COVID-19 : pratique et éthique de l’évaluation par vidéoconsultation des enfants avec trouble du spectre de l’autisme

OBJECTIVES: The COVID-19 crisis dramatically broke down the administrative, technological and clinical barriers that previously existed in the field of telemedicine. There is an important need to define standards for remote clinical observation, for instance in case of suspected autism spectrum disorder (ASD). Describing tools for the remote assessment of children with ASD and reflecting upon the ethical aspects of this practice will improve the quality of care with telemedicine. METHOD: Since 2013, we have conducted clinical evaluations by means of telemedicine at the center for diagnostic and evaluation of autism of the GHU Paris Psychiatry and Neurosciences which have afforded us opportunities to develop information tools and specific procedures. This clinical procedure is associated with ethical reflections that we included in our procedure. RESULTS: Benefits and risks are presented to families, and informed consent is obtained. The use of validated tools is privileged and their results are analyzed in light of the clinical experience of the professional. Privacy for persons and professionals is preserved, and the patient-doctor relationship is reinforced because of the ability of the patient to make decisions and feel more empowered in the context of the videoconsultation. CONCLUSION: The COVID-19 crisis was the impetus for a dramatic increase in the use of telemedicine with a potential risk because of the broad and blurry framework of its application. Clinical and ethical concerns must be studied. Moving forward, societal reflection about the accessibility of telemedicine will be necessary: telemedicine for all should be a future perspective.