251012P - ETHICS OF VIRTUAL CARE: CHALLENGES

Presented at the orientation of Postgraduates KAAUH on October 12, 2025 by Prof Omar Hasan Kasule, Chairman, Ethics Committee

DEFINITION OF VIRTUAL CARE

• Virtual care uses digital technology (phone, video, apps, etc.) to provide health services remotely by connecting patients with healthcare providers.
• Its benefits are enabling monitoring and care at home.
• Complements and does not replace the personal physician-patient relationship.
• Covers a wide range of services: consultation, assessment, and monitoring.

WHY VIRTUAL CARE

• Convenience: not traveling saves time and money.
• Accessibility: increases accessibility to professional services.
• Efficiency: can be more efficient in some services.

PRIVACY AND CONFIDENTIALITY

• Physician-patient privacy and confidentiality.
• Virtual care is liable to violations of confidentiality.

EFFECTIVE COMMUNICATION AND INFORMATION ACCURACY

• Effective communication is necessary for successful patient-physician communication.
• Virtual care may not have all the aspects of effective communication.
• Virtual communication may involve some inaccuracies or incompleteness.

HOLISTIC CARE

• The human being is dualistic: jasad & nafs. He has material as well as psychological needs.
• Medical care must be holistic to cover all the needs of the human body.
• Virtual care, by removing the direct patient-physician contact, limits holistic care.

HUMAN CONTROL vs MACHINE CONTROL

• Under the Qur’anic paradigm of taskhiir (14:32-33, 31:20, 45:13), the human was endowed with special intellectual power in the form of the largest cerebral cortex area/body volume to control the rest of creation (living and non-living). 
• The human makes tools like computers that must remain under human control. The human was also endowed with moral judgement to be able to tell the right from the wrong pathways (najdain) (90:10). 
• Before recent developments of autonomous artificial intelligence, the computer was a decision support system under the programmer who could predict all its decisions. 
• In the modern AI era, the computer has some ability to learn on its own, to think, and to decide solutions to some problems creatively, such as disease diagnosis, disease drug treatment, and surgical procedures

LIABILITY FOR ERRORS

• The debate is still open whether the human has lost control or, worse, whether the human is under machine control. 
• Assuming the human has lost control raises the legal and ethical question of who is liable (machine vs human) in cases of mistakes by AI that result in residual harm for the patient: mistakes in the diagnosis, the procedures, and the prognostication. Liability also arises in cases of potential criminal manipulation of AI. 
• In case of a medical error, who is professionally accountable and liable: the programmer, the seller of the software, the owner of the software, or the physician in closest contact with the patient? Assuming the human has lost the endowment of taskhiir and is under AI control, we have to discuss legislation that will modify or, if necessary, stop unwanted AI developments.