Building sufficient trust and mutual understanding are equally important to patients as privacy and confidentiality.

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Section: Introductionmentioning

confidence: 99%

Promise and peril-defining ethical telehealth practice from the clinician and patient perspective: A qualitative study

2022

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“…The ethical considerations in ICT methods may be different, greater, or more variable as compared to face-to-face care models. The “major polarities of the medical practice,” including “respect for the patient, health-care quality and humaneness, as well as aiming at matching the needs of the whole population equitably” [ 3 ] are complicated by concerns about patient autonomy, the altered nature of the professional–patient relationship, the lack of the human touch in care, and the medicalization of the home environment [ 3 , 4 ]. Ignoring ethical impacts of ICT health service delivery creates unintended risk for patients and can lead to reduced effectiveness, noncompliance, and harm, undermining the best intentions of governments and clinicians [ 5 , 6 ].…”

Section: Introductionmentioning

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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“…The ethical considerations in ICT methods may be different, greater, or more variable as compared to face-to-face care models. The "major polarities of the medical practice," including "respect for the patient, health-care quality and humaneness, as well as aiming at matching the needs of the whole population equitably" [3] are complicated by concerns about patient autonomy, the altered nature of the professional-patient relationship, the lack of the human touch in care, and the medicalization of the home environment [3,4]. Ignoring ethical impacts of ICT health service delivery creates unintended risk for patients and can lead to reduced effectiveness, noncompliance, and harm, undermining the best intentions of governments and clinicians [5,6].…”

Section: Introductionmentioning

confidence: 99%

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

Keenan¹,

Tsourtos²,

Tieman³

2020

Preprint

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BACKGROUND We undertook a systemic literature review to provide a critical overview of existing research into the incorporation of ethical principles into telehealth practice. As the use of technology to deliver health services is increasing rapidly, these initiatives may fail if ethical impacts are not fully identified and acted upon by practitioners. Our objective was to explore how, in providing telehealth services to patients, applying ethical principles can improve patient experience, clinical care and effectiveness in practice, compared to not doing so. OBJECTIVE Our objective was to explore how, in providing telehealth services to patients, applying ethical principles can improve patient experience, clinical care and effectiveness in practice, compared to not doing so. METHODS The framework for the principles of health ethics applied by the researchers is provided by Beauchamp and Childress: autonomy, justice, beneficence, non-maleficent and the professional-patient relationship. Six databases of systematic reviews were searched between March 2016 to May 2016. A combination of broad terms (“ethics, ethical, health and care”) with the restrictive terms of “telehealth and telemedicine” was used in keyword searches. RESULTS Of the 39 papers that identified or discussed ethical principles that were included at the analysis stage autonomy presented the highest risk (72%), followed by the professional-patient relationship (41%), non-maleficence (36%), beneficence (33%), and justice (33%). CONCLUSIONS While a small number of studies identify 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 in clinical practice. Several studies proposed frameworks, codes of conduct, or guidelines, but there is little discussion or evidence of how these recommendations are being used to improve ethical telehealth practice.

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What Ethics for Telemedicine?

Cited by 3 publications

References 7 publications

Promise and peril-defining ethical telehealth practice from the clinician and patient perspective: A qualitative study

Promise and peril-defining ethical telehealth practice from the clinician and patient perspective: A qualitative study

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

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

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