Let’s say we have adequately addressed the confidentiality issues and sufficiently disguised the case to the point that even the client would not recognize himself or herself as Prof. Reamer suggests.[1] However that would mean that the facts that are presented in the open discussion group or listserv have bee so changed or disguised that they now bare only a tangential relation to the actual patient. That means that any advice others may offer will be on the disguised facts and may have little or no bearing on the actual case.
The situation of going to an Internet discussion or listserv for consultation or advice is quite different from presenting a paper at a conference. When one presents a paper one may be inviting comments but not advice on how to treat a patient. With that in mind, the text below is definitely NOT legal advice on the matter and definitely should not be taken as such. Nonetheless it is very sound general advice on the subject of discussing patients on the Internet by someone who happens to be an attorney
We would all be wise to be so cautious about Internet discussions.
The following are those emails printed with permission:
JR: Hi Mike I really appreciate your help on this. If I am not mistaken you are an attorney. If so could we use your comments or something similar?
M.S. John, Now you are going to put me in the overly cautious mode. I can't, and won't, give legal advice to persons outside the jurisdiction where I practice who are not my clients.
I have given general advice, when requested, on how to live and behave to my children and my friends. My children got it unsolicited as well. Most of us do that, if too much we become pests or nags. I think the general advice not to post on the Internet anything you would not want to see in the LA Times is good general advice.
One of my early mentors (an investigator, not an attorney) gave me good advice early in my career: "Don't talk [about a case] in hallways, restaurants or elevators unless you know who is listening." That was good advice in the days before listservs. I know he would modify it now. Harvey has a good suggestion about setting up virtual grand rounds. He identifies some of the problems and has good suggestions for their implementation and assurance of some qualification of participants and protection of privacy.
The advice is not copyrighted. It is not designed or intended to apply to any legal dispute that any reader may have, or may later encounter. It might prevent some social blunders or embarrassment. If you find it helpful, use it.
Good luck,
Mike S.
1. “One useful rule, I think, is that the presentation should be such that even the client wouldn’t recognize himself or herself. ..... “ See Dr. Frederic G. Reamer Interview
2 Harvey S. Frey MD PhD Esq. owner and moderator of Health Administration Responsibility Project See http://www.harp.org
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