Blogging Physicians And Medical Ethics: Bumping Into Patient Privacy Rules?

COLUMBUS (TDB) -- This legal liability issue is probably already signed into the free speech waiting room. Sooner or later, a state medical board or plaintiffs' lawyers will tangle with a blogging doctor. The dispute will erupt over the doc's description of something involving a patient, something that was considered too private, or too embarrassing or too identifying of the patient to disclose to a worldwide audience on the Internet.

Already, the ethical ramifications of blogging docs are under discussion, and blogging doc Medpundit is offering a good standard for fellow physicians to follow:

"Just use the elevator rule. If you wouldn't say something in an elevator full of people, don't say it on your blog."

Medpundit's post about blogging doctors appears to be one of the first about an emerging medical ethics issue that mixes patient privacy expectations, federal law, free speech and the unfettered nature of the Internet. Apparently, the topic was punted to the fore last week by a newspaper article in the Detroit Free Press that warned of potential pitfalls if docs are unrestrained.

"As the rage of Internet blogging spreads across professions, hundreds of doctors across the country are now writing online diaries that sometimes include harsh judgments of patients, coarse observations and distinct details of some cases.

"Critics say the blogs cross into an ethical gray area and threaten patient privacy while posing liability risks for health workers and their employers.

"A popular medical blogger, for example, wrote this in discussing an 18-year-old who on Christmas Day had her third baby: 'I don't mind it so much when a young single woman comes in with her first pregnancy, because anyone can make a mistake. But when that woman gets pregnant repeatedly, time after time, she degrades herself and her children, by condemning herself to a lifetime of dependency and irresponsibility.'

"The writer, who identifies himself as a neonatologist working in a U.S. urban area, writes about his practice at neonatal doc.

The anonymity provided by blogs has proved to be a powerful lure for doctors and other medical professionals, who, sworn to strict rules of confidentiality regarding patients, have few outlets to speak their minds."