1
|
Lasheras-Pérez MA, Taberner R, Martínez-Jarreta B. Bioethical Conflicts in Current Dermatology: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00264-3. [PMID: 38556205 DOI: 10.1016/j.ad.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
Both the functions and equipment of dermatologists have increased over the past few years, some examples being cosmetic dermatology, artificial intelligence, tele-dermatology, and social media, which added to the pharmaceutical industry and cosmetic selling has become a source of bioethical conflicts. The objective of this narrative review is to identify the bioethical conflicts of everyday dermatology practice and highlight the proposed solutions. Therefore, we conducted searches across PubMed, Web of Science and Scopus databases. Also, the main Spanish and American deontological codes of physicians and dermatologists have been revised. The authors recommend declaring all conflicts of interest while respecting the patients' autonomy, confidentiality, and privacy. Cosmetic dermatology, cosmetic selling, artificial intelligence, tele-dermatology, and social media are feasible as long as the same standards of conventional dermatology are applied. Nonetheless, the deontological codes associated with these innovations need to be refurbished.
Collapse
Affiliation(s)
- M A Lasheras-Pérez
- Servicios de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - R Taberner
- Unidad de Dermatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, España.
| | - B Martínez-Jarreta
- Departamento de Medicina Legal y Forense, Universidad de Zaragoza, Zaragoza, España
| |
Collapse
|
2
|
Sud E, Anjankar A. Applications of Telemedicine in Dermatology. Cureus 2022; 14:e27740. [PMID: 36106261 PMCID: PMC9445412 DOI: 10.7759/cureus.27740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Abstract
Telemedicine is a technological tool that enhances well-being all around the globe. Practicing medicine or performing a clinical examination from a distance was a mere thought until this decade's pandemic hit the world. Telemedicine is practicing medicine sitting on one side of a globe and diagnosing and treating a different individual from the opposite part of the world. There is a long way to go for medical practitioners to execute an entire clinical examination analogous to an accurate clinical examination. Telemedicine is a supplement to a patient's total care, not a replacement for in-person doctor visits. Family doctors can easily access specialists using telemedicine, which enables them to monitor their patients closely. Numerous telemedicine systems, including store and forward, real-time and remote, or self-monitoring, are used worldwide for education, healthcare delivery and control, sickness screening, and disaster management. Even if telemedicine cannot solve every issue, it can significantly lessen the strain on the healthcare system. Nevertheless, investigations performed via telemedicine have started incorporating various medical instruments called telemedicine peripherals, including electronic stethoscopes, teleophthalmoscopes, and video-otoscopes. The prevailing disease around the globe of coronavirus has remarkably debilitated the medical infrastructure in providing diagnosis, treatment, monitoring, and follow-ups. As a result, there is a significant change in the way of practicing medicine and managing patients. Telemedicine provides timely patient care and reduces the risk of exposure to various communicable diseases offered to medical practitioners. The development of imaging technologies has significantly impacted dermatology, a specialty that relies on visual signals. Reviewing dermatology's existing situation and potential digital future, in brief, is the goal of this study. This study provides brief information on telemedicine, its application and scope in dermatology, and how it can alter the healthcare system.
