University of Florence, Italy.
Nurs Ethics. 2019 Mar;26(2):357-367. doi: 10.1177/0969733017705004. Epub 2017 May 15.
Over the last two decades, a public rationale for the implementation of telehealth has emerged at the interplay of specialised literature and political orientations. Despite the lack of consistent findings on the magnitude of its benefits, telehealth is nowadays presented as a worthy solution both for patients and healthcare institutions. Far from denying the potential advantages of telehealth, the main objective of this work is to provide a critical assessment on the spread of the remote services as a vector of positive transformation of contemporary health systems. For pursuing this objective, the EU agenda for the promotion of telehealth will be retraced, and the main evidences alleged to sustain the implementation of remote care services will be assessed. Furthermore, it will be evaluated the attempt made by the European Commission to establish an ethical framework for guiding the use of telehealth in daily practice, and a roadmap of the most relevant legal and ethical issues posed by the spread of telehealth will be traced. In the conclusions, it will be argued that the radical transformations induced by this form of technological innovation call on to a new, ad hoc ethics through which critically evaluate benefits and implications of telehealth services, with a view to keep high the standard of healthcare against the economic interests of private stakeholders and ICTs' vendors.
在过去的二十年中，专门文献和政治取向的相互作用下，出现了实施远程医疗的公众理由。尽管关于其效益的幅度缺乏一致的发现，但远程医疗现在被认为是患者和医疗机构的一种有价值的解决方案。本文远非否认远程医疗的潜在优势，其主要目的是对远程服务的传播进行批判性评估，将其作为当代卫生系统积极转型的一个载体。为了实现这一目标，将追溯欧盟促进远程医疗的议程，并评估支持远程护理服务实施的主要证据。此外，还将评估欧盟委员会为建立一个指导远程医疗在日常实践中使用的伦理框架所做的尝试，并追溯远程医疗传播所带来的最相关法律和伦理问题的路线图。在结论中，将认为这种形式的技术创新所带来的彻底变革需要一种新的、专门的伦理，通过这种伦理来批判性地评估远程医疗服务的效益和影响，以保持高标准的医疗保健，防止私营利益相关者和信息通信技术供应商的经济利益受到影响。
