Ethical Questions for Doctors

Should patient’s online information affect treatment?

By Kevin RR Williams

SOCIAL MEDIA Art Caplan from the Division of Ethics at the New York University Langone Medical Center in New York City broached the subject now published on Medscape. What if a prospective liver transplant patient is told he must abstain from alcohol for a period of time in order to qualify? The former alcoholic manages to pass all the screenings and swears he hasn't had a drink. But then a photo of him holding beer in a bar is discovered on a social media site or blog. Should a transplant be denied based on the contradictory Internet evidence?

‘Aha, I Caught You!’

We realize that employers may consider Internet behavior when evaluating candidates. An ignominious congressman blamed the Internet for his political woes. Even doctors have had their hands held to the fire by peers based on things posted on Twitter. But should doctors or staff follow patient Internet activity to incidentally or intentionally corroborate medical history? Of course most doctors do not have the manpower or man-hours to chase down patients' social media behavior. Nonetheless, what if by chance the doctor becomes aware of such information? Should it be ignored? Will it be added to the patient's chart? In the example previously presented, could it prevent one from receiving a transplant for which he otherwise qualifies?

Caplan provides clarity. The information may be taken into consideration. However, the patient should have opportunity to provide an explanation. Perhaps it is an old picture that has been recently published. Maybe someone edited a photo or made up derogatory comments attributed to the patient. Perhaps a damning image was staged by the patient as a gag.

With so many possible explanations, Internet information must be considered circumstantial and not conclusive evidence of otherwise undocumented medical history — or so the theory goes. In reality, it is unlikely that the man received a new kidney. As a patient, what have you gleaned from this discussion?

Tags: anonymity, censor, Facebook, hipaa, legality, physicians, privacy, somed