بررسی تطبیقی جایگاه قراردادهای درمانی الکترونیکی (تلهمدیسین) در حقوق ایران و فرانسه
محورهای موضوعی : حقوق پزشکی
1 - کارشناسی ارشد حقوق خصوصی، گروه حقوق، دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، رشت، ایران.
کلید واژه: تلهمدیسین, قرارداد درمانی الکترونیکی, مسئولیت پزشک, رضایت آگاهانه, حقوق ایران, حقوق فرانسه. ,
چکیده مقاله :
تحولات گسترده فناوری اطلاعات و ارتباطات در دهههای اخیر، عرصه سلامت را بهطور بنیادین دگرگون ساخته و زمینهساز شکلگیری قراردادهای درمانی الکترونیکی یا تلهمدیسین شده است. این شیوه نوین درمانی با رفع محدودیتهای جغرافیایی و افزایش دسترسی بیماران به خدمات تخصصی، بهویژه در دوران همهگیری کرونا، به یکی از ارکان اصلی نظامهای سلامت جهانی تبدیل گردیده است. با وجود این مزایا، تلهمدیسین با چالشهای حقوقی و اخلاقی متعددی مواجه است؛ از جمله اعتبار قراردادهای الکترونیکی، مسئولیت پزشک در صورت بروز خطا، رضایت آگاهانه بیمار در فضای دیجیتال و حفاظت از دادههای سلامت.مطالعه حاضر با رویکرد توصیفی–تحلیلی و تطبیقی، جایگاه قراردادهای درمانی الکترونیکی در حقوق ایران و فرانسه را بررسی میکند. یافتهها نشان میدهد که حقوق فرانسه با تدوین مقررات اختصاصی، توانسته چارچوبی روشن برای اعتبار قراردادهای درمانی الکترونیکی، الزام به رضایت آگاهانه، حفاظت سختگیرانه از دادههای سلامت و نظام مسئولیتپذیری چندلایه ایجاد کند. در مقابل، حقوق ایران همچنان بر قواعد عام حقوق پزشکی و مسئولیت مدنی تکیه دارد و فاقد چارچوب مستقل و شفاف برای ساماندهی این روابط است. بر این اساس، پژوهش حاضر پیشنهاد میکند که نظام حقوقی ایران با الهام از تجربه فرانسه، نسبت به تدوین قوانین جامع، بازنگری در مسئولیت پزشکان و مراکز درمانی، و ایجاد نظام حمایتی ویژه برای دادههای سلامت اقدام نماید. این اصلاحات میتواند زمینه ارتقای کیفیت خدمات سلامت دیجیتال و افزایش اعتماد عمومی به قراردادهای درمانی الکترونیکی را فراهم سازد.
The extensive developments in information and communication technologies over recent decades have fundamentally transformed the field of healthcare and paved the way for the emergence of electronic medical contracts, or telemedicine. By removing geographical barriers and increasing patients’ access to specialized services, particularly during the COVID-19 pandemic, this modern mode of healthcare delivery has become one of the core pillars of global health systems. Despite these advantages, telemedicine faces numerous legal and ethical challenges, including the validity of electronic contracts, physicians’ liability in cases of medical error, informed consent in the digital environment, and the protection of health data.The present study adopts a descriptive–analytical and comparative approach to examine the legal status of electronic medical contracts in Iranian and French law. The findings indicate that French law, through the enactment of specific regulations, has succeeded in establishing a clear framework for the validity of electronic medical contracts, the requirement of informed consent, stringent protection of health data, and a multilayered liability regime. In contrast, Iranian law continues to rely on general principles of medical law and civil liability and lacks an independent and transparent framework for regulating these relationships. Accordingly, this study proposes that the Iranian legal system, drawing on the French experience, undertake the drafting of comprehensive legislation, revise the liability of physicians and healthcare institutions, and establish a dedicated protective regime for health data. Such reforms can contribute to improving the quality of digital health services and enhancing public trust in electronic medical contracts.
1. Ahmadi, M., Meraji, M., & Mashouf Jafarabad, E. (2018). Evidence of telemedicine in Iran: A systematic review. Journal of Paramedical Sciences and Rehabilitation, 7(1), 112–124. https://doi.org/10.22038/jpsr.2018.21592.1551[In Persian]
2. Alshawabkeh, F. A., & Al Ghaithi, R. A. A. (2024). The range of the administrative electronic contract. Ain Shams University Journal of Business and Law, 8(1). https://doi.org/10.51958/aaujbl2024v8i1p2
3. Badur, E. (2022). Uzaktan sağlık hizmeti sözleşmesi. Hacettepe Hukuk Fakültesi Dergisi. https://doi.org/10.32957/hacettepehdf.1173471
4. Bastani, P., Tahernezhad, A., & Hakimzadeh, S. M. (2020). A review of upstream health sector policy documents of the Islamic Republic of Iran regarding strategic purchasing of advanced and high-cost medical equipment. International Journal of Health Governance, 25(3). [In Persian]
5. Choi, H.-T. (2021). Liability for medical malpractice in telemedicine: A review of relevant regulations under medical law. Hanyang University Law Review, 32(4), 235–260. https://doi.org/10.35227/hylr.2021.11.32.4.235
6. Fujino, Y. (2022). À la recherche du juste consentement en matière de soins. Les Cahiers de la justice, 4, 635–646. https://doi.org/10.3917/cdlj.2104.0635
7. George, F. (2021). L’obligation d’information du médecin et le consentement éclairé du patient. Cliniques et Organisations, 48(1), 21–32. https://doi.org/10.3917/coe.481.0021
8. George, G., & Heitmann, B. E. (2021). Legal and regulatory implications of telemedicine. In Telehealth and Mobile Health (pp. 129–140). Springer. https://doi.org/10.1007/978-3-030-56917-4_9
