Tele-Ethics Consultations

With increased availability of advanced clinical technology, medical ethics dilemnas become more frequent. More and more, families and healthcare professionals have differing views on whether aggressive treatment should be insituted (or continued). Nursing homes are often faced with the dilemna of a non-responsive patient who doesn't have immediate family or caretakers to make end-of-life decisions.

Major medical centers have robust Medical Ethics Committees to advise and consult on these issues, comprised of experts in medicine, the law, religion, ethics and philosophy, etc. But the smaller hospital or nursing home (especially in remote areas)often doesn't have access to internal resources of this nature.

Telehealth is providing a valuable link to solve these problems, allowing small remote facilities to access Tele-Ethics consultations and education for professionals.

The Missouri Dept of Health developed a collaborative effort where rural nursing homes could access virtual ethics consultation via telephone, email and video conferencing. The Missouri Telehealth Network and the Long Term Care Ombudsman Office collaborated to facilitate communications between remote nursing homes an an academic medical center to provide consultations with a clinical ethicist.

Facilities without videoconferencing were given laptops with video cameras, and in 2006 the network provided 23 "portable ethics consultations". The technology was also used to conduct training for clinical personnel to increase their understand of and comfort with challenging bioethics situations.

This targeted nice of distance education is another example of telehealth as a cost-effective means of improving patient care outside of physical borders.

Source: Fleming & Reynolds (2007), "Virtual clinical ethics consultation for long term care facilities." Presented at American Society for Bioethics and Humanities 9th Annual Meeting, October 2007, Washington DC.

For more information on ethics and telehealth, see www.ecri.org