Cybermedicine and the moral integrity of the physician-patient relationship

Some critiques of cybermedicine claim that it is problematic because it fails to create physicianpatient relationships. But, electronically mediated encounters do create such relationships. The issue is the nature and quality of those relationships and whether they are conducive to good patient care and meet the ethical ideals and standards of medicine. In this paper, I argue that effective communication and compassion are, in most cases, necessary for the establishment of trusting and morally appropriate physician-patient relationships. The creation of these relationships requires patients and physicians to take psychological and emotional risks and to make commitments to each other. The problem is that by altering the form and content of verbal and non-verbal behaviors and by limiting the kinds of interactions that can take place, cybermedicine makes risk-free interactions easier and more commonplace and retards the development of physician compassion and patient trust. In doing so, cybermedicine encourages morally inappropriate physician-patient relationships. I argue that Merleau-Ponty's notion of embodiment and Kierkegaard's criticisms of disinterested reflection help us to understand how cybermedicine can undermine patient health and well being and why it should be seen as a possible threat to the moral integrity of physician-patient relationships. © 2004 Kluwer Academic Publishers.