The statement calls on national medical associations to develop and implement practice guidelines for physicians and to encourage the development of standard protocols, which address medical and legal issues such as physician registration and liability, and the legal status of electronic medical records.

In its new statement on Accountability, Responsibilities and Ethical Guidelines in the Practice of Telemedicine, the WMA says that the use of telemedicine has many potential advantages, allowing patients greater access to specialists and speeding up specialist services by transmission of medical images over long distances. Telesurgery enabled less experienced surgeons to perform critical surgery with the guidance of experts.

But because telemedicine disrupted some of the traditional principles governing the physician patient relationship, new ethical guidelines were required.

The Statement, adopted at the WMA's annual General Assembly meeting in Tel Aviv, Israel, sets out the principles governing the accountability and responsibilities of the physicians involved in telemedicine, the role of the patient and the rules governing patient consent and confidentiality. It says that when practising telemedicine directly with a patient located in another country or state, the physician must be authorised to practice in that state or country or it should be an internationally approved service.

Dr Anders Milton, chairman of the WMA Council, said:

'There is no doubt that development of electronic communications will increase the possibilities of the medical profession to further help our patients. But at the same time there is concern that this growing electronic medium could replace the personal relationship between patient and physician'.

'The WMA believes that in any consultation this personal relationship must continue'.