CYIL vol. 14 (2023)

PETR ŠUSTEK CYIL 14 (2023) souhlasu. Není potřebné měnit systém právní odpovědnosti za lékařské pochybení pro účely telemedicíny, neboť jeho principy postačují k tomu, aby se pacienti byli schopni domoci spravedlivé náhrady újmy. Key words: telemedicine, equitable access to health care, standard of care, informed consent, Convention on Human Rights and Biomedicine, Czech law, health law, medical law On the author: doc. JUDr. Petr Šustek, Ph.D., is an Associate Professor at the Charles University Faculty of Law (Prague), where he is the head of the Department of Medical Law and teaches at the Department of Civil Law. His main area of interest lies in civil law (especially tort law) and medical law. Introduction Telemedicine has been widely discussed in the professional discourse on health care in the recent years, only to reach unprecedented relevance during the Covid-19 pandemic 2 and beyond. Its potential benefits to individual patients and public health are many, ranging from better access to health care and higher patient comfort to actual improvements in clinical outcomes in certain fields. 3 Yet there remain many unanswered critical questions regarding the very definition and classification of telemedical services, legal liability for malpractice, standard of care, or informed consent. A consensus has yet to be reached among the professional community on the nomenclature for different types of telemedicine. It has not even been clarified just how many types of remote services it is reasonable to distinguish and what they consist of. As an example, consider the World Health Organization basic classification of telemedicine, which consists of four components: 4 – consultations between remote client and health worker – remote monitoring of client health or diagnostic data by provider – transmission of medical data to health worker – consultations for case management between health worker(s). It is obvious that telemedicine contains a vast array of different procedures, communication strategies, and situations such as when the patient and the health professional (provider) are not physically located in the same place at the time of the provision of health services. Many of these activities have little to no parallel in the history of health care. In the absence of longer experience and international consensus, national laws struggle to find their own way to regulate telemedicine. Nevertheless, many of jurisdictions are bound by international law obligations that delineate the basic framework for such regulation. 2 See for example SOUMIK, M., WIESENFELD, B. M., MANN, D., LAWRENCE, K., CHUNARA, R., TESTA, P., NOV, O. Evidence for Telemedicine’s Ongoing Transformation of Health Care Delivery Since the Onset of COVID-19: Retrospective Observational Study. JMIR Formative Research. (2022, Vol. 6, No. 10). Doi: https://doi.org/10.2196/38661. 3 See for example SNOSWELL, C. L., CHELBERG, G., DE GUZMAN, K. R., HAYDON, H. H., THOMAS, E. E., CAFFERY, L. J., SMITH, A. C. The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare. (2021.) doi: https://doi. org/10.1177/1357633X211022907. 4 As cited from Annex 1 (Classification of Digital Health Interventions and Health System Challenges) to the WHO Guideline: Recommendations on Digital Interventions for Health System Strengthening. WHO 2019, p. 97.

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