Telemedicine Practice: Current Challenges of Consent and Autonomy, Patient Privacy and Data Security Worldwide

Abstract

Background: Telemedicine, facilitating medical services remotely, introduces ethical concerns. Safeguarding patient data, ensuring informed consent, addressing access disparities, and managing biases in artificial intelligence-driven diagnoses are critical. Navigating these challenges ethically is essential for harnessing telemedicine benefits while upholding patient trust and welfare. Objective: To ascertain the primary obstacles affecting global telemedicine practice, including issues concerning patient confidentiality, privacy, autonomy, informed consent, and data security. Methodology: Conducted a systematic literature review, for which we searched two databases (Pubmed and Google Scholar) between January 2018 to December 2022. Broad terms such as ethical issues, legal issues, health care providers were used as keyword searches. The authors used a narrative approach according to PRISMA guidelines 2020 (Checklist). The authors did a qualitative synthesis of selected studies according to inclusion criteria. The inclusion criteria required articles that reported ethical and legal concerns associated with the use of telemedicine; the full texts articles were electronically available and published in English. Systematic reviews and papers in other languages are not a part of the study. Results: Results showed that most reported ethical and legal concerns were related to privacy and confidentiality, followed by informed consent, patient autonomy and data security. From the 16 papers reviewed, authors identified or discussed the following ethical concerns faced by healthcare professionals during the use of telemedicine: patient privacy was addressed in 75% (n = 12/16) studies, informed consent 56.25% (n = 9/16), patient autonomy 31.25% (n = 5/16), data security 25% (n = 4/16). Conclusions: In the dynamic landscape of telemedicine, healthcare providers and policy makers play pivotal roles in addressing its ethical and legal concerns. Collaborative efforts are essential to establish clear guidelines, secure patient data, ensure informed consent, and create adaptable regulations, fostering a responsible and effective telemedicine ecosystem.