Raveesh Bevinahalli Nanjegowda, Munoli Ravindra Neelakanthappa
Dept. of Psychiatry, Mysore Medical College & Research Institute, Mysore, Karnataka, India.
Legal Subcommittee, Indian Psychiatry Society (National).
Indian J Psychol Med. 2020 Nov 1;42(5 Suppl):63S-69S. doi: 10.1177/0253717620962033. eCollection 2020 Oct.
Ethical and legal frameworks are essential components in mental health care, due to inherent nature of illnesses and practice modules. These serve to safeguard rights and privileges of patients and mental health professional. Gradual evolution of technology and its' application in assessments and interventions is making it as an essential part of mental health care delivery. This transition will bring innovative challenges for mental health care delivery in terms of practice, ethical and legal aspects. Existing ethical and legal frameworks are time tested for real time/face to face delivery of mental health care. Ongoing pandemic provided opportunity and necessitated use of technology for delivering health care needs. Newer operational and practice guidelines have emerged for practice of telemedicine in general and telepsychiatry in specific. These are in lines with existing ethical and legal frameworks. However, additional frameworks with specific definitions about what constitutes consultation, assessment methods, prescription modes and contents of prescription, documentation, certification, eligible platforms for telepsychiatry, need to be incorporated and observed. The article addresses these ethical and legal aspects in telepsychiatry practice with the background of existing practice guidelines and rules.
由于精神疾病的内在性质和实践模式,伦理和法律框架是精神卫生保健的重要组成部分。这些框架有助于保护患者和精神卫生专业人员的权利与特权。技术的逐步发展及其在评估和干预中的应用正使其成为精神卫生保健服务的重要组成部分。这种转变将在实践、伦理和法律方面给精神卫生保健服务带来创新挑战。现有的伦理和法律框架经过了时间考验,适用于实时/面对面的精神卫生保健服务。持续的疫情提供了机会,也使得利用技术来满足医疗保健需求成为必要。针对一般远程医疗尤其是远程精神病学的实践,出现了新的操作和实践指南。这些指南与现有的伦理和法律框架一致。然而,还需要纳入并遵守关于什么构成会诊、评估方法、处方模式和处方内容、文档记录、认证、远程精神病学的合格平台等具有特定定义的额外框架。本文结合现有实践指南和规则的背景,探讨了远程精神病学实践中的这些伦理和法律方面。