Online professionalism at #Scio10

Next week, Val Jones and I are leading a discussion of professional ethics as they intersect with a professional's online life.

Each profession has its own set of ethics and draws its own lines but medicine is what I know best. I'd like to invite participants (or anyone, actually) to proffer ethical dilemmas related to having an online presence.

Some things to think about:

  • Some professionals bypass the issue by either staying off the internet or remaining anonymous/pseudonymous. To abandon the internet is like practicing abstinence for STD and pregnancy prevention. To stay offline without considering the problem of "outing" is dangerous.
  • Many professionals are entrusted with personal or proprietary information. Aside from legal implications, how should you approach the problem of disclosing too much?
  • A professional's reputation is fluid. How can your online life affect this?

These are just a few of the questions I'm hoping people wish to discuss.

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It would be interesting to discuss the ways in which differing ethical constructs found in different professions come into conflict with each other when brought to the common arena of the blogosphere.

For example, the process of producing copy by a journalist and the process of producing written material that will be read by others by a scientist, vs. the same for a marketing specialist. Very different worlds, but when all are manefest as a blog post, and then people start talking about "blogging ethics" .... it can get interesting.

Very different worlds, but when all are manefest as a blog post, and then people start talking about "blogging ethics" .... it can get interesting.

One theme emphasized by authors who do serious work in the comic book/"graphic novel"/"sequential art" domain is that comics are a medium, not a genre; it's just the prevalence of superheroes in the American market which makes people conflate the two. (See, e.g., Scott McCloud's Understanding Comics.) I think that blogging has something of the same identity problem. To blog is to produce text with a certain type of software. Does each person using the technology employ it in the same way? Of course not: we vary in style, frequency, intended audience, use of multimedia elements, comment control, subjects of interest and much more besides. To treat the medium of blogging as a unified genre is to judge Maus or The Cartoon History of the Modern World or The Manga Guide to Statistics by the same standards as, I dunno, Ultimate Spider-Man.

Intriguing ideas. The trigger for my blog today (http://bit.ly/53xenE)was an email I received yesterday about a woman who resigned under pressure from University of Mississippi Medical Center. Seems a few years back the govna' may have had a physical on a Saturday, requiring a clinic to be open on a day not normally staffed with a whole bunch of OT for the employees. This woman suggested via twitter that Barbour should not have incurred these extra expenses. That was a way he could help with the state's "dire fiscal state."
Of course, seeing your doctor is protected health information. HIPAA violation = job loss for this woman.
Now, had she been a reporter and heard rumors of this, confirmed them, and published an article decrying this misuse of state resources, her speech would be protected I assume. I'm not a lawyer (thank the deities or random chance), but the reporter's article would be OK; they would have to get to the confirmatory sources, in that case, for the HIPAA violation.
Basically, my question is whether we in the health professions must protect patient confidentiality in this situation, especially if we feel there may have been misuse of public funds.
I thought it was an interesting issue that mushed up a bunch of "rights."

Wish I could go to Scio10, but I have this job... Will plan on it for next year.

What's your responsibility if Joe posts some personal medical information in the comments section ?
Joe should know better than to put personal info in an online forum, but say he didn't and now his last MRI is all up there for everyone to see. Do you take it down and hope nothing bad happens ?

From an ethical and legal standpoint, an individual can post any of their own medical information, no matter how imprudent. The real question is as a physician-blogger, do i have any responsibility to counsel him against it?

I had some recent medical issues which I will not discuss other than to say it got me thinking. And thus I asked my question. As for discouraging the posting of personal information, I'd think it would be enough to post a note that you don't do personal cases here. But, I'm no doctor, and my ethics training comes out of Engineering school, which is a different situation.

My identity is fairly easy to discover as a blogger, so I'm aware that I could be "outed" at any time.

My strategy has been to fictionalise: to change sexes, dates, details, but keep the major thinking point that makes the case interesting. Sometimes I combine cases. If you were a patient of mine looking carefully for yourself, it's still unlikely you would see yourself in the case, as my perspective is different from that of my patients. Imaging is anonymised, with details of history changed.

That's for medical stuff. For stuff like people coming into my office and trying to convert me to some religion, or lying drug reps, I merrily leave things alone.

Presumably this is what everyone does. I suppose at some point someone might ask me to stop, but my blog has such a small readership, the chances are pretty remote.