The Ethical Implications of Telemedicine and the Internet for Home Healthcare

Information and communication technologies, such as the Internet, are transforming our business, education, and leisure practices. The healthcare industry is no exception to this trend and the burgeoning field of home-based telemedicine is evidence of this. As with many technological innovations in healthcare, assessments of homebased telemedicine and correlative policies are being driven by economic and technological criteria that emphasize cost reduction and technologic efficiency. These are important considerations, but these assessments neither identify the ethical values involved in home-based telemedicine nor address its possible ethical implications. Since the economic and technologic viability of home-based telemedicine is not identical with its ethical appropriateness and justification, this is a serious oversight. Hence, the use of telemedicine and the Internet in home healthcare invite a discussion about their ethical implications for the traditional goals and moral ideals of healthcare practice.

The purpose of this study is to argue that the ethical implications of telemedicine and the Internet for home healthcare should be better understood and incorporated into future home-based telemedicine research and policy development. To this end, this study reviews the home-based telemedicine literature and examines the normative connections between home-based telemedicine and the following: (1) provider-patient relationships, (2) healthcare privacy and confidentiality, (3) distributive and family justice, and (4) informed consent.

This study concludes that given the traditional values and goals of healthcare, information and communication technologies present both possible harms and benefits for home healthcare recipients and providers, but that on balance the benefits are more likely to outweigh the harms. However, because the exact benefits and harms of homebased telemedicine are unknown at this time, additional empirical research and outcome studies are needed. Finally, as part of a general technology assessment of home-based telemedicine, future research should include an ethical evaluation of all information and communication technologies that will be employed. If this is not done, home-based telemedicine policies will be inadequately informed and many of the possible harms of home-based telemedicine that could be prevented will not be prevented.