Ethical Issues for Online Health & Social Care Bloggers

 

Ethical Issues for Online Health & Social Care: Bloggers  entry 4

Cynthia Kana

Introduction

The digital revolution of health and social care practise has seen the online blogging move being an effective tool which may be exploited by professionals with the aim of knowledge, experience, and insight sharing (Murphy et al., 2020). This is assuming the projection of digital transformation of communication and this has been accompanied by a chance and challenges and practitioners must navigate through complex ethical and safety concerns. The work of medical bloggers significantly influences the prevention of diseases and the population of healthy individuals, and the responsibility of online presence should be viewed as an important issue, as it is stated by Russkikh et al. (2024). It is the process of turning into such a so-called thoughtful practitioner who has to engage in critical contact with such digital realities and brings the technical adequacy into the ethical consciousness and professional accountability. Two aspects of health and social care blogging, that can be deemed important, will be addressed in the essay, namely the ethical dimension of patient confidentiality and their privacy, and the safety dimension of the professional boundaries in the virtual world. 

Ethical Consideration: Confidentiality and Patient Privacy in Online Blogging 

One of the pillars of health and social care practise is confidentiality, and patient confidentiality is facing unprecedented challenges due to the durability and scope of digital platforms. This also complicates finding the boundary between the professional knowledge being shared on online blogs and breach of confidential information. This is an ethical concern that demanded an acute degree of reflexive practise in which even good intentioned posts could easily result in violation of patient anonymity or the violation of trust. 

 

Figure: Understanding Patient Confidentiality And Privacy (Beauchamp and Childress, 2019)

      Theoretical Framework and Analysis

Professional codes of conduct including the Nursing and Midwifery Council (NMC) Code and the Standards of Conduct of the Health and Care professions council (HCPC) entrench the idea of confidentiality. These models support the necessity to protect the patient information and to maintain the trust relations. In addition, the Data Protection Act 2018 and General Data Protection Regulation (GDPR) provide the legal framework within the framework of which treatment of personal health information in the digital space can take place. The deontological ethical theory assists in supporting the imperative of confidentiality because it suggests that some duties cannot be breached regardless of the rewards that can be received (Beauchamp and Childress, 2019).

Health blogging is an area that has very high conflict between sharing information and privacy. The social support and health education can be facilitated using such tools (blogs) although there is a chance of unintentional disclosure as well (Rains and Keating, 2011). Digital content is never lost, is searchable and it may be traceable, i.e even anonymized cases could be identified by aggregated data. The article by Tsai and other researchers about chronic pain blogging demonstrates that even though personal health storeys are valuable in community-building and support, there are two sides of the topic that should be taken into account the aspects of authenticity and privacy. 

Reflexive Engagement with Practice

When reflecting on my case in my professional setting, I realise that there is the desire to share impressive clinical storeys that can educate or inspire other individuals. However, this fact introduces another ethical dilemma; it is the very things that make storeys captivating and easy to connect with that are also the easiest to use in order to distinguish people. One of them is the risk of confidentiality being broken in smaller communities where the practitioners operate by explaining a certain set of circumstances a patient has. The realisation has become the focal area that has led me to perceive the meaning of professional responsibility in the online space as the ethical blogging does not merely relate the news anonymization to technical aspects of the matter but also attentively the context identifiability. 

Safety Dilemma: Professional Boundaries and Dual Relationships in Digital Spaces

A key safety concern in health and social care blogging is professional boundaries, where online services are casual, therefore, accidentally leading to mingling the two worlds and blurring of the professional and personal identity. Unlike in the traditional clinical setting where there is a clear definition of space and time, online blogging introduces the aspect of unlimited availability and lack of role demarcation that is highly risky to both the consumers and the practitioners of the service. It is a safety dilemma since the digital boundaries are permeable and need to be researched on critically and addressed proactively. 

                              Figure: Professional boundaries (Peek et al., 2015) 

Theoretical Framework and Analysis

The theory of professional boundary stresses the necessity to keep the relationship parameters within the proper limits to serve vulnerable people and ensure the effectiveness of the therapy (HCPC, 2016). The social media policy of regulatory bodies emphasizes that the same standards of professionalism should be employed in a digital context, but the informal aspect of blogging platforms may lead to the illusion of informality or friendship. In digital communication, the risk management frameworks emphasise the possible outcomes such as the violation of boundaries, role confusion, and impaired professional judgement (Murphy et al., 2020).

The risks associated with safety are multiple. To start with, there are chances of inappropriate dual relationships through blogging as the content related to a practitioner is made available to service users or their families, and hence, it creates a risk of role confusion or dependency problems. The authors illustrate that mental health professionals advocating via social media have to negotiate the complicated boundary issues to preserve therapeutic relationships (Peek et al., 2015). Secondly, professional misconduct allegations are a risk to the practitioners whose personal opinions or informal content may be misunderstood in professional situations. Digital footprints are here to stay, making personal posts that have been made by individuals subject to examination regarding professional conduct. Third, the availability of bloggers can promote unwarranted contact by service users not through the existing care channels, which could pose a risk to both parties. 

