title: Ethical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession.
abstract: Home care, including hospice care, is a growing component of the current healthcare system and pertains to care services that are provided to individuals, their family members, and caregivers in their own residence. Both domains face funding limitations as life expectancy and the segment of the population older than 65 years increase. Tele-health, defined as the use of advanced telecommunication technologies to enable communication between patients and healthcare providers separated by geographic distance, is perceived as a concept that can enhance both home and hospice care and address some of the current challenges. This article discusses ethical challenges associated with the utilization of tele-health technologies by the nursing profession in the home setting. These factors form a framework for the ethical considerations that result from the introduction of these technologies in nursing practice. Specifically, the article discusses the issue of privacy and confidentiality of patient data, informed consent, equity of access, promoting dependency versus independence, the lack of human touch and the impact of technology on the nurse-patient relationship, and the medicalization of the home environment. These issues constitute a road map both for nursing practitioners who are aiming to provide an efficient delivery of services in the home and for nursing administrators who are asked to make judgments about the use of tele-health technology as a supplement to traditional care and as a cost-saving tool.
authors.affiliation: Department of Health Management & Informatics, School of Medicine, School of Social Work, and Sinclair School of Nursing, University of Missouri - Columbia, Columbia, Mo 65211, USA. DemerisG@missouri.edu
authors.forename: George
authors.initials: G
authors.lastname: Demiris
authors.forename: Debra Parker
authors.initials: DP
authors.lastname: Oliver
authors.forename: Karen L
authors.initials: KL
authors.lastname: Courtney
mesh_terms: D003219:Confidentiality; D006297:Health Services Accessibility; D006699:Home Care Services / Q000941:ethics*; D017051:Hospice Care / Q000941:ethics / Q000379:methods*; D006801:Humans; D007258:Informed Consent; D009723:Nurse-Patient Relations; D017216:Telemedicine / Q000941:ethics*; D014481:United States; D014584:User-Computer Interface