Approved by the Executive Board of the Finnish Medical Association in 1997. The term telemedicine refers to the practice of medicine over a distance. In
telemedicine, interventions, diagnostic and treatment decisions and recommendations are
based on data, documents and other information transmitted through telecommunication
systems. Telemedicine is one way of practising medicine which may provide opportunities and
increase possibilities to effectively use available human and material resources The
possibilities offered by telemedicine must be open to all doctors over geographical
borders. Physicians practising telemedicine must be authorised to practise medicine in the
country or state in which they are located and must be competent in the field of medicine
in which they are practising it. When practising telemedicine directly with the patient,
the doctor must be authorised to practice medicine in the state where the patient is
normally resident or the service must be internationally approved. The use of telemedicine must not adversely affect the individual patient-doctor
relationship which, as in all fields of medicine, must be based on mutual respect, the
independence of judgement of the doctor, autonomy of the patient and professional
confidentiality. It is essential that the doctor and the patient can reliably identify
each other in a telemedicine consultation. Preferably, all patients seeking medical advice should see a doctor in a face to face
consultation, and telemedicine should be restricted to situations in which a doctor can
not be physically present within acceptable time. The major application of telemedicine is
the situation in which the treating doctor seeks another doctor´s opinion or advice, at
the request of or with the permission of the patient. Where a direct telemedicine consultation is sought by the patient, it should normally
only take place when the doctor has an existing professional relationship with the
patient, or has adequate knowledge of the presenting problem, such that the doctor will be
able to exercise proper and justifiable clinical judgement. In an emergency, such judgements may have to be based on less than complete
information, but in these instances the danger to the health of the patient will be the
determinant factor in providing advise or treatment. The doctor asking for another doctor´s advice remains responsible for treatment and
other decisions and recommendations given to the patient. When practising telemedicine directly with the patient, the doctor assumes
responsibility for the case in question. The doctor performing medical interventions via telemedical techniques is responsible
for those interventions. A doctor practising telemedicine is responsible for the appropriate quality of his/her
services. He/she must not practise telemedicine without ensuring that the equipment
necessary for the telemedical services rendered is of sufficiently high standard and
adequately operational. The doctor must carefully evaluate the data and other information he/she has received.
Medical opinions and recommendations can only be given and medical decisions made if the
quality and quantity of data or other information received is sufficient and relevant for
the case in question. When performing medical interventions over distance, the doctor must secure the
presence of sufficient and adequately trained personnel assisting the patient and his/her
continuing care. All doctors practising telemedicine must keep adequate patient records and all cases
have to be properly documented. The manner of patient identification shall be recorded, as
well as the quantity and quality of data and other information received. Findings,
recommendations and telemedical services delivered shall be adequately documented. The principles of medical ethics which are binding upon the profession shall also be
followed in the practice of telemedicine. Normal rules of confidentiality and security also apply to telemedicine documentations
Storing or transmission methods may be used only where confidentiality and security can be
guaranteed. Patient data and other information may only be transmitted to a doctor or other health
professional on the request or with the informed consent (permission) of the patient and
to the extent approved by him/her. The data transmitted must be relevant to the problem in
question.ETHICAL GUIDELINES IN TELEMEDICINE
Adopted by the Commité Permanent the 12th of April 1997
CP 97/033 EN Definition
Authorisation - competence
Patient - doctor relationship
The responsible physician
Quality, security and safety in telemedicine
Patient documents
Medical ethics, patient consent and confidentiality
Förbund
The Finnish Medical Association -
Health Care and the Medical Profession in Finland
Association
