Online medical ethics: Transparency and confidentiality

September 7, 2011

Ethics are one of the fundamentals of medicine and healthcare, and the majority of medical school students swear to The Hippocratic Oath when graduating, meaning that they swear to practice medicine ethically. We’ve previously brought up the issue of knowledge sharing among both physicians and patients through online communities. What are the limits of what can be shared online?

How does the Internet impact the physicians’ practice?
As in “real life”, healthcare professionals have to stringently apply the ethical rules online. Knowledge sharing on online communities among doctors and medical researchers implies a number of complications, as the confidentiality issue is raised when they discuss patient cases with other physicians and when they provide advice for one another. Furthermore, the physicians and researchers must be careful about what they speak publically about to the patients, as they must avoid disclosing confidential information.

Health websites
Several codes of conduct have been created by health organisms in order to guide site managers in setting up a set of mechanisms to provide qualitative, objective and transparent medical information.

The Health On the Net Foundation (HON) grants a certificate to health websites that complies with the eight rules: of the HONcode standard for trustworthy health information:

  • Authorities:  advice will only be given by qualified professionals
  • Complementarity: information should support, not replace, the doctor-patient relationship
  • Privacy: the website respects the privacy and confidentiality of personal data
  • Attribution: clear references to the sources
  • Justifiability: the website must justify the benefits of a specific treatment
  • Transparency: the site must provide accurate contact addresses
  • Financial disclosure: funding sources are easily identified
  • Advertising policy: advertising is easily distinguished from editorial content

This certificate makes it reassuring for people to navigate through medical websites. However, the Journal of Medical Internet Research (JMIR) has criticised the HONcode for not judging the quality of the content and thus potentially leading readers astray. In that sense, the JMIR suggest that the eight principles of the HONcode are a good starting point for indicating the reliability of a website, but they are only a first step and must be elaborated to guarantee better quality and accuracy of the medical content online.

Do you trust the content on medical website? When you visit a health website, do you check if it’s certificated?

Copyright photo: © czardases / © Yanik Chauvin –