scholarly journals Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1314
Author(s):  
Renata Solimini ◽  
Francesco Paolo Busardò ◽  
Filippo Gibelli ◽  
Ascanio Sirignano ◽  
Giovanna Ricci
Keyword(s):  
Quality Of Care ◽  
Data Protection ◽  
Ethical Issues ◽  
Healthcare Services ◽  
Legal Issues ◽  
Patient Privacy ◽  
Professional Liability ◽  
Mesh Terms ◽  
Ethical And Legal Issues

Background and objective: Telemedicine or telehealth services has been increasingly practiced in the recent years. During the COVID-19 pandemic, telemedicine turned into and indispensable service in order to avoid contagion between healthcare professionals and patients, involving a growing number of medical disciplines. Nevertheless, at present, several ethical and legal issues related to the practice of these services still remain unsolved and need adequate regulation. This narrative review will give a synthesis of the main ethical and legal issues of telemedicine practice during the COVID-19 pandemic. Material and Methods: A literature search was performed on PubMed using MeSH terms: Telemedicine (which includes Mobile Health or Health, Mobile, mHealth, Telehealth, and eHealth), Ethics, Legislation/Jurisprudence, and COVID-19. These terms were combined into a search string to better identify relevant articles published in the English language from March 2019 to September 2021. Results: Overall, 24 out of the initial 85 articles were considered eligible for this review. Legal and ethical issues concerned important aspects such as: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional–patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%). Conclusions: The ethical and legal issues related to the practice of telehealth or telemedicine services still need standard and specific rules of application in order to guarantee equitable access, quality of care, sustainable costs, professional liability, respect of patient privacy, data protection, and confidentiality. At present, telemedicine services could be only used as complementary or supplementary tools to the traditional healthcare services. Some indications for medical providers are suggested.

scholarly journals Ethical and Legal Issues in Medical Tourism

2015 ◽  
Vol 23 (2) ◽  
Author(s):  
Hanis Wahed
Keyword(s):  
Medical Treatment ◽  
Medical Tourism ◽  
Ethical Issues ◽  
Developed Countries ◽  
Legal Issues ◽  
Secondary Sources ◽  
The Future ◽  
Ethical And Legal Issues

In these days, millions of people, especially from developed countries, are travelling to other countries for medical treatment. This development is called ‘medical tourism’. Medical tourism is one of the lucrative industries that has expanded rapidly worldwide, including Malaysia. The development is due to factors such as seeking quality medical treatment at lower costs.  However, there are certain ethical and legal issues arising from the development of the industry.  These issues should be addressed because it may affect the development of medical tourism in the future.  Lack of legal recourse and lack of regulation are some examples of legal issues that are discussed in this paper.  The ethical issues include the quality of care for treatment provided by medical providers, lack of follow-up care for patients at their home countries, access to care for the local people at destination countries and the issue that arises from the treatment that is illegal in patients’ home countries.   The objective of this article is to examine these ethical and legal issues in order to assist the growth of the industry and the country’s economy in the future. This research is based on analysis of primary and secondary sources such as legislation, textbooks, and journal articles that relates to the medical tourism and issues arising from its development. The article concludes that these ethical and legal issues can be resolved by having a uniform medical tourism regulation. 

Chances for and Limitations of Brain-Computer Interface use in Elderly People

2015 ◽  
pp. 1723-1734
Author(s):  
Emilia Mikołajewska ◽  
Dariusz Mikołajewski ◽  
Tomasz Komendziński ◽  
Joanna Dreszer-Drogorób ◽  
Monika Lewandowska ◽  
...  
Keyword(s):  
Elderly People ◽  
Heart Diseases ◽  
Developed Countries ◽  
Legal Issues ◽  
Medical Problems ◽  
Computer Interfaces ◽  
Ethical And Legal Issues ◽  
Control Devices ◽  
And Control

Recent demographic prognoses show tendencies toward a significant increase in the number of elderly people, especially in developed countries. This makes geriatric therapy, rehabilitation, and care difficult, especially with maintaining as long as possible the highest quality of life and independence in activities of daily living. Lack of specialized personnel and financial shortages may cause increased application of Assistive Technology (AT) and associated control devices. The most advanced current devices for diagnosis, communication, and control purposes are perceived Brain-Computer Interfaces (BCIs). BCIs use brain-derived bioelectrical signals as an input to enable diagnosis, communication, and/or control (e.g. neuroprostheses, medical robots, wheelchairs, whole integrated environments) without any movement. BCIs are regarded as novel solutions offering another breakthrough in everyday life, care, therapy, and rehabilitation in patients with severe sensory and neuropsychological deficits. However, particular issues in the area of BCIs use in elderly people should be emphasized, including influence of neurodegenerative disorders accompanied with secondary changes resulting from other medical problems (e.g. heart diseases, hypertension, diabetes mellitus, and osteoporosis), co-occurence of various drug therapies, etc. This chapter investigates the extent to which the available opportunities are being exploited, including both chances and limitations, medical, technical, psychological, societal, ethical, and legal issues.

