Ethical and Legal Issues Related to Telepractice

ABSTRACT

The subject of speech-language pathologists providing services over a distance via telepractice is attracting the attention of the profession. The new service delivery model will challenge us to exploit its potential without violating legal constraints or compromising our affirmative ethical responsibilities. This article provides an overview of the implications of current state licensure laws on telepractice and a look at the issues of competence, standard of care, privacy, informed consent, and the use of support personnel. Several principles are offered to guide the practitioner and additional resources are suggested.

KEYWORDS

Speech-language pathology - telepractice - standard of care - interstate licensure - privacy - speech-language pathology assistants - ethical responsibility

REFERENCES

• 1 American Speech-Language-Hearing Association. Telepractices and ASHA: Report of the Telepractices Team. Rockville, MD: American Speech-Language-Hearing Association; 2001
• 2 American Speech-Language-Hearing Association. Survey of telepractice use among audiologists and speech-language pathologists. Rockville, MD: American Speech-Language-Hearing Association; 2002
• 3 American Speech-Language-Hearing Association. Code of Ethics (revised). ASHA Supplement 23. Rockville, MD: American Speech-Language-Hearing Association; 2003
• 4 Brennan D, Georgeadis A, Barker L. Comparison between face-to-face and remote telerehabilitation with brain injured subjects [abstract].  Telemed J E Health . 2002;  8 224
• 5 Burgiss S, Sprang R, Tracy J. Telehealth technology guidelines. Health Resources and Services Administration Office for the Advancement of Telehealth Available at: http://telehealth.hrsa.gov/ pubs/tech/techhome.htm. Accessed January 16 2003
• 6 Anonymous. 2001 Report to congress on telemedicine. Health Resources and Services Administration Office for the Advancement of Telehealth Available at: http://telehealth.hrsa.gov/pubs/report2001/main.htm. Accessed January 16 2003
• 7 Bartholomew L. Presented at Center for Telemedicine Law, April 2002, Washington, DC . 
• 8 World Medical Association. 1999 Statement on accountability, responsibilities and ethical guidelines in the practice of telemedicine.  Available at: http://www.wma.net/e/policy/a7.htm. Accessed June 3 2003
• 9 Pope K, Vasquez M. Ethics in Psychotherapy and Counseling.  San Francisco, CA: Jossey-Bass 1991: 51-52
• 10 American Speech-Language-Hearing Association. Guidelines for training, credentialing, use, and supervision of speech-language pathology assistants. ASHA 1996 38 (suppl 16): 2
• 11 American Speech-Language-Hearing Association. Model Bill of Rights for people receiving audiology or speech-language pathology services.  ASHA   1994;  36 70
• 12 American Speech-Language-Hearing Association. Technical report: the protection of rights of people receiving audiology or speech-language pathology services.  ASHA   1994;  36 60-62
• 13 Maheu M. Risk management in telehealth and telemedicine. Presented at the May 2000 Annual Meeting of the American Telemedicine Association, Phoenix, AZ; 2000
• 14 Anonymous. State health privacy laws. Health Privacy Project. Available at: http://www.healthprivacy.org/info-url_nocat2304/info-url_nocat.htm. Accessed January 21, 2003
• 15 Anonymous. 2001 Report to congress on telemedicine, executive summary. Health Resources and Services Administration Office for the Advancement of Telehealth Available at: http://telehealth. hrsa.gov/pubs/report2001/exec.htm. Accessed January 16 2003
• 16 Office for the Advancement of Telehealth. Privacy, HIPAA and telemedicine. Health Resources and Services Administration Office for the Advancement of Telehealth. Available at: http://telehealth. hrsa.gov
• 17 Anonymous. Medical privacy-national standards to protect the privacy of personal health information. US Department of Health and Human Resources Office of Civil Rights Available at: http://www.hhs.gov/ocr/hipaa/privacy.html. Accessed January 16 2002