Collapse
|
3
|
Willem T, Krammer S, Böhm A, French LE, Hartmann D, Lasser T, Buyx A. Risks and benefits of dermatological machine learning healthcare applications – an overview and ethical analysis. J Eur Acad Dermatol Venereol 2022; 36:1660-1668. [DOI: 10.1111/jdv.18192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Theresa Willem
- Technical University of Munich School of Medicine, Institute of History and Ethics in Medicine Germany
- Technical University of Munich School of Social Sciences and Technology, Department of Science, Technology and Society (STS)
| | - Sebastian Krammer
- Ludwig Maximilian University of Munich Department of Dermatology and Allergology Munich Germany
| | - Anne‐Sophie Böhm
- Ludwig Maximilian University of Munich Department of Dermatology and Allergology Munich Germany
| | - Lars E. French
- Ludwig Maximilian University of Munich Department of Dermatology and Allergology Munich Germany
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Daniela Hartmann
- Ludwig Maximilian University of Munich Department of Dermatology and Allergology Munich Germany
| | - Tobias Lasser
- Technical University of Munich School of Computation, Information and Technology, Department of Informatics Germany
- Technical University of Munich Institute of Biomedical Engineering Germany Munich
| | - Alena Buyx
- Technical University of Munich School of Medicine, Institute of History and Ethics in Medicine Germany
| |
Collapse
|
4
|
Medico-legal recommendations for the safe use of medical photography in orthopaedic surgery and traumatology. ACTA ACUST UNITED AC 2021. [PMID: 34112452 DOI: 10.1016/j.recote.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
5
|
Gómez Arias P, Abad Arenas E, Arias Blanco M, Redondo Sánchez J, Galán Gutiérrez M, Vélez García-Nieto A. Medical and Legal Aspects of the Practice of Teledermatology in Spain. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2020.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
6
|
Gómez Arias PJ, Abad Arenas E, Arias Blanco MC, Redondo Sánchez J, Galán Gutiérrez M, Vélez García-Nieto AJ. Medical and Legal Aspects of the Practice of Teledermatology in Spain. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:127-133. [PMID: 33035496 PMCID: PMC7537602 DOI: 10.1016/j.ad.2020.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022] Open
Abstract
Teledermatology is now fully incorporated into our clinical practice. However, after reviewing current legislation on the ethical aspects of teledermatology (data confidentiality, quality of care, patient autonomy, and privacy) as well as insurance and professional responsibility, we observed that a specific regulatory framework is still lacking and related legal aspects are still at a preliminary stage of development. Safeguarding confidentiality and patient autonomy and ensuring secure storage and transfer of data are essential aspects of telemedicine. One of the main topics of debate has been the responsibilities of the physicians involved in the process, with the concept of designating a single responsible clinician emerging as a determining factor in the allocation of responsibility in this setting. A specific legal and regulatory framework must be put in place to ensure the safe practice of teledermatology for medical professionals and their patients.
Collapse
Affiliation(s)
- P J Gómez Arias
- UGC de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Reina Sofía, Córdoba, España.
| | - E Abad Arenas
- Departamento de Derecho Civil, Facultad de Derecho, Universidad Nacional de Educación a Distancia, Madrid, España
| | - M C Arias Blanco
- Consultorio de Villaharta. UGC La Sierra. Distrito Córdoba-Guadalquivir, Córdoba, España
| | - J Redondo Sánchez
- Centro de Salud Lucano. UGC Lucano. Distrito Córdoba-Guadalquivir, Córdoba, España
| | - M Galán Gutiérrez
- UGC de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Reina Sofía, Córdoba, España
| | - A J Vélez García-Nieto
- UGC de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Reina Sofía, Córdoba, España
| |
Collapse
|
7
|
Medico-legal recommendations for the safe use of medical photography in orthopaedic surgery and traumatology. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021. [PMID: 33431334 DOI: 10.1016/j.recot.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
8
|
Arimany-Manso J, Pujol RM, García-Patos V, Saigí U, Martin-Fumadó C. Medicolegal Aspects of Teledermatology. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:815-821. [PMID: 32910922 PMCID: PMC7476561 DOI: 10.1016/j.ad.2020.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/13/2020] [Accepted: 08/28/2020] [Indexed: 12/19/2022] Open
Abstract
Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible exposure of patients or dermatologists. However, teledermatology brings forward certain ethical and medicolegal questions. A medical consultation in which the patient is not physically present is still a medical act, to which all the usual ethical and medicolegal considerations and consequences apply. The patient's right to autonomy and privacy, confidentiality, and data protection must be guaranteed. The patient must agree to remote consultation by giving informed consent, for which a safeguard clause should be included. Well-defined practice guidelines and uniform legislation are required to preserve the highest level of safety for transferred data. Adequate training is also needed to prevent circumstances involving what might be termed «telemalpractice».
