CYIL vol. 14 (2023)

CYIL 14 (2023) TELEMEDICINE IN THE CZECH REPUBLIC AND THE CONVENTION … telemedicine will be one of the crucial means to achieve at least the same equity in the access to health care as European patients benefit from nowadays. The demographic change seems to point to a rather disconcerting future. Aging populations of developed countries are known to increase health care expenditures 41 in synergy with the development of ever more complex and ever more expansive medical technologies. 42 At the same time, the demand for health services is growing much more rapidly than the numbers of physicians and other health professionals. The World Health Organization estimates that there will be the global shortage of 10 million health workforce by 2030, including in high-income countries (even though to a lesser extent than in their low- and middle-income counterparts). 43 As university-educated doctors have historically spread from cities to the countryside, today we seem to be at the start of the opposite process, where many villages and small towns will be gradually losing their physicians. From the human rights perspective, this process may conflict with the requirements set by the international law including the Convention on Human Rights and Biomedicine, since it would establish unjustified discrimination against people living outside of big population centres or those with limited economic or social capital. For the better or worse, future health systems will most likely be comprised of lower numbers of hospitals and other health facilities than we are used to today. The only viable remedy for the negative effects of the outlined trend seems to consist in building digital infrastructure of remote care. Telemedicine in close connection with artificial intelligence and other digital tools is likely to play a crucial role in that process. 3.2 Standard of Care Article 4 of the Convention on Human Rights and Biomedicine states that “ [a]ny intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards. ” It is left to the national jurisdictions what form will the professional standards take: whether they will be embodied in professional codes of ethics, codes of medical conduct, health legislation, or even whether some of them will be unwritten. 44 The Explanatory Report to the Convention acknowledges that “ [t]he content of professional standards, obligations and rules of conduct is not identical in all countries. The same medical duties may vary slightly from one society to another. ” 45 However, it also takes notice that “ the fundamental principles of the practice of medicine apply in all countries. Doctors and, in general, all professionals who participate in a medical act are subject to legal and ethical imperatives. They must act with care and competence, and pay careful attention to the needs of each patient. ” 46 41 See DE MEIJER, C., WOUTERSE, B., POLDER, J., KOOPMANSCHAP, M. The effect of population aging on health expenditure growth: a critical review. European Journal of Ageing. (2013, Vol. 10, No. 4), pp. 353–361. doi: https://doi.org/10.1007/s10433-013-0280x. 42 See CINAROGLU, S., BASER, O. The relationship between medical innovation and health expenditure before and after health reform. Health Policy and Technology. (2018, Vol. 7, No. 4), pp. 379–387. doi: https://doi. org/10.1016/j.hlpt.2018.10.001. 43 See Health workforce. World Health Organization. accessed 27 August 2023. 44 See Explanatory Report to the Convention on Human Rights and Biomedicine, point 30. 45 Ibid., point 31. 46 Ibid.

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