Critical Analysis and Consequences

According to the study by Heponiemi et al. (2020) regarding digital health services, online platforms positively impact accessibility, but also establish the expectations of unlimited availability that may result in professional boundaries being broken. Moreover, Hu (2019) discovered that bloggers in mental health can traverse between helping and an adequate professional distance with their audience. The impact of the violation of boundaries is not limited to the individual practitioners but it also spills over to the trust people have in health and social care professions. As the line is crossed, power distance existing on the basis of practitioner-patient relationships may be used unfavorably, which may harm vulnerable people.

Integration of Peer Feedback

The group discussion with other colleagues on the blog platform was invaluable in enhancing my knowledge on ethical and safety aspects of health and social care blogging. Peer feedback illuminated the views that I had not given enough attention especially on the intersectionality of confidentiality breaches and boundary violations. One of my colleagues made it clear that seemingly harmless posts about the hard days might unconsciously convey the information about certain patients with people that are aware of care situations, which makes the concept of privacy even more complicated. Another peer disagreed with my original stance of sufficiency of anonymization stating that contextual information and timestamps pose the potential risks of identification even in the absence of specific patient information. Elements of intersections became apparent concerning the need to take proactive control of boundaries with colleagues expressing the same concern regarding role confusion in the cyberspace. There was however a differing feeling on where practitioners were supposed to censor themselves with some of them suggesting that this is too restrictive and yet some felt that this avoids sharing of quality knowledge. 

Rearrangement into Compelling Argument

The ethical aspect of privacy and the safety issue of professionalism are two interrelated concepts that constitute two sides of the same issue: how to secure vulnerable people without invading their privacy and upholding professionalism in the digital environment. The breach of confidentiality is most likely to happen by means of boundary violation because informal online communication may allow the practitioner to reveal information that would not have been disclosed during the formal interaction. On the other hand, indistinct boundaries have the potential to undermine privacy in the event that practitioners do not understand that personal online information is professionally liable. Peer discourse enhanced my awareness that both problems are the result of digital platforms having permanent, accessible, and informal properties that pose risks where there are none in the context of standard practice.

Learning for Future Practice

This theoretic interaction and collective consideration has produced a lot of learning in my future health and social care practice. The first thing is that ethical digital practice is intentional; I cannot guess that well-meaning and anonymization, in general, is enough to ensure confidentiality or boundaries. In practice, this would be applying specific measures: creating clear personal social media guidelines, consulting supervisors prior to posting practice-related materials, and having two different online personas (professional and personal). On the downside, I have come to understand that the dangers of online involvement can be greater than those associated with its advantages, and acting cautiously is necessary instead of engaging in some online debates. On the positive side, being aware of these aspects of ethics and safety will enable me to be an active participant in the digital advocacy and knowledge exchange when the boundaries are set.

Conclusion

This essay has critically examined confidentiality as one of the core ethical considerations and professional boundaries as one of the major safety dilemma in health and social care blogging. Theoretical interaction, with the help of regulatory frameworks and empirical studies, shows that digital platforms are exceptionally challenging and demand proactive management of ethical issues. Peer feedback contributed to the learning process as it demonstrates the interdependency of these issues and the fact that reflexive practice needs a context. The significance of the responsible and safe blogging practice cannot be overestimated; as online communication becomes an inseparable part of health and social care, the practitioners should acquire advanced skills to find their way in online ethics and safety.

References 

Heponiemi, T., Jormanainen, V., Leemann, L., Manderbacka, K., Aalto, A.M. and Hyppönen, H., (2020) Digital divide in perceived benefits of online health care and social welfare services: national cross-sectional survey study. Journal of Medical Internet Research, 22(7), p.e17616.

Hu, Y., (2019) Helping is healing: examining relationships between social support, intended audiences, and perceived benefits of mental health blogging. Journal of Communication in Healthcare, 12(2), pp.112-120.

Keating, D.M. and Rains, S.A., (2015) Health blogging and social support: a 3-year panel study. Journal of Health Communication, 20(12), pp.1449-1457.

Murphy, E., Donohue, G. and McCann, E., (2020) Exploring mental health issues through the use of blogs: A scoping review of the research evidence. Issues in Mental Health Nursing, 41(4), pp.296-305.

Peek, H.S., Richards, M., Muir, O., Chan, S.R., Caton, M. and MacMillan, C., (2015) Blogging and social media for mental health education and advocacy: a review for psychiatrists. Current Psychiatry Reports, 17(11), p.88.

Rains, S.A. and Keating, D.M., (2011) The social dimension of blogging about health: Health blogging, social support, and well-being. Communication Monographs, 78(4), pp.511-534.

Russkikh, S.V., Tarasenko, E.A., K.D., Gorbacheva, N.A., Vasiliev, M.D., Zagdyn, Z.M., Drobizhev, M.Y. and Rotov, V.M., (2024) Impact of medical bloggers' activities on the prevention of disease risk, public, population and individual health: the opinion of social media users. Оригинальные исследования, 44(2), p.173.

Tsai, S., Crawford, E. and Strong, J., (2018) Seeking virtual social support through blogging: a content analysis of published blog posts written by people with chronic pain. Digital Health, 4, p.2055207618772669.