Cyberdermatoethics I: ethical, legal, technologic, and clinical aspects of patient-physician e-mail

Bioethical Conflicts in Current Dermatology: A Narrative Review

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.

Complexity and Simplicity in Doctor–Patient Email Consultations

NEW TECHNOLOGIES HAVE FACILITATED DOCTOR–PATIENT EMAIL CONSULTATIONS (E-CONSULTATIONS). GUIDELINES FOR E-CONSULTATION USE IN DENMARK STATE THAT THEY SHOULD BE USED FOR SIMPLE, CONCRETE AND NON-URGENT QUERIES; HOWEVER, A SMALL-SCALE DANISH STUDY SUGGESTED THAT DOCTORS ENCOUNTER E-CONSULTATIONS THAT DO NOT MATCH THE GUIDELINES. THE PURPOSE OF THIS ARTICLE IS TO EXPLORE WHETHER E-CONSULTATIONS IN DENMARK REFLECT RECOMMENDATIONS THAT THEY SHOULD BE SIMPLE, SHORT, CONCRETE AND WELL DEFINED, AND IF NOT, WHAT FORMS OF COMPLEXITY ARE EVIDENT. WE INDUCTIVELY ANALYSED 1,671 E-CONSULTATIONS FROM 38 PATIENTS AGED 21–91 YEARS COMMUNICATING WITH 28 DOCTORS, 6 NURSES, 1 MEDICAL STUDENT AND 8 SECRETARIES. RESULTS SHOWED BOTH QUANTITATIVE COMPLEXITY IN TERMS OF NUMBER OF INTERACTION TURNS, COMMUNICATIVE PARTICIPANTS, AND QUESTIONS ASKED, AND QUALITATIVE COMPLEXITY RELATING TO PATIENTS’ PSYCHOSOCIAL CONTEXTS AND GPS’ BIOMEDICAL DISEASE PERSPECTIVE. THUS, DESPITE EXISTING GUIDELINES AND THE LEANNESS ASSOCIATED WITH THE EMAIL MEDIUM, MULTIPLE FORMS OF COMPLEXITY WERE EVIDENT. THIS MISMATCH HIGHLIGHTS THE NEED FOR THEORETICAL DEVELOPMENT AS WELL AS THE VALUE OF RE-EXAMINING EXISTING POLICIES AND GUIDELINES REGARDING EXPECTATIONS FOR E-CONSULTATION USE.

Legal risks of "curbside" consults

"Curbside" consults, in which physicians informally solicit one another's opinions, are an integral part of our medical culture and invaluable to the care of our patients. Unfortunately, there is widespread uncertainty as to the degree of legal risk they pose and growing concern in the risk management community that curbside consults should be limited in scope if not eliminated entirely. This places curbside consultants in a quandary, seemingly forced to choose among their ethical obligation to patients, their sense of duty to colleagues, and their own legal well-being. The author evaluates the legal aspects of curbside consults, distinguishes them from clinical interactions with which they must not be confused, and then provides guidance for conducting curbside consults. In conclusion, curbside consults should occur as often as needed and to whatever degree is necessary for proper patient care.