Health Ethics and Telehealth: Addressing the Challenges
When treating patients, providers must be mindful of health ethics. Health ethics refers to the careful and ongoing consideration of practicing medicine in a mindful and ethical way. This includes striving to ensure that providers practice medicine in a way that promotes respect for persons, beneficence, justice, unity, and solidarity. These are core principles of health ethics specifically highlighted by the World Health Organization (WHO).
Health ethics, like most studies of ethics, is a deceptively simple topic. There are a wide variety of healthcare decisions that are not simple to make. When making complicated decisions, providers and healthcare professionals are guided by health ethics. They are often discussed in relation to patient choice, informed consent, end-of-life care, and a myriad of other healthcare topics. Because telehealth is a rapidly growing and increasing prevalent aspect of the healthcare landscape, it too has become part of the discussion of ethics surrounding healthcare in recent years.
Telehealth and Health Ethics
Many ethical discussions that must be considered when practicing in-person medicine also apply to telehealth. Though it is being delivered in a different form, telehealth is still healthcare – any ethical dilemmas or considerations that exist while seeing patients in person must be considered when treating patients via telehealth.
Additionally, there are some ethical considerations that are unique to telehealth. Because a different tool is being used to deliver healthcare, there are certain limitations that will exist. Patients should be aware of these limitations and be able to choose the type of care that is best suited for them. At the crux of this is ensuring that patients are giving informed consent for the treatment that they’re receiving. Patients who are being treated via telehealth should know what that entails and should know if there are significant differences, either in treatment or in the outcome, between telehealth and in-person care.
Patient and Provider Challenges
When receiving care via telehealth, there are a number of ethical concerns that a patient may have. Patients may have concerns surrounding privacy and the confidentiality of their information. It is ethical, as well as legally required, to ensure that patient information is kept confidential. However, when practicing telehealth, there may be a greater risk that patient data may be intercepted. Additionally, patients may have concerns about transparency in their care – because some patients may be limited by a lack of digital literacy or comfort with technology, they may have a less comprehensive understanding of their health and will have difficulty making informed healthcare decisions.
Providers may also face ethical challenges when providing telehealth to their patients. While the vast majority of telehealth provides a similar experience to in-person healthcare, there are limitations – such as the lack of ability to physically examine a patient – that can potentially lead to ethical provider pitfalls such as misdiagnosis. While there are procedures in place for addressing misdiagnosis, there are no procedures specific to telehealth. Providers who are comfortable and experienced with telehealth may find little difference between a virtual visit and an in-person visit, but providers with less experience or training may find themselves providing less effective care via telehealth. It is up to a provider to determine their comfort level with telehealth and to determine if they can provide responsible and ethically-appropriate care.
Ethically speaking, it must be considered whether or not the benefits of telehealth outweigh the possible risks. It has been widely accepted that the ethical benefits of telehealth, such as greater access, increased equity, and informed patient choice, do outweigh this and other risks. Regardless, providers and health professionals should be mindful of ethical risks that exist and address new ones as they arise with diligence and careful consideration.
Considering Future Ethical Implications
As telehealth continues to develop and to increase in prevalence, careful consideration must be taken to ensure that telehealth is being practiced in an ethical way. Additional ethical complications may arise that are unique to telehealth, particularly when considering emerging technology such as artificial intelligence. Providers should strive to provide ethical care to their patients and consider how best to utilize all aspects of telehealth to provide care in the most effective and ethical way.
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