Abstract

Objective: Teleneuropsychology (TeleNP) and the ethical guidance related to TeleNP is not new. However, the emergence of the coronavirus-2019 (COVID-19) has generated renewed interest in the potential utility and feasibility of transitioning the clinical practice of neuropsychological assessment from an in-person evaluation to one that occurs at least partially via telehealth. Recent surveys of neuropsychologists practicing in the early stages of COVID-19 indicate that, while most clinicians will or currently engage in TeleNP services, many have concerns about ethical issues related to providing TeleNP. Despite the presence of APA guidelines for telepsychology, no formal APA ethical guidelines or standards of practice exist for TeleNP. We provide ethical considerations and suggestions for potential practitioners of TeleNP based on new models of practice derived in response to the COVID-19 pandemic. Method: We provide operational definitions of TeleNP and its models including: In-Clinic, Home, and Hybrid TeleNP models. Results: We outline ethical considerations and suggestions in general and by model related to: issues of competence, education and training, benefits and risks of conducting TeleNP, health disparities, informed consent, patient privacy, confidentiality, test security, and administration and interpretation of standardized assessments. Conclusions: The decision of which TeleNP model to use is a difficult one. Providers must balance several ethical considerations to complete an accurate assessment while managing numerous inherent challenges. Future efforts should focus on the creation of formal ethical guidelines and standards for the practice of TeleNP through joint task force efforts (e.g., APA, Inter Organizational Practice Committee).

摘要

客观的：Teleneuropsychology (TeleNP) 和与 TeleNP 相关的伦理指导并不新鲜。然而，2019 冠状病毒 (COVID-19) 的出现引起了人们对将神经心理学评估的临床实践从面对面评估转变为至少部分通过远程医疗进行评估的潜在效用和可行性的新兴趣。最近对在 COVID-19 早期阶段执业的神经心理学家进行的调查表明，虽然大多数临床医生将或目前从事 TeleNP 服务，但许多人对与提供 TeleNP 相关的伦理问题表示担忧。尽管存在远程心理学的 APA 指南，但 TeleNP 没有正式的 APA 道德指南或实践标准。方法：我们提供 TeleNP 及其模型的操作定义，包括：临床、家庭和混合 TeleNP 模型。结果：我们概述了一般的伦理考虑和建议，并通过与以下模型相关的模型：能力问题、教育和培训、进行 TeleNP 的益处和风险、健康差异、知情同意、患者隐私、保密性、测试安全以及管理和解释标准化评估。结论: 决定使用哪种 TeleNP 模型是一个困难的决定。提供者必须平衡几个道德考虑，以完成准确的评估，同时应对众多固有挑战。未来的努力应该集中在通过联合工作组的努力（例如，APA，组织间实践委员会）为 TeleNP 的实践创建正式的道德准则和标准。