The ethical and medico-legal challenges of telemedicine in the coronavirus disease 2019 era: A comparison between Egypt and India

Abstract

Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice. Results The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements. Conclusions Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services.

Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study

“…Notably, healthcare professionals have had ethical concerns, including instances of blackmail, defamation, hate speech, false accusations in court, and privacy violations. A significant percentage of Indian physicians (39.2%) and Egyptian physicians (24%) believe that the penalties for such misconduct should be less severe in the context of telemedicine compared to traditional practice [ 43 ].…”

Medical professionals’ job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt

“…On the contrary, finding out how far medical professionals are ready to accept and use telemedicine in Egypt has been evaluated in small studies in certain specialties [ 12 , 13 ]. Studies conducted in other countries during the COVID-19 crisis to evaluate physicians’ perception of telemedicine revealed variable results; for example, a study conducted in northeast Florida in 2020 found physicians had a positive attitude towards the adoption of telemedicine and perceived the quality of health service delivery as comparable to in-person care [ 14 ].…”