Elaborating and Discoursing the Ethics in eHealth in the Philippines: Recommendations for Health Care Practice and Research

Martha Jane Pauline S. Umali,1,2 Alyssa Marie A. Evangelista-Sanchez,1 Jinky Leilanie Lu1,3
Arturo M. Ongkeko Jr.,1 Patrick G. Sylim,1 Abby Dariel F. Santos,1 Jonathan G. Fabia,1
Portia H. Fernandez-Marcelo1 and Paul Matthew D. Pasco1,4

1National Telehealth Center, National Institutes of Health,
University of the Philippines Manila
2Department of Family and Community Medicine, College of Medicine and
Philippine General Hospital, University of the Philippines Manila
3College of Arts and Sciences, University of the Philippines Manila
4Department of Neurosciences, College of Medicine and
Philippine General Hospital, University of the Philippines Manila

Objectives. The objectives of the research study were to determine ethical guidelines and principles applicable in the practice and research of eHealth and telehealth in the Philippines, how these are applicable to the Philippines, and to differentiate between the ethical issues in research and in clinical practice of eHealth.

Methods. This research study used: 1) review of ethics manuscripts, guidelines and literature; 2) focused group discussion and key informant interviews of experts; and 3) triangulation. The information sought for the review were- 1) relevant policies, guidelines in eHealth that are pertinent to the discussion of eHealth ethics in the Philippines; 2) components of ethics in eHealth research; and 3) components of ethics in eHealth practice. The framework of the consultation with experts was to identify mechanisms and strategies in incorporating ethics in both eHealthpractice and eHealth research within the following- 1) in reference to existing laws, policies, and guidelines on ethics in medicine and health; and 2) in the context of the Philippine setting.

Results. Based on the review, there are pertinent codes of ethics, applicable laws, policies and guidelines in eHealth, both in the international and local settings. The focus group discussion and key informant interview with experts yielded significant and deeper understanding on how to address the gaps and lapses of ethics applied to eHealth in the country. These recommendations were given which distinguish between the ethics in clinical practice and ethics in the planning and implementation of eHealth systems. There is also a need to resolve the problem of whose primary responsibility the patient is- the referring, commonly referred to as the attending physician in the local community, or the specialist from the center. The proposed resolution was also presented.

Conclusion. The study has shown how important eHealth in potentially promoting timely and improved health care access. However, there are still lapses and gaps in the implementation of policies and guidelines on and relating to eHealth in the Philippines as shown by the data culled from the review and the focus group discussions with the experts. With more specific ethical guidelines and relevant policies, the development and practice of eHealth and telehealth will be on its way in bridging the gap and aiding in health systems development in the Philippines, especially with the support of the national government and collaboration of various agencies and stakeholders.

Key Words: ethics, eHealth, telehealth, telemedicine, Philippines