This document discusses the need for a code of ethics for physicians and patients using social media. It begins with background definitions of ethics, social media, and why social media is used. It then outlines existing Philippine codes like the PMA Code of Ethics and the Cybercrime Law. A proposed "Code of Ethics of the Filipino Physician Using Social Media" is presented, outlining guidelines regarding maintaining patient privacy and confidentiality, appropriate professional boundaries, respectful relationships, avoiding clinical advice online, protecting one's reputation, and complying with laws. The code stresses exercising caution when posting any information related to patients.

1. THE PHYSICIAN & PATIENT IN SOCIAL MEDIA
DO WE NEED A CODE OF ETHICS?
1
Alvina Pauline D. Santiago, MD
Pediatric Ophthalmology & Strabismus
Student, Health Informatics
October 17, 2014

2. 2
DISCLOSURE / DISCLAIMER
I am not an expert in
Health Informatics. I
am a student.
cdm.depaul.edu
I am not an expert in
ethics. I am a student.

3. WHAT IS LACKING IN OUR
CODE OF ETHICS FOR HEALTH INFORMATICS:
!
CODE OF ETHICS
FOR THE FILIPINO PHYSICIAN & PATIENT
USING SOCIAL MEDIA
A requirement of Health Informatics 271
Ethics in Health Informatics
Submitted by Alvina Pauline D. Santiago, MD
September 30, 2014
http://worldofdtcmarketing.com 3

4. TROUBLESHOOTING
AUSTRALIAN MEDICAL ASSOCIATION
Have you ever…
Googled yourself?
Googled your patient without their consent?
Posted information about a patient or
person from your workplace on Facebook?
Have a look through your old online posts and
blogs;
Added patients as friends on Facebook or
MySpace?
Added people from your workplace as friends?
4
www.tradebit.com

5. TROUBLESHOOTING
AUSTRALIAN MEDICAL ASSOCIATION
Have you ever…
Made a public comment online that could be considered offensive?
Become a member or fan of any group that might be considered
racist, sexist, or otherwise derogatory? Browse through all the
groups that you have joined and consider whether these are an
accurate reflection of the person you are, and the values that you
hold.
Put up photos or videos of yourself online that you would not want
your patients, employers or people from your workplace to see?
Checked your privacy settings on Facebook or MySpace?
Felt that a friend has posted information online that may result in
negative consequences for them? Did you let them know?
5
http://mywindowshelp.com

6. ETHICS DEFINITION
Branch of moral philosophy
Attempts to distinguish that
which is right from wrong.
Basic concepts and fundamental
principles of right human conduct
HI271 Lecture, Ethical Theories and Bioethics,
Dr. M Rilazan, 081514
6
www.acfe.com

7. SOCIAL MEDIA
DEFINITION
‘social media’ refers to web and
mobile technologies and practices
that people use to share content,
opinions, insights, experiences,
and perspectives online.
7
cpso.on.ca
sys2K.com

8. SOCIAL MEDIA
DEFINITION
forms of electronic
communication (as Web sites
for social networking and
microblogging)
!
through which users create
online communities
!
to share information, ideas,
personal messages, and other
content (as videos)
www.merriam-webster.com 8
bcg.connect.com

9. WHY USE SOCIAL MEDIA
“opportunities to enhance patient care, medical education, professional
competence, and collegiality…”
“connectivity need not come at the expense of professionalism”
9
cpso.on.ca
localseosites.com
wikipilipinas.org
-Farnan et al

10. WHAT THE PHILIPPINES HAS
PMA Code of Ethics
Bill of Rights, Philippine
Constitution 1987
RA10175. Cybercrime Law
Code of Ethics of Subspecialty
Societies
10

11. PMA CODE OF ETHICS, 2008
Article 1. General Principles.
Section 2. On entering the profession, a physician assumes the
obligation of maintaining the honorable tradition that confers the
well deserved title of a “friend of mankind”. The physician should
cherish a proper pride in the calling and conduct himself/herself
in accordance with this Code and in the generally accepted
principles of the International Code of Medical Ethics.
11

12. PMA CODE OF ETHICS 2008
Article 1. General Principles.
Section 3. Physicians should fulfill the civic duties of a good citizen,
must conform to the laws and cooperate with the proper authorities
in the application of medical knowledge for the promotion of the
common welfare.
Section 4. Physicians should work together in harmony and mutual
respect.
Section 5. Physicians should cooperate with and safeguard the interest,
reputation and dignity of paramedical and other health professionals.
12

