Legal requirements for tele-assistance and tele-medicine

In dealing with tele-medicine including tele-diagnosis and tele-assistance, the legal and ethical components of medical liability must be satisfied. With medical tele-diagnosis, the spreading of medical liability is the main risk. How can we ensure a clear identification of the medical liabilities involved in cases where damage occurs? From a legal point of view, the spreading of the liability is not allowed and the use of tele-diagnosis must ensure a total transparence. As we cannot presently estimate the cost of a medical act based on the cost of the image records and the cost of image interpretation, it is necessary to establish a contract. Today the most convenient contract is similar to the contract between laboratories which implies that the liability is on the practitioner who has received the sample. In the future, other legal obligations may appear as tele-diagnosis develops. Indeed, with the increase in reliability in tele-diagnosis it could become a part of the medical obligation to use the latest technology. However, the excessive use of tele-assistance, when there is neither emergency nor medical isolation, is dangerous because it may affect the integrity and the quality of the traditional medical act. In general, medical practice without any clinical examination of the patient is contrary to medical ethics.