9. Kasemsap, K. (2017). Telemedicine and electronic health: Issues and implications in developing countries. IGI Global. https://doi.org/10.4018/978-1-5225-2262-1.CH009
10. Khatibi, S., Norouzian, N., & Ahmadi Tabari, B. (2020). Factors affecting the quality of telemedicine during the COVID-19 pandemic with emphasis on Internet of Things technology. In Proceedings of the First National Conference on the Realization of Unattainable Ideas in Information Technology and Electronic Technology (Conference paper, in Persian). [In Persian]
11. Karimi, N. (2016). The ruling on receiving fees exceeding official tariffs by physicians in public medical centers from the perspective of jurisprudence and law. Journal of Medical Jurisprudence. [In Persian]
12. Kroitor, V. (2024). Electronic contracts on medical care of the population under the medical guarantees program. Bulletin of Kharkiv National University of Internal Affairs, 105(2, Part 1), 42–51. https://doi.org/10.32631/v.2024.2.04
13. Legros, P. (2023). L’impératif de sécurité des données de santé: De la nécessité technique à l’obligation juridique. Revue internationale de droit économique, 36(3), 13–37. https://doi.org/10.3917/ride.363.0013
14. Lytvynenko, A. A., & Jurkeviča, T. (2022). Freedom of contract and informed consent as part of contract for healthcare services. Socrates, 1, 33–42. https://doi.org/10.25143/socr.22.2022.1.033-042
15. Maharani, A. W., & Kolib, A. (2023). Legal aspects of therapeutic agreements in online-based health services (telemedicine). Asian Journal of Health Studies, 2(11). https://doi.org/10.58631/ajhs.v2i11.84[In Persian]
16. Manard, S., Vergos, N., Tamayo, S., & Fontane, F. (2019). Electronic health record in the era of Industry 4.0: The French example. arXiv.
17. Malekizadeh, A. H., Bagheban, R., Rahmanian, S., Biinat, S., & Kiani, M. A. (2020). Telemedicine: An unavoidable necessity for healthcare service providers with emphasis on legal aspects. Iranian Journal of Legal Research. https://doi.org/10.22038/IJP.2020.51593.4099[In Persian]
18. Mirniam, S. S. (2025). Transformation of healthcare services through telemedicine: The digital revolution in service of global health. Preprint, Islamic Azad University, Najafabad Branch. Retrieved from https://civilica.com/doc/2240821[In Persian]
19. Moeini, E., & Bakhtiari, Z. (2010). Identification and analysis of factors affecting the adoption of telemedicine technology in Iranian hospitals (Master’s thesis). Islamic Azad University, Science and Research Branch, Tehran. [In Persian]
20. Mohammadi, A., & Vahabzadeh, M. (2020). Legal and ethical challenges of medical confidentiality in Iran. Journal of Forensic Medicine, Toxicology and Legal Medicine of Iran, 10(1). [In Persian]
21. Nieto Melgarejo, P. (2016). Electronic commerce and electronic contracting: Foundations of the virtual market. 15, 54–76. http://repositorio.usil.edu.pe/handle/USIL/3243
22. Ollat, D. (2021). Preoperative information: Written first? Orthopaedics & Traumatology: Surgery & Research, 107(1), Article 102771. https://doi.org/10.1016/J.OTSR.2020.102771
23. Rasul, Z. M. (2023). The law applicable to the electronic medical consultation contract: A comparative analytical study. https://doi.org/10.17656/jlps.10245[In Persian]
24. Raynaud, J. (2022). L’e-santé en France: Déclinaisons et implications territoriales. NETCOM, 36(3–4). https://doi.org/10.4000/netcom.7295
25. Rastegar, R., Feyjan, M. B., & Babaei, D. (2024). Factors affecting the development of legal culture of civil liability in telemedicine. Contemporary Legal Studies, 2(4), 280–297. https://doi.org/10.61838/jecj.2.4.16[In Persian]
26. Saee, S. M. H., & Saghafi, M. (2014). A legal study of telemedicine. Journal of Medical Law, 8(28), 143–166.
27. Salmani, M., Taghizadeh, E., & Saeedi, M. H. (2019). The role of fault in physicians’ civil liability and its comparison with the general rule of civil liability in Iranian jurisprudence and law. Journal of Islamic Jurisprudence and Law Research. [In Persian]
28. Saradhadevi, S., & Hemavathy, R. (n.d.). Telemedicine. https://doi.org/10.21275/v5i1.20121501
29. Sedaghat Dabestan, M., & Latifi, E. (2024). The role of information and communication technology in the economic and social transformation of contemporary societies. In Proceedings of the Ninth National Conference on New Approaches in Education and Research, Iran. [In Persian]
30. Sitarz, M., Gliwa, A., & Dudzińska, E. (2023). Telemedicine as a new form of medical services: Legal aspect. Teka Komisji Prawniczej PAN. https://doi.org/10.32084/tkp.8112
31. Sravanthi, K., Prasant, P., Bedi, R. K., & Rajpoot, N. K. (2025). Smart contracts and healthcare transactions (pp. 102–128). https://doi.org/10.2174/9798898810634125010009
32. Stanberry, B., et al. (2000). Contracting with health-care customers and specialists for the provision of telemedicine services across European borders. Journal of Telemedicine and Telecare, 6. https://doi.org/10.1258/
33. Williatte, L. (2022). Télésanté et cadre réglementaire: Des conditions de réalisation aux responsabilités juridiques des professionnels de santé. La Presse Médicale Formation.