13. PMA CODE OF ETHICS 2008
Article 1. General Principles.
Section 6. Physicians should be upright, diligent, sober, modest and
well-versed in both the science and the art of the profession.
Section 7. The promotion and advancement of the health of the
patients should be prioritized over the benefits of the physicians
and the health products industries.
13

14. PMA CODE OF ETHICS 2008
Article 2. Duties of Physicians to their patients
Section 5. A physician should exercise good faith and honesty in
expressing opinion/s as to the diagnosis, prognosis, and treatment of a
case under his/her care…..A physician shall not conceal nor exaggerate
the patient’s condition except when it is to the latter’s best interest. A
physician shall obtain from the patient a voluntary informed consent…
Section 6. The physician should hold as sacred and highly confidential
whatever may be discovered or learned pertinent to the patient even
after death,except when required in the promotion of justice, safety
and public health.
14

15. 1987 CONSTITUTION
Article 3. Bill of Rights
Section 3. (1) The privacy of
communication and
correspondence shall be
inviolable except upon lawful
order of the court, or when
public safety or order requires
otherwise, as prescribed by law.
15

16. 16
byte-notes.com
RA 10175.
AN ACT DEFINING CYBERCRIME

17. RA 10175.
AN ACT DEFINING CYBERCRIME
CHAPTER II
PUNISHABLE ACTS
SEC. 4. Cybercrime Offenses.
(a) Offenses against the confidentiality,
integrity and availability of computer data
and systems:
(1) Illegal Access.
(2) Illegal Interception.
(3) Data Interference.
…
http://media2.arabia.msn.com
17

18. MANIFESTO: #HEALTHXPH
T1. I am a physician and I will conduct myself
in a manner worthy of my profession even
online.
T2. Whatever I post online in relation to my
medical expertise should be of benefit to my
countrymen. I will prioritize the promotion
and advancement of health rather than
medical products.
T3. I will not use online platforms to rant
against or bash patients and healthcare
professionals.
T4. I will refrain from posting information
online that will compromise patient
confidentiality..
http://www.endocrine-witch.net/2014/02/12/social-media-and-medical-professionalism-a-manifesto-from-healthxph1/8

19. CODE OF ETHICS OF THE FILIPINO
PHYSICIAN USING SOCIAL MEDIA
How to use social media
Meet professional expectations
Assume all content in internet is
not private and accessible.
“Define standards of the
professional MD in digital
environment” - Farnan teal
wikipilipinas.org 19

20. The Physician must
maintain patient privacy and confidentiality.
exercise caution when posting information online
that relates to an actual patient to maintain privacy
and confidentiality.
obtain informed consent even in an unnamed patient
that may still be identifiable through a range of other
information, such as a description of their clinical
condition, or area of residence, or place of consult
Breaching confidentiality undermines the public's
trust in the medical profession.” -wma.net
wikipilipinas.org
20
Patterned after cpso.on.ca and wma.net

21. The Physician must
maintain appropriate professional boundaries with
patients.
limit posts about patients only to health-related issues
and concerns.
not post about patient’s personality flaws, whether
perceived or real.
refrain from establishing personal connections with
patients or persons closely associated with them online.
“adopt a conservative approach when disclosing
personal information…”-wma.net
wikipilipinas.org
21
Patterned after cpso.on.ca and wma.net

22. The Physician must
maintain professional and respectful relationships with
patients, colleagues, and other members of the health-care
team.
refrain from seeking out patient information that may be
available online without prior consent.
not malign other physicians / colleagues, recognising
differences in management can exist.
not malign health institutions.
not comment on another physician’s patient case
management online (as one did not have the benefit of a
full examination and evaluation of the patient)
wikipilipinas.org
22
Patterned after cpso.on.ca and wma.net

23. The Physician must
not treat patients through social media exchange.
avoid giving clinical advice to specific patients
through social media.
(It is acceptable, however, to use social media to
disseminate generic medical or health information
for educational or information sharing purposes.)
wikipilipinas.org
23
Patterned after cpso.on.ca and wma.net

24. The Physician must
protect his/her own reputation, and that of his
profession, by not posting content that could be
viewed as unprofessional.
“monitor his 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.” -wma.net
be proactive in removing content posted by
themselves or others which may be viewed as
unprofessional.
wikipilipinas.org
24
Patterned after cpso.on.ca and wma.net

