Sound Trust and the Ethics of Telecare

The adoption of web-based telecare services has raised multifarious ethical concerns, but a traditional principle-based approach provides limited insight into how these concerns might be addressed and what, if anything, makes them problematic. We take an alternative approach, diagnosing some of the main concerns as arising from a core phenomenon of shifting trust relations that come about when the physician plays a less central role in the delivery of care, and new actors and entities are introduced. Correspondingly, we propose an applied ethics of trust based on the idea that patients should be provided with good reasons to trust telecare services, which we call sound trust. On the basis of this approach, we propose several concrete strategies for safeguarding sound trust in telecare

Axial, coronal and sagittal PET/CT images showing increased FDG-uptake in the rib (A, red arrow), spine (B, red arrowhead), spleen (B, brown arrowhead) and pelvic bone (C, blue arrow) suggesting lymphoproliferative disease.

<p>This PET/CT diagnosis was histologically confirmed after a bone marrow biopsy was performed.</p

Flowchart retrospective study (ESR = Erythrocyte Sedimentation Rate; FUO = Fever of Unknown Origin, PMR = Polymyalgia rheumatica, AML = acute myeloid leukemia, n.a. = not applicable).

<p>*This patient died 1 month after PET/CT, gastric cancer was confirmed pathologically. † Polyarteritis nodosa (diagnosed with angiography).</p

Examinations performed prior to PET/CT scan in patients included in retrospective study.

<p>Examinations performed prior to PET/CT scan in patients included in retrospective study.</p

Axial PET/CT images showing physiological 18-FDG uptake in the bladder (green arrow) and increased peri-rectal 18-FDG uptake (A, red arrow).

<p>Additionally, the presence of air is detected on the low-dose CT (B). This was not present on an abdominal CT-scan that was performed prior to the PET/CT-scan. A diagnosis of peri-rectal abscess was confirmed during explorative surgery.</p