Mediating telemedicine: ethics at a distance.

摘要

The advance of telemedicine promises to revolutionize the structures and delivery of health care and orders of medical knowledge and practice. Digital imaging, telematic and telecommunication-assisted technologies tear down the old obstructions of distance and time, preparing the ground for an expansion of the options that physicians have to practise medicine. Many of its advocates enthusiastically imagine that as telemedicine crystallizes institutionally, patients will develop into more knowledgeable and responsible agents for decisions about their health 'to an extent never imagined'.4 Yet, for all of its seductive power, its 'takeoff in new therapeutic systems and its expansion to new settings invokes varying degrees of mistrust, insecurity and contention among physicians who hold different outlooks. There are those who argue that repositioning doctors and patients under electronic mode weakens the common links and reciprocal connections that are important to efficacious therapeutic relationships. Coming into contact with patients through telemedical technologies puts 'true medicine' at risk.