Collapse
Affiliation(s)
- J Arimany-Manso
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Unidad de Medicina Legal y Forense, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España; Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, España
| | - R M Pujol
- Servicio de Dermatología, Hospital del Mar. Parc de Salut Mar, Institut Mar d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, España
| | - V García-Patos
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - U Saigí
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España
| | - C Martin-Fumadó
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, España; Departamento de Medicina, Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España.
| |
Collapse
|
9
|
Arimany-Manso J, Pujol RM, García-Patos V, Saigí U, Martin-Fumadó C. Medicolegal aspects of teledermatology. ACTAS DERMO-SIFILIOGRAFICAS 2020. [PMID: 34012149 PMCID: PMC7836632 DOI: 10.1016/j.adengl.2020.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible exposure of patients or dermatologists. However, teledermatology brings forward certain ethical and medicolegal questions. A medical consultation in which the patient is not physically present is still a medical act, to which all the usual ethical and medicolegal considerations and consequences apply. The patient's right to autonomy and privacy, confidentiality, and data protection must be guaranteed. The patient must agree to remote consultation by giving informed consent, for which a safeguard clause should be included. Well-defined practice guidelines and uniform legislation are required to preserve the highest level of safety for transferred data. Adequate training is also needed to prevent circumstances involving what might be termed "telemalpractice."
Collapse
Affiliation(s)
- J Arimany-Manso
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, Spain.,Unidad de Medicina Legal y Forense, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain.,Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - R M Pujol
- Servicio de Dermatología, Parc de Salut Mar, Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - V García-Patos
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - U Saigí
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, Spain
| | - C Martin-Fumadó
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, Spain.,Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Departamento de Medicina, Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
| |
Collapse
|
10
|
Emerging Formats for Dermatology Conferences and Meetings. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
11
|
Marin-Gomez FX, Vidal-Alaball J, Poch PR, Sariola CJ, Ferrer RT, Peña JM. Diagnosis of Skin Lesions Using Photographs Taken With a Mobile Phone: An Online Survey of Primary Care Physicians. J Prim Care Community Health 2020; 11:2150132720937831. [PMID: 32590923 PMCID: PMC7328057 DOI: 10.1177/2150132720937831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Skin conditions are one of the most frequent reasons for visiting a primary
health care facility, making it of vital importance that general practitioners
(GPs) have the right knowledge and tools to diagnose the most frequent
dermatological conditions. Methods: This study evaluates the
accuracy of dermatological diagnoses made by 120 GPs based on photographs taken
with a smartphone by an anonymous online cross-sectional survey.
Results: The study was carried out between August and October
2018. The results show that the majority of the participants are in favor of
using mobile phones to communicate with other professionals and use them to
consult medical images. The majority (69%) took dermatological photographs and
the preferred device was a smartphone (70%). From 22 different images evaluated,
in 69% of responses, participants expressed a high degree of confidence in their
ability to diagnose the lesion shown and in 72% of the cases, the diagnosis
chosen was correct. Conclusions: The study confirms that the use of
smartphone to send medical images is growing rapidly and its potential for
taking medical images is an opportunity to help primary care teams deal with
dermatological problems. The results suggest that GPs need further training in
interpreting dermatological images, to increase their diagnostic confidence and
to avoid the need for referrals to face-to-face visits.
Collapse
Affiliation(s)
- Francesc X Marin-Gomez
- Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Josep Vidal-Alaball
- Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Pere Roura Poch
- Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | | | | | - Jacobo Mendioroz Peña
- Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| |
Collapse
|
12
|
Martin-Gorgojo A, Del Río de la Torre E. Emerging Formats for Dermatology Conferences and Meetings. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:453-459. [PMID: 32401717 DOI: 10.1016/j.ad.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- A Martin-Gorgojo
- Servicio de ITS/Dermatología, Centro de Diagnóstico Médico, Madrid, España.
| | | |
Collapse
|