ICoME and the moral significance of telemedicine

Parsa-Parsi et al systematically discuss and elucidate contentious and non controversial ethical issues that emerged during the ICoME (International Code of Medical Ethics) revision process and the consensus they achieved. The ethical issues discussed include the physician’s duty to act in the best interests of patients and to ensure they are protected from the unjustifiable risk of harm, respect for patient autonomy and the duties of physicians during emergencies, among others. This paper examines paragraph 26, which requires doctors to provide only medically justified remote treatment, ensure patients offer informed consent and adequately protect their confidentiality. At the peak of the COVID-19 pandemic, many countries in Europe and America implemented remote-by-default healthcare policies. At that time, the policy aimed to ensure that patients enjoyed continued access to care while protecting healthcare professionals’ health and wellbeing. After the COVID-19 pandemic, this policy remained in place. Regardless of the nature of their ailment, patients have consistently preferred in-person care out of concern that their health issues might not be accurately diagnosed and that they may not receive quality care remotely. So, in revising the doctors’ duty for remote care, the workgroup noted that remote care must be fundamentally based on the patient’s medical needs. Of course, some ailments require a comprehensive diagnosis and treatment. So, the workgroup recommended that where medically appropriate, patients should receive in-person care.