Ethical Issues Linked to the Development of Telerehabilitation: A Qualitative Study
DOI:
https://doi.org/10.5195/ijt.2021.6367Keywords:
Telerehabilitation, Telemedicine, Ethics, Physical Therapy ModalitiesAbstract
While telerehabilitation (TR) makes it possible to respond to many significant health system problems, TR still gives rise to debates, particularly concerning ethical issues. This qualitative study collected the opinions of stakeholders with varied profiles. A guided interview focused on discerning strategies that might foster the ethical deployment of TR. Such strategies were found to be linked to the decision-making of the public authorities, the role of scientific and professional bodies, the training of health professionals, and the management of patient information. Ethical issues relating to the development of TR included universal accessibility, patients’ free choice, respect of privacy, and professional confidentiality. The ethical development of TR can be fostered by the provision of information to stakeholders as well as reminding practitioners of the ethical framework that regulates medical practice.
References
Agence d’évaluation des technologies et des modes d’intervention en santé. (2006). Télésanté: lignes directrices cliniques et normes technologiques en téléréadaptation. https://www.inesss.qc.ca/fileadmin/doc/AETMIS/Rapports/Telesante/ETMIS2006_Vol2_No3.pdf
Association Médicale Mondiale. (2015). Manuel d’éthique médicale. https://www.wma.net/wp-content/uploads/2016/11/Ethics_manual_3rd_Nov2015_fr.pdf
Association Médicale Mondiale. (2017). Prise de position de l’AMM sur l’éthique en télémédecine. https://www.wma.net/fr/policies-post/prise-de-position-de-lamm-sur-les-responsabilites-et-les-directives-ethiques-liees-a-la-pratique-de-la-telemedecine/
Brennan, D., Tindall, L., Theodoros, D., Brown, J., Campbell, M., Christiana, D., Smith, D., Cason, J., & Lee, A. (2010). A blueprint for telerehabilitation guidelines. International Journal of Telerehabilitation, 2(2), 31–34. https://doi.org/10.5195/IJT.2010.6063
Chan, C., Yamabayashi, C., Syed, N., Kirkham, A., & Camp, P. G. (2016). Exercise telemonitoring and telerehabilitation compared with traditional cardiac and pulmonary rehabilitation: A Systematic review and meta-analysis. Physiotherapy Canada, 68(3), 242–251. https://doi.org/10.3138/ptc.2015-33
Code de la santé publique. (2019). Article L1121-1 - Chapitre Ier: Principes généraux relatifs aux recherches impliquant la personne humaine. https://www.legifrance.gouv.fr/codes/section_lc/LEGITEXT000006072665/LEGISCTA000006170998/
Commission Européenne. (2010). MethoTelemed, final report. https://ec.europa.eu/eip/ageing/file/364/download_en%3Ftoken=QPmdb6Ue
Conseil Européen Ordres des Médecins. (2014). Déclaration du Conseil Européen des Ordres des Médecins sur la télémédecine. https://www.conseil-national.medecin.fr/sites/default/files/external-package/rapport/19dp3bm/declaration_finale_ceom_sur_la_telemedecine.pdf
Conseil National de l’Ordre des Médecins. (2015). Santé connectée : de la e-santé à la santé connectée. https://www.conseil-national.medecin.fr/sites/default/files/external-package/edition/lu5yh9/medecins-sante-connectee.pdf
Conseil National de l’Ordre des Médecins. (2018). Médecins et patients dans le monde des Data, des algorithmes et de l’Intelligence Artificielle - Analyses et recommandations du CNOM. https://www.conseil-national.medecin.fr/sites/default/files/external-package/edition/od6gnt/cnomdata_algorithmes_ia_0.pdf
Conseil National de l’Ordre des Médecins. (2019). Ma santé 2022, des paroles aux actes, la contribution des médecins au grand débat national. https://www.conseil-national.medecin.fr/sites/default/files/external-package/rapport/1x60xoe/cnom_synthese_masante2022.pdf
Haute Autorité de Santé. (2013). Efficience de la télémédecine : état des lieux de la littérature internationale et cadre d’évaluation. https://www.has-sante.fr/upload/docs/application/pdf/2013-07/efficience_tlm_vf_2013-07-18_14-48-38_743.pdf
Haute Autorité de Santé. (2021). E-santé. https://www.has-sante.fr/jcms/c_2056029/en/e-sante
Kaur, K., Forducey, P. G., Smith, L., & Scheideman-Miller, C. (2004). Organisational design and implementation of a telerehabilitation system in Oklahoma. International Journal of Healthcare Technology and Management, 6(1), 56. https://doi.org/10.1504/IJHTM.2004.004825
Ministère des Solidarités et de la Santé. (2018). Faire en sorte que les Applications et Objets Connectés en santé bénéficient à tous. https://solidarites-sante.gouv.fr/IMG/pdf/avis_cns_aoc_adopt_plen_0802_contrib_cnle_cncph_220218.pdf
Nordmann, A. (2004). Technologies convergentes - Façonner l’avenir des sociétés européennes. http://publications.europa.eu/resource/cellar/7d942de2-5d57-425d-93df-fd40c682d5b5.0001.02/DOC_2
Observatoire de la santé visuelle et auditive. (2016). MHealth Quality. https://www.observatoire-groupeoptic2000.fr/actualites/en-direct/mhealth-quality-label-sante-certifier-valeur-scientifique-applications-sante/
Organisation mondiale de la Santé. (2009). Comités d’éthique de la recherche : Notions de base pour le renforcement des capacités. https://apps.who.int/iris/bitstream/handle/10665/44109/9789242598001_fre.pdf?sequence=1&isAllowed=y
Schmeler, M. R., Schein, R. M., McCue, M., & Betz, K. (2009). Telerehabilitation clinical and vocational applications for assistive technology: Research, opportunities, and challenges. International Journal of Telerehabilitation, 1(1), 59–72. https://doi.org/10.5195/IJT.2009.6014
Sénat. (2019). Avis sénatorial n°515 sur le projet de loi, adopté par l’Assemblée Nationale après engagement de la procédure accélérée, relatif à l’organisation et à la transformation du système de santé. https://www.senat.fr/rap/a18-515/a18-515.html
Simon, P. (2015). Télémédecine - Enjeux et pratiques (Le Coudrier (ed.); 1st ed.). https://www.edition-lecoudrier.fr/produit/7/9782919374083/telemedecine-enjeux-et-pratiques
Thomas, R. J., Beatty, A. L., Beckie, T. M., Brewer, L. C., Brown, T. M., Forman, D. E., Franklin, B. A., Keteyian, S. J., Kitzman, D. W., Regensteiner, J. G., Sanderson, B. K., & Whooley, M. A. (2019). Home-based cardiac rehabilitation. Journal of the American College of Cardiology, 74(1), 133–153. https://doi.org/10.1016/j.jacc.2019.03.008
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