Result card

  • ETH12: Does the implementation or use of STS affect the realisation of basic human rights?
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Does the implementation or use of STS affect the realisation of basic human rights?

Authors: Plamen Dimitrov, Gottfried Endel, Anelia Koteva

Internal reviewers: Pseudo293 Pseudo293

The answer to this question could be quite simple and intuitive. However, the issue is more appropriate to be dealt with in the Legal Domain.

Although health professionals are morally obligated under the Hippocratic Oath to protect patient confidentiality, with the latter understood back then as a sacred obligation or an absolute right, modern healthcare fails to see the concept of confidentiality as a sacred category. What is more, a conflict appears between the limits of confidentiality and the common good, where one is often at the expense of the other. In order to balance the two concepts, a trade-off position should be adopted, allowing exceptions or confidentiality infringement in particular situations of competing health interests, such as a threat to other moral values ​​or social benefits (for example: public health, medical research, child abuse, infectious diseases as stipulated under law, etc.), patient’s authorization for disclosure of information and more broadly speaking – maximizing overall public health. Next, in order to cure their patients, healthcare workers must sometimes compromise (override) their privacy, entering their intimate sphere and questioning them on their lifestyle and personal habits.

Practicing telemedicine should be accompanied by a proper legal and regulatory framework, stipulating clear standards and rules, compliant with the rights of patients, while at the same time maintaining parity between professional and ethical standards applied to all aspects of physician’s practice.

Existing standards related to the classical face-to-face medical care must be adapted to the new healthcare models, with the regulations comprising: a license for practicing this type of service by medical specialists; a mechanism for physician’s selection by the patient (identified or random); identification standard of the provider and the patient upon relationship establishment; standard for evaluation and treatment of the patient; measures for securing and protecting patient’s data as well as data of the doctors providing the service; continuity of care; a mechanism for access to archived data; quality and surveillance mechanisms.

It is necessary that the following aspects are also defined and specified:

  1. Type of medical services provided;
  2. Information on the medical staff (qualification, license, professional experience);
  3. Confidentiality conditions – to whom may be disclosed health information regarding the patient and for what purposes, especially in the case of using mobile devices;
  4. Patients’ rights with regard to the service;
  5. Procedures for coordination of services in case of technical problems;
  6. Access and timely information as well as information on any additional or altered personal health data of patients;
  7. Provided feedback regarding the quality of information/service;
  8. Providing a mechanism for registering complaints about services delivered, etc.
Dimitrov P et al. Result Card ETH12 In: Dimitrov P et al. Ethical analysis In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=305