Doctors Go Digital With Anonymous Blogs — And They’re Taking Your Story With Them
March 21, 2007 by Kristen King
Filed under Women's Health
What if you were this patient?
This particular ER physician must have been new since I’ve never heard of him prior to this morning. He told me about a patient who came in with groin pain x 3days and he ordered a CT scan showed an abscess in his perineum extending from under his scrotum to his rectal area. The radiologis’s report had the words “Fournier’s gangrene”.*
Or this one?
She walked into the NICU with a slow gait, her head bowed, and not making eye contact with anyone. When I began talking to her she answered in short, quiet phrases. A former heroin and methadone addict whose other children had been removed from her custody, her body language and demeanor practically screamed “I have no self confidence.”
And why should she? Unemployed herself, she was walking into a room full of productive, gainfully employed people. Her mothering skills were thought to be so marginal that she had to have Protective Services check her out before she could take her baby home. Everyone in the NICU knew that, and she knew they knew it. It was no wonder she felt insecure.*
The authors may have the best of intentions, and may even be recounting the stories warmly and with a loving tone, but they’re still doctors telling patient stories in a public forum, and that’s an ethical gray area at best.
Here’s what the Washington Post had to say about it:
As Internet blogging spreads across professions, doctors’ observations and opinions about patients — some expressed in graphic detail — are now ending up on the Web for all to see.
Hundreds of doctors across the country are writing Internet diaries that sometimes include harsh judgments of patients, coarse observations and distinct details of some cases.
Medical blogging is so new that medical boards, schools and professionals disagree on what is acceptable. Critics say the blogs cross into an ethical gray area and threaten patient privacy while posing liability risks for health workers and their employers.
What do you think?
Contents © Copyright 2007 Kristen King
I do think anonymous blogging about patients (without permission–Discover’s Vital Signs column prints similarly personal stories, but sans judgment and with patient consent) gets into unpleasant and perhaps morally problematic areas. While mostly it can just be kind of mean, I think the moral issues come in when the doctor provides enough detail about the case that someone would be able to recognize herself or his family member/friend.
Anonymous blogging in general, though–I continue to support that. I adore academic blogs, particularly those of grad students and female professors. I think the issues are a bit different there, since many of the academic blogs are about people with power over the blogger rather than someone vulnerable like a patient. Anonymity is the only way these people can safely discuss the sometimes gross unfairness and nasty politics of academic life. (And even when professors complain anonymously about students, it doesn’t have that edge of invasion of privacy that blogging about people’s medical conditions does.)
Really? This is a grey area? I’m seeing only black and white here.
Blogging about patients’ symptoms and diagnoses can definitely be beneficial for doctors and patients alike, but when doctors inject their personal and/or moral judgments about their patients and stray from just the facts ma’am, we’re swimming in decidedly unethical waters.
My opinion is based not only on my feelings as a potential patient but also on my training as an attorney. I would never dream that it would be ethical for a lawyer to blog about the personal lives of a client–even anonymously.
How could a doctor’s code of ethics be lower than a lawyer’s? Now that’s a scary thought.
I understand the need for an outlet, and I know that blogging seems safe, but I just hope that the person responsible for my medical care would have more sense. Is that too much to ask? A doctor with good common sense? Le sigh…
kk