Ethical Issues Relating to Telemedicine

Abstract

There is the forward march of telemedicine in healthcare service. Telemedicine has previously been used when it is required to provide patients with access to healthcare or specialist treatment. However, due to the recent advancement of telecommunication technology, the applications of telemedicine have been becoming more extensive: it is not only used for providing access to medical treatment, but also for rendering medical treatment more effective and convenient for both doctors and patients. There are many pieces of irrefutable evidence demonstrating the benefits of telemedicine. This is especially the case in the situation of COVID-19 pandemic, whereby telemedicine becomes particularly prominent.  Notwithstanding, the applications of telemedicine could negatively affect a doctor-patient relationship. Also, the regulations on telemedicine in Thailand could be considered, albeit adequate, incomprehensive when considering all possible uses of telemedicine in practice. This article therefore studies into ethical issues concerning telemedicine by analyzing the effects of telemedicine on a doctor-patient relationship, and then provides practical guidance for the healthcare providers who plan to use telemedicine as part of their service. Noting that the consideration of this article deals with an ethical aspect of telemedicine and is neither limited to certain types of treatment nor certain medical specialties.

This article starts with describing the meaning of telemedicine, and then categorizing the modalities of telemedicine by considering the extent to which telecommunication is applied to the provision of medical treatment. It then elaborates five ethical issues relating to telemedicine: the change in a doctor-patient relationship, the burdens imposed upon the patients who receive medical treatment through telemedicine, the reduced effectiveness of medical treatment, the effects on patients’ data security and privacy, and the doctors’ responsibilities in each modality of telemedicine. Finally, it suggests five recommended practices that could help maintain a doctor-patient relationship when applying telemedicine, i.e. deciding sensibly when to use telemedicine, obtaining informed consent for telemedicine, assisting patients in dealing with telemedicine, ensuring data safety, and developing specific practical guidelines.

This article summarizes that telemedicine should be applied to medical treatment in a cautious fashion, because there are many resultant ethical issues that could undermine a doctor-patient relationship. Some might perceive that, when applying telemedicine, doctors’ responsibilities are relatively limited when compared with conventional treatment. However, this perception is not always accurate, as this application probably leads doctors to shoulder additional responsibilities towards patients. This article also suggests that the regulations on telemedicine in Thailand should be more detailed by, inter alia, distinguishing different modalities of telemedicine.