The Journal of clinical ethics
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Although many physicians have been using the internet for both clinical and social purposes for years, recently concerns have been raised regarding blurred boundaries of the profession as a whole. In both the news media and medical literature, physicians have noted there are unanswered questions in these areas, and that professional self-regulation is needed. This report discusses the ethical implications of physicians' nonclinical use of the internet, including the use of social networking sites, blogs, and other means to post content online. It does not address the clinical use of the internet, such as telemedicine, e-prescribing, online clinical consultations, health-related websites, use of electronic media for clinical collaboration, and e-mailing patients (some of which are already covered in the AMA's Code of Medical Ethics).
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Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. ⋯ Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources.
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After falling from a roof, an older man lost neurological function below his face. In two days, the patient regained consciousness, but it was unclear whether he could communicate his preferences, whether due to injuries or difficulties with language. His family believed he could communicate with them, and that he was capable of making treatment decisions. The staff did not think to contact the hospital's largely inactive ethics consultation service for assistance, and instead looked to the patient's living will for guidance, even though the patient was not terminally ill, and his lack of capacity had not been determined.
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Social media challenge--or have already redefined--conventional boundaries of public and private, personal and professional, friendship, and social relations generally. Here, I consider how these developments may affect professionalism, the physician-patient relationship, and our cultural experiences in a wholly different and unexpected way.
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The AMA Council on Ethical and Judicial Affairs (CEJA) has written a position paper on how social medical use challenges medical professionalism. The report offers persuasive ethical and practical guidelines for nonclinical internet use, specifically for social networking. ⋯ The guidelines call for professional reporting of questionable online portrayals or behaviors, but this commentary argues that this may be not only cumbersome to implement, but may violate aspects of constitutional rights. While online social networking may in many ways be a new application of old challenges, there may be other aspects that require novel approaches to medical professionalism.