Ethical, Legal, and Social Issues in Digital Dermatology

Telemedicine and artificial intelligence (AI) are expected to revolutionize healthcare. These digital healthcare services can contribute to increased access to quality services and improve accuracy of diagnosis and treatment. However, as in other domains of care, technological innovation can have profound implications and reveal new scenarios that deserve ethical, legal, and social scrutiny. In this chapter we identify and analyze some of the most important ethical, legal, and social issues related to the deployment of these innovations in dermatology. We assess risks that these services can pose to the doctor-patient relationship and consider their impact on healthcare accessibility. We then focus on the risks of bias intrinsic to AI predictions, particularly with regard to patients’ skin color. Then we summarize the most important policies, current at the time of this writing in 2021, regarding telehealth, digital medicine, and the field of AI by the European Commission in the European Union and the Food and Drug Administration in the United States. We also present professional organization guidelines issued by late 2021 by the World Health Organization, World Medical Association, American Medical Association, and the American Academy of Dermatology. We conclude with suggestions for how dermatologists can assess ethical, legal, and social issues raised by teledermatology and AI.