The Computer Will See You Now: Ethics of Teledermatology

Abstract

Teledermatology is the use of telecommunication for dermatology diagnosis and care. This technology can provide diagnostic services to underserved and rural regions that lack access to higher-level specialty medical expertise. Accumulating data shows that teledermatology is diagnostically accurate, safe, cost-effective, and well received by patients. While the potential of teledermatology to increase access to care is exciting, it is critical to recognize that the nature of the doctor–patient relationship is drastically altered when the doctor is located remotely, never having face-to-face contact with the patient. This is a new type of therapeutic relationship, one in which the principles of respect for autonomy, beneficence, non-maleficence, and justice must be emphasized, and at the same time recontextualized. Case scenarios will be used to examine some of the ethical issues that may arise with the use of teledermatology. As a framework for our analysis, we will use the generally accepted ethical principles to which physicians are expected to adhere and will discuss how these principles apply specifically to challenging scenarios with which practitioners of teledermatology may be faced.