Clinical Record Keeping

2013 ◽  
pp. 139-150
Author(s):  
Mary Alice Fisher
Keyword(s):  
Risk Management ◽  
Patient Information ◽  
Ethical Issues ◽  
Legal Issues ◽  
Clinical Record ◽  
Patient Centered ◽  
Record Keeping ◽  
Clinical Patient ◽  
Ethical And Legal Issues

Chapter 10 discusses only ethical issues related to the confidentiality of patient information that has been recorded, whether on paper or electronically. It examines the shift away from clinical (patient-centered) and ethical (patient-protective) considerations and toward a risk management (therapist-protective) focus, and that documentation serves many functions, but addresses only ethical and legal issues related to confidentiality, regardless of the function being served.

Telepsychiatry Use in Rural Areas in the United States

2020 ◽  
Vol 13 (4) ◽  
pp. 1-13
Author(s):  
Alberto Coustasse ◽  
Morgan Ruley ◽  
Tonnie C. Mike ◽  
Briana M. Washington ◽  
Anna Robinson
Keyword(s):  
Mental Health ◽  
United States ◽  
Quality Of Care ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Access And Quality

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

Ethical and Legal Issues in Teaching and Learning in Second Life in a Graduate Online Course

2010 ◽  
pp. 228-238
Author(s):  
R.S. Talab ◽  
Hope R. Botterbusch
Keyword(s):  
Second Life ◽  
Criminal Behavior ◽  
Teaching And Learning ◽  
Ethical Issues ◽  
Legal Issues ◽  
Course Content ◽  
Teaching Platform ◽  
Legal Literature ◽  
Ethical And Legal Issues ◽  
The Many

As a growing number of faculty use SL as a teaching platform, outside of anecdotal articles and the legal literature, no research exists on the many legal and ethical issues that affect course development. Ethical issues include abuse (“griefing”) nudity and lewd behavior, and false/misleading identities. Legal issues include creation and use of copyrighted and trademarked items, faculty intellectual property rights in objects and course content, and criminal behavior. Following the experiences of the instructor and 5 students, their 12-week journey is documented through interviews, journals, weekly course activities, SL class dialogs, and in-world assignments. Additionally, 5 faculty and staff experts who teach or train in SL at this university were interviewed and consulted, as well. This study provides insight for designing courses that foster exploration of rich learning opportunities outside a traditional classroom-both real and virtual.

Psychosurgery

2002 ◽  
Vol 12 (12) ◽  
pp. 443-448
Author(s):  
Marilyn Williams
Keyword(s):  
Surgical Procedures ◽  
Ethical Issues ◽  
Mental States ◽  
Legal Issues ◽  
History Of ◽  
Ethical And Legal Issues ◽  
The Subject ◽  
The Brain

The use of surgical procedures to alter mental states raises many issues. Surgery on the brain has been known for thousands of years, but procedures developed in the 1930s, ‘40s and ‘50s, and the reasons for them, raised many ethical issues that remain with us today. The following article touches on the history of psychosurgery, the conditions treated, the literature on the subject, and the ethical and legal issues.

scholarly journals Overpriced? Are Hospital Prices Associated with the Quality of Care?

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 135
Author(s):  
Brad Beauvais ◽  
Glen Gilson ◽  
Steve Schwab ◽  
Brittany Jaccaud ◽  
Taylor Pearce ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Clinical Care ◽  
Healthcare Services ◽  
Cost Ratio ◽  
Performance Score ◽  
Significant Positive Association ◽  
The Public ◽  
Total Performance

In most consumer markets, higher prices generally imply increased quality. For example, in the automobile, restaurant, hospitality, and airline industries, higher pricing generally conveys a signal of complexity and superiority of a service or product. However, in the healthcare industry, there is room to challenge the price-quality connection as both health prices and health quality can be difficult to interpret. In the best of circumstances, health care costs, prices, and quality can often be difficult to isolate and measure. Recent efforts by the Trump Administration and the Center for Medicare and Medicaid Services (CMS) have required the pricing of hospital services to be more transparent. Specifically, hospital chargemaster (retail) prices must now be available to the public. However, many continue to question if the pricing of health care services reflects the quality of service delivery. This research focuses on investigating the prices hospitals charge for their services in relation to the costs incurred and the association with the quality of care provided. By analyzing data from a nationwide sample of U.S. hospitals, this study considers the relationship between hospital pricing (as measured by the charge-to-cost ratio) and hospital quality performance as measured by the Value Based Purchasing Total Performance Score (TPS) and its associated sub-domains. Results of the study indicate that hospital prices, as measured by our primary independent variable of interest, the charge-to-cost ratio, are significantly and negatively associated with Total Performance Score, Patient Experience, and the Efficiency and Cost Reduction domains. A marginal statistically significant positive association is shown in the Clinical Care domain. The findings indicate that unlike most other industries, in medicine, higher pricing compared to cost does not necessarily associate with higher quality and, in fact, might indicate the opposite. The results of this study suggest that purchasers of healthcare, at all levels, have justification in challenging the pricing of healthcare services considering the quality scores available in the public domain.

