Ethical Concerns

Telemedicine-related hardware and software fundamentally don't bring rise to any ethical dilemmas themselves, it is in how the technology is used that can create ethical concerns. Thus proper policies must be in place to ensure the proper use of this service.

The American Medical Association (AMA) shares ethical obligations between patient and provider along the continuum of care. This varies from websites guiding patients to real time video telehealth visits. The standards of in person care such as confidentiliatly, transparency, adequate training, and so on (Fields, 2020). The principles of autonomy, beneficence, nonmalificence, and justice still apply as they do in in-person care. 

While one of the goals of telehealth is to increase access to care in underserved communities, there is still inequity. Americans that are unable to access in-person care are unable to access telemedicine. Those who do not have at home technology may travel to center-to-center telemedicine as opposed to center-to-home, however this requires overcoming obsticles such as lack of transportation, work time constraints, lack of child care, etc. The center-to-home modality would resolve these issues but the digital divide is a barrier. There needs to be further development to ensure justince in the equity of access to care. 

When it comes to looking at ethical issues in the licensure and regulation of telehealth, a large consideration should be access to care. Regulations in place help to ensure that providers have specific boundaries to prevent any ethical dilemmas. However, if restrictions become to too strict, there is a decrease in use and access to services which leaves patients without the ability to receive care. For example, regulations that limit the provider from delivering care via certain mediums (i.e. not allowing telephone visits and only allowing video calls) limits those who are able to receive care. Delivery of care should still be patient centered. While regulations may push for telemedicine to be delivered across on a video conference medium, some patients may prefer telephone or text message services. It is important to consider patients comfort, access and preference.