WMA Statement on the Professional and Ethical use of Social Media

Adopted by the 62^nd WMA General Assembly, Montevideo, Urugay, October 2011

DEFINITION

Social Media is generally understood to be a collective term for the different platforms and applications that allow user-generated content to be created and shared electronically.

PREAMBLE

The objectives of the proposed policy are to:

Examine the professional and ethical challenges related to the increasing usage of social media by physicians, medical students and patients.
Establish a framework that protects their respective interests.
Ensure trust and reputation by maintaining high professional and ethical standards.

The use of social media has become a fact of life for many millions of people world wide including physicians, medical students and patients.

Interactive, collaborative tools such as wikis, social networks, chat rooms and blogs have transformed passive Internet users into active participants. They are means for gathering, sharing and disseminating personal information, including health information, socializing and connecting with friends, relatives, professionals etc. They can be used to seek medical advice, and patients with chronic diseases can share their experiences with each other. They can also been used in research, public health, education and direct or indirect professional promotion.

The positive aspects of social media should be recognized such as in promoting healthy life style, in empowering patients and in reducing patients' isolation.

Areas, which may require special attention:

Sensitive content, photographs, other personal materials posted on online social forums often exists in the public domain and have the capacity to remain on the internet permanently. Individuals may not have control over the ultimate distribution of material they post on-line.
Patient portal, blogs and tweets are not a substitute for one on one consultation with physicians but may widen engagement with health services amongst certain groups. Online "friendships" with patients may also alter the patient-physician relationship, and may result in unnecessary, possibly problematic physician and patient self-disclosure.
Each party's privacy may be compromised in the absence of adequate and conservative privacy settings or by their inappropriate use. Privacy settings are not absolute; social media sites may change default privacy settings unilaterally, without the user's knowledge. Social media sites may also make communications available to third parties.

Interested stakeholders such as current/prospective employers, insurance companies and commercial entities may monitor these Internet web sites for various purposes such as to better understand their customer's needs and expectations, to profile job candidates or to improve a product or a service.

RECOMMENDATIONS

The WMA urges their NMA´s to establish guidelines for their physicians addressing the following issues:

To maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just as they would in any other context.
To study carefully and understand the privacy provisions of social networking sites, bearing in mind their limitations.
For physicians to routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others is accurate and appropriate.
To consider the intended audience and assess whether it is technically feasible to restrict access to the content to pre-defined individuals or groups.
To adopt a conservative approach when disclosing personal information as patients can access the profile. The professional boundaries that should exist between the physician and the patient can thereby be blurred. Physicians should acknowledge the potential associated risks of social media and accept them, and carefully select the recipients and privacy settings.
To provide factual and concise information, declare any conflicts of interest and adopt a sober tone when discussing professional matters.
To ensure that no identifiable patient information be posted in any social media by their physician. Breaching confidentiality undermines the public's trust in the medical profession, impairing the ability to treat patients effectively.
To draw the attention of medical students and physicians to the fact that online posting may contribute also to the public perception of the profession.
To consider the inclusion of educational programs with relevant case studies and appropriate guidelines in medical curricula and continuing medical education.
To bring their concerns to a colleague when observing his or her clearly inappropriate behavior. If the behaviour significantly violates professional norms and the individual does not take appropriate action to resolve the situation, physicians should report the conduct to appropriate authorities.