scholarly journals Real-world data: how they can help to improve quality of care

2021 ◽  
Vol 8 ◽  
pp. 134-139
Author(s):  
Giovanni Corrao ◽  
Giovanni Alquati ◽  
Giovanni Apolone ◽  
Andrea Ardizzoni ◽  
Giuliano Buzzetti ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Care ◽  
Real World ◽  
Ethical Issues ◽  
Data Availability ◽  
Quality Data ◽  
Real World Data ◽  
World Data ◽  
Critical Issues

The current COVID pandemic crisis made it even clearer that the solutions to several questions that public health must face require the access to good quality data. Several issues of the value and potential of health data and the current critical issues that hinder access are discussed in this paper. In particular, the paper (i) focuses on “real-world data” definition; (ii) proposes a review of the real-world data availability in our country; (iii) discusses its potential, with particular focus on the possibility of improving knowledge on the quality of care provided by the health system; (iv) emphasizes that the availability of data alone is not sufficient to increase our knowledge, underlining the need that innovative analysis methods (e.g., artificial intelligence techniques) must be framed in the paradigm of clinical research; and (v) addresses some ethical issues related to their use. The proposal is to realize an alliance between organizations interested in promoting research aimed at collecting scientifically solid evidence to support the clinical governance of public health.

scholarly journals The Medical Society’s Role in Assessing Physician’s Performance: An Analysis of Six Years of Grievances Considered by an Urban Medical Society

2006 ◽  
Vol 92 (4) ◽  
pp. 9-15
Author(s):  
Arthur Frank ◽  
Howard A. Hoffman ◽  
Edward H. Stolar
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Ethical Issues ◽  
Professional Standards ◽  
Medical Society ◽  
Legal Authority ◽  
Behavior Issues ◽  
Staff Behavior ◽  
Office Procedures

ABSTRACT Context Although they have no legal authority, medical organizations are frequently asked to assess physician conduct. These organizations have established a variety of procedures to review grievances brought for their consideration. Objective This analysis was conducted to assess the nature and the disposition of the complaints considered by the Professional Standards Committee (Committee) of an urban medical society. Design All cases considered by the Committee (193 complaints) during a six-year period were arbitrarily sorted into categories and the nature of how the case was resolved was tabulated. Results Of all the cases considered 108 (56 percent) were categorized as related to quality of care and physician/staff behavior issues. Of these, 39 (20 percent) dealt with the characteristics of the care provided, 28 (15 percent) with physician and staff behavior, 23 (12 percent) with physician and staff communications and 18 (nine percent) with ethical issues. An additional 85 cases (44 percent) were related to administrative issues and office procedures. Of these, 50 (26 percent) were related to billing, fees and charges, 23 (12 percent) concerned medical records, 10 (five percent) dealt with office practices and procedures and two (one percent) were related to worker’s compensation. Of 141 cases in which a judgment could be made, 48.2 percent were decided in the complainant’s favor and corrective recommendations were made. The grievance appeared to be inappropriate in 51.8 percent of the cases and the reason for this decision was explained to the complainant. In the remaining 22 percent of the cases irreconcilable descriptions of the circumstances made it impossible for the Committee to make a decision or recommendation about the grievance. Conclusion The mechanism of review by the Professional Standards Committee of a medical society does appear to offer a procedure by which there can be some resolution of these complaints. In cases in which a judgment could be made the complaint was decided in favor of the complainant as frequently as in favor of the physician.

scholarly journals Ethical and Legal Issues in the Use of Online-Based Health Services (E-Health)

SOEPRA ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Fitriani Nur Damayanti ◽  
Absori Absori ◽  
Kelik Wardiono ◽  
Sri Rejeki
Keyword(s):  
Health Services ◽  
Health Information ◽  
Ethical Issues ◽  
Health Workers ◽  
Code Of Ethics ◽  
Online Communication ◽  
Legal Issues ◽  
Public Health Issue ◽  
The Internet ◽  
Ethical And Legal Issues

The internet offers unprecedented power to provide users with health information for patients, health professionals, and professionals. Maintaining the integrity, data systems, and confidentiality of individual health information, quality of content, and consumer protection and the commercial interests of the health industry against unethical practices, are areas of greatest concern in the implementation and use of the Internet. However, there is no national and international legislation for regulating the use of online-based health services. This research is a Literature review that aims to explore ethical and legal issues in the use of online-based health services (E-Health). The review process begins by identifying journal articles that are relevant to the research topic. This study concludes that the use of online-based health services (E-Health) is an important public health issue. E-Health emerged as a tool for developing new diagnostics and therapeutic interventions. Ethical issues related to crossing clinical practice and online communication about health services. This allows discriminatory or unethical behavior and is not following the professional code of ethics. E-Health licensing standards and regulations have not been implemented in many countries. So that health workers are required to code of ethics in the use of online-based health services (E-Health).

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