The current status of medicolegal issues surrounding telepathology and telecytology in Japan

The medicolegal issues surrounding telepathology and telecytology in Japan have been partly resolved since the government declared that telediagnosis in these fields using a microscope is essentially a medical practice betwee n doctors. Thus it does not contravene article 20 of the law pertaining to medical practice in Japan, which states that there must be an actual face-t o-face encounter between the doctor performing any diagnostic or treatment episode and the patient. It is, however, only beginning to be recognized th at the medicolegal issues surrounding telepathology and telecytology depend on factors such as the type of system used (e.g. active versus passive). I n an active diagnostic system, the telepathologist or telecytopathologist c an control a robotic microscope at the remote site, while in a passive diag nostic system the telepathologist or telecytopathologist makes the diagnosi s based on the microscope images that have been selected, and transmitted, by someone in the remote hospital. In the former case the interpreting tele pathologist or telecytopathologist must assume most of the responsibility f or the diagnostic process, while in the latter more responsibility must be assumed by those at the remote site. The duties and responsibilities of all participants in the telediagnostic process, whatever the system employed, must be determined. We have established working guidelines for telepatholog ical and telecytological diagnoses to help achieve this and hence ensure sa fe and effective clinical practice.