Bioethics and telemedicine in Primary Health Care: a state-of-the-art review

Abstract

Telemedicine has emerged as a significant tool, particularly at the first level of health care — Primary Health Care (PHC) — and gained considerable prominence during the COVID-19 pandemic. As a relatively new health technology, several questions regarding its bioethical implications warrant thorough discussion. This narrative review explores telemedicine within the context of PHC and the associated bioethical considerations, aiming to present the current state of knowledge on the topic. The literature search was conducted in the Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), MEDLINE/PubMed, and Cochrane databases. The distinction between telemedicine and telehealth is often blurred, and the terms are used interchangeably in this study. Telemedicine has seen substantial development in recent decades, and PHC represents a particularly suitable environment for the expansion of this technology due to its structural and functional characteristics. Despite the apparent benefits, the ethical and legal challenges surrounding telemedicine require further investigation. Although international and national guidelines and regulations have been established to address these issues, they remain inadequate given the complexities of information and communication technologies and the inherently multifaceted nature of PHC.