Ethical Legal Feature
Should Health Care Professionals Google Patients or
Family Members?
Feature Editor Introduction: Kristi L. Kirschner, MD
For this issue, I have invited Rebecca Brashler, LCSW, an ethics consultant and director of
Care Management and Family Support Services at the Rehabilitation Institute of Chicago, to
share an interesting ethics case that recently was brought to the Rehabilitation Institute of
Chicago consultation service. Without a doubt, the use of the Internet for e-mail and social
networking has raised novel issues for professional practice. By recognizing the allure as well
as the potential pitfalls of such practices, many institutions and professional organizations
have begun to develop guidelines and policies for their use. Ms Brashler raises a related, but
slightly distinct, concern: the use of the Internet by health care professionals seeking
personal information about patients and their family members. Ms Brashler lays out the
parameters of the case, the issues raised, and the discussion ensued. I have invited Matthew
K. Wynia, MD, MPH, FACP, the director of The Institute for Ethics, and Bette-Jane Crigger,
PhD, the director of Ethics Policy, the American Medical Association, to provide the first
commentary. The second commentary is by Anita Halvorsen, FACHE, MBA, MS, CCC-SLP,
vice president at Schwab Rehabilitation Hospital in Chicago. In addition to her current
leadership role in hospital administration, Ms Halvorsen has extensive prior experience in
hospital corporate compliance. Finally, Ms Brashler provides some closing comments about
how she came to see the issue after consulting on the particular case. As always, please do
feel free to write in and provide your thoughts and comments!
Column Introduction by Rebecca Brashler, LCSW
Is it ethical for health care professionals to google their patients and/or family members?
This question was brought to our hospital ethics consultation service after a nurse googled
a child’s mother when the parent’s behavior raised concerns about her integrity and
character. The google search led the clinician to a Web site blog that discussed the woman’s
history of white collar crimes and fraud. This finding was shared with others on the
treatment team and raised additional concerns about what should be done with the newly
discovered information and whether the staff member’s actions were acceptable.
An informal poll of colleagues revealed that there was little consensus. Reactions
varied from “Of course it’s okay, I google everyone” to “I think it’s highly unprofessional
and unethical.” Anecdotally, opinions seemed to be split along generational lines, with
younger staff members generally finding the behavior more acceptable than older staff
members. There was agreement, however, that googling in nonclinical hospital areas
(such as a human resources recruiter googling an applicant for employment) was largely
without controversy, whereas the clinical setting posed a more complicated ethical
landscape.
There is little in the ethics literature to verify how prevalent this practice has become
among health care professionals. Lal [1] published a study in the August 2010 American
Psychological Association’s Monitor on Psychology that asked graduate psychology
students about googling practices and found that 22% of students reported googling a
patient to get additional information, whereas 42% reported googling a supervisor. The
different rates may be indicative of a more widely accepted sense that there is
“something” improper about launching a Web search on patients, although this is not
clear.
A common initial response from health care professionals was that googling seems like a
violation of patient privacy. But a review of the laws confirmed that the behavior does not
Contributors:
Rebecca Brashler LCSW Care Management
and Family Support Services, Rehabilitation
Institute of Chicago, Chicago, IL; Physical
Medicine and Rehabilitation, and Medical Hu-
manities and Bioethics, Northwestern Univer-
sity Feinberg School of Medicine, Chicago, IL
Disclosure: nothing to disclose
Matthew K. Wynia, MD, MPH, FACP The
Institute for Ethics, American Medical Associ-
ation, Chicago, IL
Disclosure: the commentary represents the
views of M.K.W. and not the AMA; nothing to
disclose
Bette-Jane Crigger, PhD Ethics Policy, Amer-
ican Medical Association, Chicago, IL
Disclosure: the commentary represents the
views of B.-J.C. and not the AMA; nothing to
disclose
Anita Halvorsen, FACHE, MBA, MS CCC-SLP
Schwab Rehabilitation Hospital at Sinai Health
System, Chicago, IL
Disclosure: 7A, Nexstim
Feature Editor:
K.L.K. Medical Humanities and Bioethics, and
PM&R, Northwestern University Feinberg
School of Medicine, 750 N. Lakeshore Drive,
Room 623, Chicago IL 60611, and Schwab
Rehabilitation Hospital, Chicago IL Address
correspondence to K.L.K; e-mail: k-kirschner@
northwestern.edu
Disclosure: nothing to disclose
Disclosure Key can be found on the Table of
Contents and at www.pmrjournal.org
PM&R © 2011 by the American Academy of Physical Medicine and Rehabilitation
1934-1482/11/$36.00 Vol. 3, 372-376, April 2011
Printed in U.S.A. DOI: 10.1016/j.pmrj.2011.02.007
372