Slightly revised slide deck from previous upload. Presented at the 2018 annual convention of the Society of Gynecologic Oncologists of the Philippines,19 July 2018.

1. SOCIAL MEDIA
& ETHICS
Iris Thiele Isip Tan MD, MSc
Professor 3, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Manila Interactive Learning Center
@endocrine_witch

2. Nothing to disclose
I give consent for the audience to
tweet this talk and give me feedback
(@endocrine_witch).
Feel free take pictures of my slides
(though it will be on
www.slideshare.net/isiptan).

3. Double-effect reasoning
OUTLINE
Maintaining professionalism
Protecting the physician-patient
relationship

4. St.Thomas Aquinas
Doing good AND
Avoiding evil

5. The act considered
separately from its
unintended harmful
effect is itself not
wrong.
Double-effect reasoning
1
Stevenson SE & Peck LA. J Mass Media 2011;26:56-65

6. The agent intends
only the good and
does not intend
harm as an end or
as a mean.
Double-effect reasoning
2
Stevenson SE & Peck LA. J Mass Media 2011;26:56-65

7. The agent reflects upon
his/her relevant duties,
considering accepted
norms and takes due
care to eliminate or
alleviate any foreseen
harm through his/her act.
Double-effect reasoning
3
Stevenson SE & Peck LA. J Mass Media 2011;26:56-65

8. https://goo.gl/images/WQnahJ

9. https://goo.gl/images/7rq0PM

15. Double-effect reasoning
OUTLINE
Maintaining professionalism
Protecting the physician-patient
relationship

16. Circulation 2013;127:1413-1421
AMA principles of medical ethics
as framework
Code of Ethics of the Philippine
Medical Association
World Medical Association statement on
the professional & ethical use of social media

17. Boundaries of professional interaction
are less clear online.

18. Maintain appropriate boundaries of the patient-
physician relationship in accordance with professional
ethical guidelines just as they would in any other
context.
https://www.wma.net/policies-post/wma-statement-on-the-professional-and-ethical-use-of-social-media/

19. A personal social media profile is moderate
risk if informal acquaintances can view
personal information.
Committee Opinion No. 622: Professional Use of Digital and
Social Media. Obstetrics & Gynecology 2015;125(2):516-20.

20. https://www.wma.net/policies-post/wma-statement-on-the-professional-and-ethical-use-of-social-media/
Consider the intended audience and assess whether
it is technically feasible to restrict access to the
content to pre-defined individuals or groups.

21. Study carefully and understand the privacy provisions
of social networking sites, bearing in mind their
limitations.
https://www.wma.net/policies-post/wma-statement-on-the-professional-and-ethical-use-of-social-media/

22. Chretien & Kind. Circulation 2013;127:1413-1421
Anonymity can breed disinhibition.

23. THE ENDOCRINE WITCHBrewing Informatics, Endocrinology & Everything Else
www.endocrine-witch.net

24. Social media is a
window through
which we ask
people to look.
How big we make
the window is up to
us, as is what we
do in front of the
window.
Journal of the American Pharmacists Association Nov/
Dec 2013 doi: 10.1331/JAPhA.2013.13536

25. Communicate availability (office hours, contact number)
WAYS PHYSICIANS CAN USE SOCIAL MEDIA
Matthews K (2017). http://www.physicianspractice.com/marketing/5-ways-physicians-can-use-social-media

26. Friend of Mankind
PMA Code of Ethics

27. Chretien & Kind. Circulation 2013;127:1413-1421
Establish norms for interaction.

28. www.facebook.com/EndocrineWitch

30. Be honest in all
professional interactions.
Chretien & Kind. Circulation 2013;127:1413-1421

31. Chretien & Kind. Circulation 2013;127:1413-1421
Disclose conflict of interest.

32. PMA Code of Ethics
Expose and report
charlatans and quacks.

33. Chretien & Kind. Circulation 2013;127:1413-1421
Bring to attention of individual
directly or report to authorities.

34. http://cnnphilippines.com/news/2016/05/07/map-
where-presidential-VP-candidates-vote.html
A physician tweets that
patients who voted for X
can seek care elsewhere.

35. Comply with the Data Privacy Act.

36. About people
Right to be left alone
Limit access to public
PRIVACY

37. CONFIDENTIALITY
About identifiable data
Extension of privacy
Prevent unauthorized access

39. Others can easily overhear conversations
without the benefit of context.
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943
SOCIAL
MEDIA IS
LIKE A
CROWDED
ELEVATOR.

40. Before you post a photo of a
patient on Facebook …
Parsi K & Elsler N. AMA J Ethics 2015;17(11):1009-1018

41. Double-effect reasoning
OUTLINE
Maintaining professionalism
Protecting the physician-patient
relationship

43. Social media provides improved
access to physicians, thereby
building trust.
Chretien & Kind. Circulation 2013;127:1413-1421

44. Do not accept Friend requests
from patients.

45. Maintain appropriate boundaries of
the patient-physician relationship.
AMA: Professionalism in the Use of Social Media (2010)

46. AVOID USING SOCIAL MEDIA
FOR DIRECT PATIENT CARE & CONTACT
Unencrypted
Inadvertently accessible to others
Controlled by a third party
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943

47. SOCIAL MEDIA TO FACILITATE
CONVERSATION AROUND MATTERS OF
PUBLIC HEALTH OR AVAILABILITY OF SERVICES
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943
rather than matters related to a
specific patient

48. GIVE NOTICE TO PATIENTS THAT
SOCIAL MEDIA IS NOT MEANT FOR
CLINICAL COMMUNICATION
Grotty B & Mostaghimi A. Confidentiality in the Digital Age. BMJ 2014;348:g2943
Monitor. Take conversation offline if sensitive
information is posted.

49. Double-effect reasoning
SUMMARY
Maintaining professionalism
Protecting the physician-patient
relationship

50. We don’t have a
choice on whether
we DO social media.
The question is
how well
we DO it.
- Eric Qualman