Yamaguchi Fabio Seiji Mazzi, Miyhara Helder de Souza, Silva Jorge Dos Santos, Rudelli Bruno Alves, Ejnisman Leandro, Gurgel Henrique Melo de Campos
Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.
Acta Ortop Bras. 2022 Dec 2;30(spe2):e253719. doi: 10.1590/1413-785220223002e253719. eCollection 2022.
Due to the pandemic of COVID-19, many outpatient services were suspended, affecting hundreds of patients. As a result, several countries were forced to seek strategies to readapt their health systems, one of which was the expansion of telemedicine. Currently, telemedicine is used for several specialties, facilitating the treatment and follow-up of patients who have difficulty accessing it. Tele-orthopedics, telemedicine applied to the orthopedic specialty, allows orthopedic care to be offered to patients regardless of distance. By reducing travel time, waiting time, and costs, tele-orthopedics presents high patient satisfaction, allowing greater rehabilitation effectiveness after surgery and treatment compliance. There is much information in the current literature about telemedicine's legal and ethical aspects, but it is fragmented. This article aims to present a general explanation of these legal and ethical aspects, emphasizing tele-orthopedics. The ethical principles of autonomy, beneficence, non-maleficence and justice must be respected, as well the privacy and confidentiality during a teleconsultation. In this respect, orthopedic surgeons should be governed by traditional moral and ethical precepts. Still, they must also adapt to the new norms and laws regulating telemedicine use.
由于新冠疫情大流行，许多门诊服务暂停，影响了数百名患者。因此，一些国家被迫寻求调整其卫生系统的策略，其中之一就是扩大远程医疗。目前，远程医疗应用于多个专科，为难以获得医疗服务的患者提供了便利的治疗和随访。远程骨科，即将远程医疗应用于骨科专科，使骨科护理能够不受距离限制地提供给患者。通过减少出行时间、等待时间和成本，远程骨科获得了患者的高度满意度，提高了术后康复效果和治疗依从性。当前文献中有很多关于远程医疗法律和伦理方面的信息，但这些信息是零散的。本文旨在对这些法律和伦理方面进行一般性解释，重点是远程骨科。必须尊重自主、行善、不伤害和公正等伦理原则，以及远程会诊期间的隐私和保密。在这方面，骨科医生应遵循传统的道德和伦理准则，但他们也必须适应规范远程医疗使用的新规范和法律。
