Ethical assessment of virtual consultation services: scoping review and development of a practical ethical checklist.

IF 1.1 Q4 PRIMARY HEALTH CARE Journal of primary health care Pub Date : 2024-09-01 DOI:10.1071/HC24027
Madeleine Reid, Tania Moerenhout
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Abstract

Introduction The use of telephone and video consultations has vastly increased since the onset of the COVID-19 pandemic. Health care providers in traditional clinical practices have embraced these virtual consultations as an alternative to face-to-face consultations, but there has also been a simultaneous increase in services offered directly to consumers via commercial entities. One of the main challenges in telemedicine (and the broader field of digital health) is how to conduct a meaningful ethical assessment of such services. Aim This article presents a novel framework for practical ethical analysis of direct-to-consumer virtual general practitioner consultation services in Aotearoa New Zealand. Methods First, a scoping review of academic and policy documents identified the core ethical challenges arising from virtual consultations. Second, a qualitative analysis was conducted to translate the main ethical themes and subthemes into practical questions to assess virtual general practice services. Results A total of 49 relevant documents were selected for review. The six key ethical themes related to telemedicine were: privacy, security, and confidentiality; equity; autonomy and informed consent; quality and standards of care; patient empowerment; and continuity of care. A practical ethical checklist consisting of 25 questions was developed from these themes and their subthemes. Discussion The checklist provides an accessible way of incorporating ethics into technology assessment and can be used by all relevant stakeholders, including patients, health care providers, and developers. Application of the framework contributes to improving the quality of virtual consultation services with a specific focus on ethics.

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虚拟咨询服务的伦理评估:范围审查和实用伦理清单的制定。
导言:自 COVID-19 大流行以来,电话和视频咨询的使用大幅增加。传统临床实践中的医疗服务提供者将这些虚拟咨询作为面对面咨询的替代方式,但通过商业实体直接向消费者提供的服务也在同步增加。远程医疗(以及更广泛的数字医疗领域)面临的主要挑战之一是如何对此类服务进行有意义的伦理评估。目的 本文提出了一个新颖的框架,用于对新西兰奥特亚罗瓦地区直接面向消费者的虚拟全科医生咨询服务进行实用的伦理分析。方法 首先,对学术和政策文件进行了范围界定,确定了虚拟咨询带来的核心伦理挑战。其次,进行定性分析,将主要伦理主题和次主题转化为评估虚拟全科医生服务的实际问题。结果 共选择了 49 份相关文件进行审查。与远程医疗相关的六个主要伦理主题是:隐私、安全和保密;公平;自主权和知情同意;医疗质量和标准;患者赋权;以及医疗的连续性。根据这些主题及其次主题,制定了由 25 个问题组成的实用伦理核对表。讨论 该核对表提供了一种将伦理纳入技术评估的简便方法,可供包括患者、医疗服务提供者和开发者在内的所有利益相关者使用。应用该框架有助于提高虚拟咨询服务的质量,并特别关注伦理问题。
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来源期刊
Journal of primary health care
Journal of primary health care PRIMARY HEALTH CARE-
CiteScore
2.70
自引率
16.70%
发文量
79
审稿时长
28 weeks
期刊最新文献
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