A detailed analysis of ethical considerations for three specific models of teleneuropsychology during and beyond the COVID-19 pandemic

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).

KEYWORDS:

• Ethics
• teleneuropsychology
• COVID-19

Acknowledgements

This work was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Medical Research Service of the VA Palo Alto Health Care System, and the Department of Veterans Affairs Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC). We would also like to acknowledge L. Chauncey Green, who assisted in the design of Figure 1.

Disclosure statement

No potential conflict of interest was reported by the authors.