Bioethics Discussion Blog: Doctor Spying on a Patient's Blog

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Monday, June 25, 2012

Doctor Spying on a Patient's Blog





How would you feel, as a patient, if without your knowledge, your doctor found your blog and was monitoring it for additional information about you?  If you would be upset about that, why? If the doctor told you in advance that he or she was going to look but asked your permission, how would you respond? Do you think that your doctor has every right to look at your open blog as any other visitor? Do you think that your privacy is being intruded upon by the doctor looking at or following your postings on your blog? Would it make any difference if you had a mental illness and your doctor was your psychiatrist? 

In the June 2012 issue of the American Medical Association's Virtual Mentor, the topic of psychiatrists monitoring their patients' blogs is brought up with a scenario and followed by a commentary by psychiatrist  David H. Brendel, MD, PhD under the title "Monitoring Blogs: A New Dilemma for Psychiatrists". The first paragraph of the commentary follows.  Go to the link above and read the entire article and then return and answer my questions. Your responses will be worth while to this topic since Dr. Brendel can only express his concerns speaking as a psychiatrist but you can provide feedback to us from any patient's point of view. ..Maurice.



Internet technologies in the twenty-first century have provided countless opportunities and potential pitfalls for professional practice in areas as diverse as medicine, law, politics, business, and academia. These technologies have especially serious implications for psychiatry, where emotional complexities, boundary issues, and privacy concerns are of particular concern in the relationship between clinician and patient. In the course of routine clinical practice, psychiatrists nowadays must grapple with questions about whether to exchange e-mails with patients, to participate in social networking sites such as Facebook, and to perform Internet searches in order to learn information about patients. Each of these uses of Internet technologies in psychiatry has received growing attention in the professional literature [1-3]. The case scenario raises the question of whether clinical psychiatrists ought to read and monitor the websites or blogs of some of their patients.

Graphic: From Google Images.

7 Comments:

At Wednesday, June 27, 2012 12:26:00 PM, Anonymous Anonymous said...

I pretty much agree with the conclusion in the article - if it's out their in public, the physician can look at it. But I would consider it quite sneaky, and a betrayal of trust, to not notify the patient first. And in general, other than a potentially dangerous psychiatric patient, I think it is inappropriate, and too invasive.
TAM

 
At Saturday, June 30, 2012 3:41:00 PM, Blogger Maurice Bernstein, M.D. said...

"Too invasive"? But why, if the goal is for the doctor to effectively diagnose and effective treat the ill patient? Surely, if the website is public what makes it "sneaky" and "betrayal of trust" to look for pertinent information not given in the history taking with the patient.
If what is found by the doctor on the website that is pertinent to the patient's health, obviously, that information should be disclosed to the patient.
And "invasive", reading a public website is much less invasive than surgery or an angiogram. ..Maurice.

 
At Saturday, June 30, 2012 11:09:00 PM, Anonymous Anonymous said...

Blogs are public domain and attainable through search
engines. Physicians used to make house calls and some
still do and that alone gives the physician more information
about you,the patient than any blog ever would.

PT

 
At Sunday, July 01, 2012 7:49:00 AM, Blogger Maurice Bernstein, M.D. said...

PT, excellent commentary. I should know about house calls, since I made them. The doctor's experience and insight on making a house call often contributes to the management of the patient's illness in terms of better understanding the social and environmental and even psychologic aspects of the patient's home environment. However, house calls by the doctor are always by specific invitation. One could argue that regardless whether the patient's website is fully open to the public, because of the special relationship to the doctor compared to the unidentified public, the patient still may reasonably demand the doctor attend the website only by personal invitation. ..Maurice.

 
At Monday, July 02, 2012 4:50:00 AM, Anonymous Anonymous said...

A doctor could potentially gain useful information to treat a patient by sitting on the road outside their house and watching through their windows also. But should he/she?
Just because you can, doesn't always mean you should.
When making a house call, the physician was invited.
Sure, the blog is public. But since there is a professional relationship, barring a dangerous psychotic patient, I believe a physician should ask permission first.
TAM

 
At Friday, August 10, 2012 10:16:00 PM, Blogger Jenny McLelland said...

My son has a rare genetic condition, and our family blog is one of the first links that comes up on a google search for the syndrome. I don't like to brag, but I think the blog gives pretty solid information about the syndrome, and provides a useful synopsis of the other available resources.

I've had several doctors who haven't seen him yet stumble into the blog prior to one of his appointments. I don't think it's unethical for a doctor to look at a blog.

 
At Tuesday, August 14, 2012 9:28:00 PM, Blogger SteveofCaley said...

The answer depends on whether the investigation is done in service to the duty to care for the patient.
We are given a fool's privilege to speak our minds and ask impertinent questions. We re-learn a childish innocence in being openly curious but not rude.
I would look. If the patient were there, I'd ask - do you mind if I look at your blog online sometime? Just like that. Sincerely. Because you don't feel like it's sneaky - and if you do, don't do it at all.
Psychotic patients appreciate simple honesty. It may offer them an anchor to reality. And, aside from the blog, the discussion itself will gather useful information on the patient's mentation.

 

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