The Moral Difference between Faces and FaceTime

Kyle E. Karches

Although telemedicine can be useful in certain situations, physicians should not consider it an adequate substitute for the office visit, writes Karches, an associate professor of health care ethics and internal medicine at St. Louis University. While seeing the potential for telemedicine to improve care for certain patients, he is concerned about what may be lost if telemedicine comes to replace many in-person visits. Telemedicine rules out an embodied encounter between physician and patient, in which the sense of touch has special importance.

Another Voice

Facing Progress with Pragmatism: Telemedicine and Family Medicine

Marc Tunzi

The singular expertise of family physicians is the ability to manage complexity with pragmatism, both clinically and ethically. Telemedicine raises multiple questions about the nature of the patient-physician relationship as manifested in clinical encounters. Some of these questions are concerning, underscoring the need to assess whether medical care is better with this new technology—or if it is just different or maybe even worse. It seems clear, however, that, regardless of its limitations, telemedicine is here to stay. The pragmatic complex ethical question, then, is how all of us together—both medical professionals and society at large—will manage it.

The Moral Value of Telemedicine to the Physician‐Patient Relationship

Benjamin S. Wilfond

Wilfond, a pediatric pulmonologist who cares for extremely premature babies, writes that his experience as a clinician was very positive and learning how to use telemedicine has made him a better doctor. An appointment can be a virtual house call that takes less time for his patient’s family and allows him to learn even more about their home. While there are limitations of telemedicine, there are good ethical reasons for clinicians to support the broader use of telehealth, including equity, efficiency, effectiveness, and respecting preferences. Empirical health-services research that assesses satisfaction, quality, and health outcomes will be necessary to determine the impact of telehealth on a population level to ensure that is used in a way that promotes equity in care.

Also in this issue:

Essay—Case Study

Smuggled Doughnuts and Forbidden Fried Chicken: Addressing Tensions around Family and Food Restrictions in Hospitals

Megan A. Dean and Laura Guidry-Grimes

It is a common practice for family members to bring food to hospitalized loved ones. However, in some cases, this food contravenes a patient's dietary plan. Such situations can create significant tension and distrust between health care professionals and families and may lead the former to doubt a family's willingness or ability to support patient recovery. This case-study essay offers an ethical analysis of these situations and offers strategies for creative problem-solving that center diet as a subject for shared decision-making and regular, ongoing communication among health care professionals, patients, and families.

Table of Contents Hastings Center Report: Vol 53, No 4 (wiley.com)

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  JOURNAL

The Hastings Center Report

METHOD OF RESEARCH

Commentary/editorial

SUBJECT OF RESEARCH

People