Digital indiscretions: New horizons in medical ethics.

Once upon a time, not so long ago, the only way to disseminate patient information beyond the walls of the hospital was through medical journals or presentations. The potential for damage to the patient was minimal and was offset by the learning potential offered by it. Now the scenario has changed drastically. With the advent of social media sites like Facebook, Twitter, YouTube and of course, personal blogs, breaching patient confidentiality is just the click of a button away. A nursing student of Johnson County Community College, USA, was expelled for posting pictures of herself holding a placenta with an umbilical cord. 1 A paediatric pulmonologist who blogged a sarcastic exposé of his malpractice suit on his anonymous blog 2 was ousted by the plaintiff, and forced to settle the case. 3 Twitter user and anaesthesiologist @Mommy_doctor discussed details of a patient with an embarrassing condition and was immediately taken to task by the online community and was forced to take down her Twitter and blog accounts. 4 A physician at Westerly Hospital, Rhode Island, was not only fired but also handed a stern reprimand by the state medical board for disclosing patient details on Facebook. Numerous such examples, anecdotal and documented, can be quoted where the use of social media by physicians has led to unforeseen disastrous results. Engaging in discussion via social media is an enriching, albeit liability-prone zone. Besides the obvious advantage of networking with other professionals, social media is also a learning tool. When publishers withdrew almost 2,500 titles from the HINARI* access scheme (which provides free online access to major journals in the fields of biomedical and social sciences to not-for-profit institutions in developing countries) in Bangladesh; the HIFA2015** (Healthcare Information For All by 2015) members stepped forward to lead a protest that led to the restoration of almost all the titles. 6,7 Efforts like the FriendFeed group 8 and Bora Zivkovic's #icanhazPDF 9 have gone a long way to ensuring the wider dissemination of research amongst the scientific community. However, the most vital point in the whole exercise is to use caution. Today, although we come pre-equipped to handle social media, fluency in social dialogue is at odds with health privacy and confidentiality issues. 10 Most of the initiatives in the field of safeguarding patient rights in social media have been in the USA 11 elsewhere, it is still in a very nascent state. …