25. The Physician must
apply the strictest privacy settings necessary to
maintain control over access to personal information,
and social media presence undertaken for personal
purposes only.
“study carefully and understand the privacy
provisions of social networking sites, bearing in mind
their limitations.” (wma.net)
wikipilipinas.org
25
Patterned after cpso.on.ca and wma.net

26. The Physician must
comply with relevant PMA Code of Ethics with
respect to advertising.
not endorse product online.
comply with the law as regards defamation, copyright,
and plagiarism when posting content online
avoid conflicts of interest and disclose fully when
such exist.
wikipilipinas.org
26
Patterned after cpso.on.ca and wma.net

27. CODE OF ETHICS OF THE FILIPINO PATIENT
USING SOCIAL MEDIA
Online Content Creator – blogger, a video
blogger, a podcaster, a microblogger or a
general social media participant (mor10.com)
pinoymdcentral 27

28. A FILIPINO PATIENT
USING SOCIAL MEDIA MUST
realise that posting his/her own health data…
signifies an implied consent of waving privacy and
confidentiality.
carries a realisation that a potential exists that
others may self-diagnose and self-treat based on
his/her story.
pinoymdcentral 28

29. A FILIPINO PATIENT
USING SOCIAL MEDIA MUST
not malign physician nor health institutions.
recognize differences in opinion and management
exist.
obtain consent from physician or health care
institution if their name or situation may be
recognisable with his/her post.
pinoymdcentral 29

30. A FILIPINO PATIENT
USING SOCIAL MEDIA MUST
maintain a professional relationship (not personal) with their
health care providers and health institutions.
not expect his/her HCP to accept a personal friend
request.
limit posts about physicians and health institutions only to
health-related issues and concerns.
not post about physician’s personality flaws, whether
perceived or real.
refrain from establishing personal connections with
physicians or persons closely associated with them online.
pinoymdcentral 30

31. A FILIPINO PATIENT
USING SOCIAL MEDIA MUST
not expect treatment advice in social media
exchange.
not expect his/her HCP to comment on another
physician’s patient or management.
comply with the law as regards defamation, copyright,
and plagiarism when posting content online
pinoymdcentral 31

32. A FILIPINO PATIENT
USING SOCIAL MEDIA MUST
be “fair, honest and respectful not only toward your fellow [netizens] but also
toward fact.”
“present fact as fact and opinion as opinion"
based on mor10.com 32

33. THE FILIPINO PATIENT
USING SOCIAL MEDIA MUST
tell the truth at all times.
state your allegiances and disclaimers to stay
independent
admit and correct your mistakes immediately.
always respect a person’s character and identity,
privacy, race, nationality and belief. Never draw
attention to personal or private aspects if they are
irrelevant.
based on mor10.com pinoymdcentral 33

34. REFERENCES
Are you maintaining professional standards online? In Social Media and the Medical Profession. Accessed September 29, 2014. https://ama.com.au/are-you-
maintaining-professional-standards-online
Code of Ethics for Bloggers, Social Media and Content Creators. Accessed September 29, 2014. http://mor10.com/code-of-ethics-for-bloggers-social-media-
and-content-creators/
Constitution of the Republic of the Philippines, 1987. Accessed September 29, 2014. http://www.gov.ph/constitutions/the-1987-constitution-of-the-republic-
of-the-philippines/the-1987-constitution-of-the-republic-of-the-philippines-article-iii/
Farnan J, Sulmasy JD, Worster BK, etal. Online Medical Professionalism: Patient and Public Relationships: Policy Statement from the American College of
Physicians and the Federation of State Medical Boards. Ann Intern Med 2013; 158: 620-627.
Lirazan M. Lecture on Ethical Theories and Bioethics. Lecture given the Health Informatics 271, August 15, 2014.
Philippine Medical Association Code of Ethics 2008. Accessed September 29, 2014 . https://www.philippinemedicalassociation.org/downloads/pma-codes/
FINAL-PMA-CODEOFETHICS2008.pdf
Republic Act 10175. An Act Defining Cybercrime, Providing for the Prevention, Investigation, Suppression and the Imposition of Penalties Therefore and
for Other Purposes. Accessed September 29, 2014. http://www.gov.ph/2012/09/12/republic-act-no-10175/
Social Media Appropriate Use by Physicians. The College of Physicians and Surgeons of Ontario. Accessed September 29, 2014. http://www.cpso.on.ca/
policies-publications/positions-initiatives/social-media-appropriate-use-by-physicians
WMA Statement on the Professional and Ethical Use of Social Media, 2011. Accessed September 29, 2014. http://www.wma.net/en/30publications/
10policies/s11/index.html.
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