1 Manuscript Version 22 February Forthcoming in Journal of Medicine and Philosophy Sound Trust and the Ethics of Telecare 1 Sander Voerman & Philip Nickel Abstract: The adoption of web‐based telecare services has raised multifarious ethical concerns, but a traditional principle‐based approach provides limited insight into how these concerns might be addressed and what, if anything, makes them problematic. We take an alternative approach, diagnosing some of the main concerns as arising from a core phenomenon of shifting trust relations that come about when the physician plays a less central role in the delivery of care, and new actors and entities are introduced. Correspondingly, we propose an applied ethics of trust, based on the idea that patients should be provided with good reasons to trust telecare services, which we call sound trust. On the basis of this approach, we propose several concrete strategies for safeguarding sound trust in telecare. Keywords: trust in medicine, web‐based telecare, informed consent, sound trust 1. Introduction Health information, monitoring and coaching are increasingly offered to individuals via web‐ based telecare services. These services take many forms, such as systems for home medical (self‐)monitoring and testing, online questionnaires with personalized feedback, personal coaching websites, or combinations of these. 2 Many have touted the benefits of web‐based 1 Thanks to Felicitas Kraemer, Manuela Luitjes, Marianne Boenink, Shannon Spruit, and two anonymous reviewers for JMP for their helpful comments and contributions. This article was based on research funded by the Netherlands Organization for Scientific Research (NWO). 2 These services, offered in many forms by many providers, share some common characteristics. They allow the physician to keep track of patients at a glance, flagging potentially dangerous situations, and allow patients to acquire knowledge and habits that help them manage their chronic illness. Along the way, patients receive feedback giving an overview of data such as blood pressure readings or progress in managing adverse health events. Some experimental systems also incorporate diagnostic and coaching functionalities that assist or take over some tasks from the physician, using algorithms