Ethics in e-Health

Divisi Bioetika dan Humaniora

Medical Education Unit
FK USU
Telecare ( care from a distance )
One of the fastest technological
developments in healthcare, especially in
home care
Define as direct patient care, in which the
recipient is remote from the clinician, or nurse
and in which communication media are
used.
 Advantages: to be the opportunity for quality
improvement and the increase of the patients
autonomy
The developments are mainly stimulate by
two factors : the short age of staff in home
care and the commercial interest of the
electronics industry
Telecare can include a whole range of care
activities, such as monitoring, diagnosing,
prescribing medical treatment, giving
instructions for self-care, or offering various
forms of support.
 The normative questions corncerning telecare
concern the changes that this form of care will cause
in care arrangements and care relationships.
The basic philosophical question is what exactly can
and will be transported through the electronic
networks connecting patients and caregivers: will it
be information, or also other elements of care,
such as attention, seriousness, involvement, and
even treatment? To what extent will the electronic
network not only function as a communication
channel, but also modify the content and meaning of
what passes between patient and professional, and
thus become an actor on its own?
 A second question is what the consequences
of telecare will be for the responsibilities and
liabilities of the parties involved. To what
extent will professional caregivers be
responsible for the safety and quality of
telecare arregements (including the provision
of information), and how and when may they
be liable for adverse events due to its use?
What responsibility will patients and families
get when telecare is provided and to what
extent must they bear the consequences of
their (possible) mistakes?
Vision
The Internet is changing how people receive
health information and health care
The goal of the e-Health Code of Ethics is to
ensure that people worldwide can confidently
and with full understanding of known risks
realize the potential of the Internet in
managing their own health and the health of
those in their care
 The Internet has the potential to revolutionize
healthcare by providing unprecedented
access to information as well as health
products and services on "e-health sites."
Health information includes information for
staying well, preventing and managing
disease, and making other decisions related
to health and health care.
 Because health and health care are critically
important to people, the organizations and
individuals that provide health information on
the Internet have special, strong obligations
to be trustworthy, provide high quality
content, protect users' privacy, and adhere to
standards of best practices for online
commerce and online professional services in
health care.
 It includes information for making decisions
about health products and health services.
It may be in the form of data, text, audio,
and/or video.
It may involve enhancements through
programming and interactivity.
1. Candor/sincere & Trustworthiness
People who use the Internet for health-related
purposes must have sufficient information to
make fully informed decisions about the
integrity of content and the potential for bias.
 People may not realize that personal information
may be collected when they use the Internet. And
they may not understand that declining to provide
personal data may affect the information or services
they receive.

2. Quality
People who use the Internet for health-related
purposes need credible, well-supported information
in order to make prudent decisions. People who use
the Internet for health-related purposes need to be
able to judge the credibility of content.
3. Informed Consent, Privacy &
Confidentiality
To make prudent decisions about whether to
provide personal information online,
especially information about their health
status,people need to know what information
is being gathered and why. The personal
information that may be gathered by a health-
related site is often intimate and highly
sensitive. People must be able to trust that
any personal information they provide will be
kept confidential and secure.
4. Best Commercial Practices
- Transparency
- Truthfulness
- Privacy

5. Best Practices for Provision of Health Care on

the Internet by Health Care Professionals
- Professional Standards
- The Professional-Patient Relationship
 Because of the large numbers and variety of
e-health sites, it is important for the
consumer, whether a healthcare provider or a
patient, to understand that e-health Web sites
have different purposes or functions and that
some may be more appropriate than others.
Some sites focus on providing services for
the health industry. Others provide patient
health and medical content. Still others sell
medical products and services.
 Many sites serve multiple functions such as
providing consumer information, hosting on-
line support groups and providing business
support services.
CONCLUSION
The e-health world is still very much a consumer-
beware environment. Identifying appropriate e-
health sites is not an easy task for most
consumers. Health professionals can play an
important role in helping patients with this
issue. The tools mentioned here are designed to
help make the selection process easier for both the
patient and the patients healthcare provider.

It is important to remember that, while the Internet is

a powerful tool to obtain information about health
and medicine, it should be considered as only one
of many different resources. Online information
should not be used as a complete substitute for
seeking medical diagnosis and treatment from a
licensed health care professional.
 In the end, a very important part of making appropriate
selections is taking the time to search out and visit
multiple sites. Just as obtaining a second opinion is
often important for the patient, visiting multiple e-
health Web sites is critical when seeking reliable
content and services over the Internet. Of course, the
most reliable way to check the accuracy of health
information and to obtain sound medical advice
whether from the Internet or elsewhere is for the
patient to discuss it with a licensed medical
professional.
Finally, all question may arise corncerning the liability
of manufacturers and importers of devices and
software, not only for hidden defects but also for
inadequate information. These question necessitate a
legal analysis, next to the moral analysis.