Unpacking Privacy

 

  

 

 

 

Pamela Ressler @pamressler

Privacy is an ambiguous, powerful concept that, while meant to protect individuals, often shuts down useful conversations and innovations. As we continue to unpack our #MedX topic, Privacy: Preventing Harm or Innovation, by flipping the panel and actively engaging conversations I am struck by the notion that perhaps the word privacy does not fully address what we are examining in the context of social media and online communities.  The Merriam Webster dictionary defines privacy as "the state of being alone: the state of being away from other people: the state of being away from public attention." If we are engaging in online communities can or should we expect privacy?

Jodi (@jsperber) pondered in her initial #MedX panel post, What's Your Relationship with Privacy...Um it's Complicated, that when we use the term privacy in this context, are really responding to a lack of control of the dissemination of the information we are sharing? Perhaps this is rooted in the difference between privacy and confidentiality. Confidentiality refers to the ethical grounding of the patient-provider relationship. Information shared is not divulged without the express understanding of both parties. Are we uncomfortable with the perceived violation of this ethical concept  when we openly share health experiences in the public forum of social media? Do the benefits of connection outweigh the risks of information sharing? Is our digital footprint truly controllable?

In 2011, when my  Tufts University School of Medicine colleagues and I surveyed patient bloggers in Communicating the Experience of Chronic Pain and Illness through Blogging, we found the majority of bloggers chose to publish their blogs on public, openly searchable platforms (such as Blogger, Wordpress). These blogs were frequently shared and read by friends and family, and potentially a broader audience of unknown readers. The issue of privacy/confidentiality did not seem to be as prominent as it is today. Did the controlled ability of blogging; being able to edit, revise and then share  lend a level of perceived privacy even though the information shared resided in a public space? Was there an unstated expectation of confidentiality between blogger and her/his audience? Has the increased prevalence of social media and online sharing changed our perception of the concepts of privacy or confidentiality?  It is interesting to consider whether participation in online communities and the rapid, real time conversations in spaces such as Twitter or Facebook feels more vulnerable and public than the more controlled method of blogging.  Do online communities and real time digital interaction with others support the benefit of group empathy but at the same time expose participants to increased fear and vulnerability?  

As the ability to connect through social media evolves,  in health information sharing and creating more personalized medical systems,  let us begin to unpack privacy by examining and investigating broadly this elusive, ambiguous, powerful concept.

Do we have you hooked on this topic yet? We are thrilled to throw open our sandbox to those who want to think, discuss and create with us. This is the essence of a flipped panel. The conversation continues and evolves  through each interaction… please join us, Colleen Young (@colleen_young), Susannah Fox (@SusannahFox), Wendy Sue Swanson (@SeattleMamaDoc), Jodi Sperber (@jsperber) and me, Pam Ressler (@pamressler). We will be using the hashtag #MedX.

Savoring Connections and Widening the Circle


As I reflect upon the year that is ending, I am struck by the beauty of connection. I am grateful for the bonds that were forged and strengthened throughout 2014.

One of my highlights of 2014 was putting connection to the test at Medicine X at Stanford University. Moving from online friends to IRL (in real life) friends proved to be seamless at Medicine X.  A testament to the power of connection that is formed in so many spaces, virtually and face to face. Thank you to my dear friends and colleagues @SusannahFox, @MeredithGould and @Colleen_Young for sharing the stage and yourselves with me at #MedX. I am looking forward to visioning our next appearance with these "Ladies of the View"

As we savor the last moments of 2014 and prepare to step into 2015, my resolution is to nurture and celebrate connections and to continue to widen my circle of community.

Wishing you a year of hope and health...along with lots and lots of connections!


Discussing Social Media and End of Life

I have been on a wonderful whirlwind tour of listening, sharing, and discussion in online forums this summer in preparation of the upcoming MedicineX panel I will be moderating with my rock-star panelists -- @SusannahFox, @MeredithGould and @Colleen_Young on September 7. (To learn more about the inception of our panel and follow our "flipped classroom" model, please take a look at the Storify that Susannah Fox has compiled)

This week is no exception, as I will be guest hosting the always engaging and robust Tweet Chat #HPM (Hospice and Palliative Medicine). I hope to pose some questions and listen to the #HPM community regarding how social media is being used and perceived at the end of life. This is a complex and multi-layered area, filled with cultural stigma, fear, courage, vulnerability and ethics. Do we afford the same level of discussion and engagement when one shares about end of life as when one shares about other health concerns? What about when family members are posting about their loved ones at end of life (NPR's Scott Simon tweeted about the experience of his mother's death)? What about choices -- is there subtle and not so subtle bullying that occurs when treatment options do not align with other members of the online community?  I don't have answers, but I am open to listening, learning and sharing with others on this topic -- please join in #HPM at 9:00 PM ET/6:00 PM PT on Wednesday, August 20--newcomers welcome!

Here is the topic rundown for the August 20 #HPM chat:

T1 Do we have different standards in the use of social media for those at the end of life than for those who are in active treatment for a disease?

T2 Who determines appropriate use of social media in a situation when a family member is doing the posting on social media/networking sites (Facebook, Blogs, Twitter, etc.) and not the patient?

T3 Are there ethical issues that we need to think about?

CT: Closing thoughts

For background info:
Communicating the Experience of Illness in the Digital Age
Storify by Susannah Fox



2014 Medicine X: Communicating the Experience of Illness in the Digital Age

Time on the Internet can often be measured by the millisecond. We bemoan the shallowness,brevity and sensationalism of topics that seek to capture our momentary attention on our news feeds. Yet in the early part of 2014, a controversy hit the Internet with the intensity of a meteor and then instead of rapidly burning out, gained in intensity and continued discussion. The controversy became known on the Twittersphere as #Kellergate and revolved around separate columns written by former New York Times editor, Bill Keller and his wife, Guardian columnist, Emma Keller opining on blogger Lisa Bonchek Adams' frequent use of social media as a platform for chronicling and sharing her experience of living with progressive, incurable cancer. Topics of public disclosure of illness, ethics, dignity, TMI (too much information), choices surrounding treatment and death and dying were thrown into the open forum of the Internet. Without any precedent for such public sharing in real time, dialogue became divisive and heated. What appeared to be missing from the discussion was the impact of social media tools and online communities on the large population of those living with chronic illness. Attempting to add some insight to the phenomenon of illness blogging, I wrote a piece in early 2014 for WBUR's Cognoscenti site: Memo to Bill Keller: This is Why Patients Blog About Illness

Now more than half a year later, the discussion has stepped away from the specifics of the Keller/Adams controversy and has entered into a broader conversation on the issues of disclosure, community, isolation and connection. The international conference, Medicine X, held annually at Stanford University, has deemed this an important topic for the upcoming 2014 conference and has invited me and several colleagues to present a panel discussion entitled: Communicating the Experience of Illness in the Digital Age: Reaching Beyond the Keller/Adams Controversy.  I am honored to be the moderator of this panel of amazing thoughtleaders, Susannah Fox, Meredith Gould, and Colleen Young, all pioneers in the fields of peer-to peer-health, online communities, community management and the evolution of communicating the  experience of illness in the digital space. As a panel we will attempt to examine and identify the key aspects of the larger phenomenon of communicating the experience of illness in the digital age that we hope will help inform the continued evolution of online communities.

I would welcome comments and discussion in the comment section of this blog -- more voices on this subject are needed as we prepare for the Medicine X conference panel. I hope to see many of you in Palo Alto, September 5-7. For those of you who can't attend, I will post live-streaming and Tweetchat information for Medicine X as it becomes available.