VA Palo Alto Health Care System Sierra Pacific Mental Illness Research Education Clinical Center, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA.
Clin Neuropsychol. 2022 Jan;36(1):24-44. doi: 10.1080/13854046.2021.1889678. Epub 2021 Mar 24.
Teleneuropsychology (TeleNP) and the ethical guidance related to TeleNP is not new. However, the emergence of the coronavirus-2019 (COVID-19) has generated renewed interest in the potential utility and feasibility of transitioning the clinical practice of neuropsychological assessment from an in-person evaluation to one that occurs at least partially via telehealth. Recent surveys of neuropsychologists practicing in the early stages of COVID-19 indicate that, while most clinicians will or currently engage in TeleNP services, many have concerns about ethical issues related to providing TeleNP. Despite the presence of APA guidelines for telepsychology, no formal APA ethical guidelines or standards of practice exist for TeleNP. We provide ethical considerations and suggestions for potential practitioners of TeleNP based on new models of practice derived in response to the COVID-19 pandemic. We provide operational definitions of TeleNP and its models including: In-Clinic, Home, and Hybrid TeleNP models. We outline ethical considerations and suggestions in general and by model related to: issues of competence, education and training, benefits and risks of conducting TeleNP, health disparities, informed consent, patient privacy, confidentiality, test security, and administration and interpretation of standardized assessments. : The decision of which TeleNP model to use is a difficult one. Providers must balance several ethical considerations to complete an accurate assessment while managing numerous inherent challenges. Future efforts should focus on the creation of formal ethical guidelines and standards for the practice of TeleNP through joint task force efforts (e.g., APA, Inter Organizational Practice Committee).
远程神经心理学(TeleNP)及其相关的伦理指导并不是新的。然而,新型冠状病毒-2019(COVID-19)的出现重新引发了人们对将神经心理评估的临床实践从面对面评估转变为至少部分通过远程医疗进行的潜在效用和可行性的兴趣。最近对 COVID-19 早期阶段的神经心理学家的调查表明,尽管大多数临床医生将或目前从事 TeleNP 服务,但许多人对与提供 TeleNP 相关的伦理问题表示担忧。尽管有 APA 远程心理学指南,但尚无针对 TeleNP 的正式 APA 伦理准则或实践标准。我们根据针对 COVID-19 大流行而制定的新实践模式,为 TeleNP 的潜在从业者提供伦理考虑和建议。我们提供 TeleNP 的操作定义及其模型,包括:临床内、家庭和混合 TeleNP 模型。我们概述了一般的和按模型的伦理考虑和建议,涉及:胜任力、教育和培训问题、进行 TeleNP 的益处和风险、健康差距、知情同意、患者隐私、保密性、测试安全性以及标准化评估的管理和解释。:选择使用哪种 TeleNP 模型是一个困难的决定。提供者必须平衡若干伦理考虑因素,以在管理众多固有挑战的同时完成准确的评估。未来的工作应侧重于通过联合工作组(例如 APA、组织间实践委员会)为 TeleNP 的实践制定正式的伦理准则和标准。