Legal & Ethical Issues Regarding Telemedicine (10% Blog)

All over the internet and news stations ordinary people and experts alike are referring to telemedicine as a step in the right direction for the future health care. But, what many don’t recognize is that there are severe legal and ethical issues to consider before healthcare jumps at the opportunity of using patient-specialist telemedical technology to advance their medical practices.

“A more cynical view suggests that the increased use of technology raises patient expectations, which could result in additional malpractice claims” (LifeHealthpro 1996). “Questions related to physician licensing, credentialing, professional standards of care and even assessments of telemedicine technology systems need to be given primary focus to by the legal system” (LifeHealthpro 1996).

As of now, courts will continue applying some existing malpractice tests in telemedicine cases, which currently center on two key legal questions. First, it must be determined that a doctor-patient relationship existed because viewing a patient's medical records could conceivably be interpreted as an informal consultation between two colleagues or the establishment of a formal doctor-patient relationship. The second existing test for a malpractice case involves determining whether the physician breached his or her duty of care. The legal system presently relies on professional standards to determine appropriate care levels in malpractice cases.

                        - LifeHealthpro 1996

According LifeHealthpro Journal, medical licenses stop at the state line which raises the question of whether physicians participating in telemedicine programs may legally practice medicine beyond their centered hospital location. So, is practicing healthcare outside North American borders through ICT considered breaking the law? There are also security issues to consider regarding patient medical history/ records private from other patients and others who don’t have the right to look through those records (1996).

An associate lecturer and researcher at Cardiff University, Ben Stanberry also points out the fact there are ethical issues factored in to the care of patients who are under the age of majority (18 in many countries worldwide). He writes that the patients can consent to something the doctor feels necessary to do on the other side of the ICT (an X-ray/MRI that needs to be taken so that he can give the right diagnosis, for instance). However, according to Stanberry, the patient doesn’t have the power to decide to refuse the doctor’s recommendation if his/her parent/guardian gives consent to the doctor to proceed with whatever the doctor said. For example, if the under-aged patient felt that s/he didn’t need the X-ray/ MRI done that the doctor requested this doctor will likely follow through and take the X-ray anyway because the patient doesn’t yet have authority to counteract his/her parent’s decision. This creates ethical issues, according Stanberry, because what if the under-aged person was right in that s/he didn’t need the X-ray/ MRI done, and it was a waste of the doctor’s time (and the government’s money). What if the parent’s consent to proceed with the doctor’s recommendation was the wrong course of action and the child had a simple illness that wouldn’t show on an X-ray scan.

Attorney, Michael Cohen comments that there are other legal issues to watch out for when practicing telemedicine because there are different laws passed regarding the use of telemedicine even between nearby states in one country, such as the U.S. This is especially true when considering to practice telemedicine outside North American borders. He also clears up the LifeHealthpro journals’ concern about patient expectations. Cohen says that sometimes doctors really* do* need the face-to-face interaction between the patient and the doctor himself to diagnose the illness correctly. With the advanced technology comes the patients’ assumption that the doctor is smart enough take one look at the patient through the video conferencing system and diagnose him/her in one second. This assumption is incorrect though because it’s impossible for the doctor to diagnose that fast. He needs to communicate the patients’ medical information with his colleagues and other specialists before diagnosing the patient.

References

Attorney Michael H. Cohen: Telemedicine Legal Issues. (2012, March 13). Retrieved November 14, 2015, from https://www.youtube.com/watch?v=Fyp5djOSYjU

Stanberry, B. (2006). Legal and ethical aspects of telemedicine. *J Telemed Telecare Journal of Telemedicine and Telecare, *166-175. Retrieved November 14, 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1296966/pdf/jrsocmed00019-0053.pdf

Telemedicine May Spawn Long-Distance Lawsuits. (1996, November 4). Retrieved November 14, 2015, from http://www.lifehealthpro.com/1996/11/04/telemedicine-may-spawn-longdistance-lawsuits