Sunday, October 23, 2005

Addressing concerns.

This is a response in regards to a concern that was raised by Fuzzbuck Fuzz in the comments section of my last post, I have an owie.

For those not in the know, in this post I have mentioned three cases that I have seen on my uni mental health placement in the last week, as examples of what I deal with and what I see at work.

Fuzzbuck was concerned about the implications of my discussing patients / clients on my blog.

I would like to thank Fuzzbuck for raising his concerns. He has a very valid point. For the record though, I would like to state my position on the situation just to clarify that I am not a totally immoral cow.

It would be seriously questionable if I posted details which might be used to identify the clients. But as I have only mentioned the cases without providing information that would identify the specific clients or the facility which they are in, according to standards, it is not an unacceptable practice amongst health professionals.

As for whether or not this practice is morally acceptable or not, I suppose that depends upon an individual's personal values and morals. I blog to keep track of things that have happened to me. Working with physically and mentally ill patients is a large part of my life and it is something that I like to share with my friends on the internet. I feel that it is acceptable to mention and discuss interesting cases that I come across as long as I do not:

a) identify the clients by providing specific information about them or the facility they are in,

and

b) I try to remain impartial when describing cases, and I try to refrain from passing judgement upon the client.

I try to live by the "Do unto others" Golden Rule, and I have thought about this long and hard. I would not be opposed to a health professional discussing my case in any open forum (on a blog, in a class, in a university paper, in a conversation, etc.) as long as I personally was not identifiable from the information given. I do not believe that my discussion comprimises my clients privacy.


I can't help but wonder if you would have voiced your concerns had I mentioned patients with purely physical illnesses.

78 Comments:

At 10:58 am, Blogger sophie said...

I am currently working in orthopedics, but I have also worked in psych. I have also been in therapy myself. I don't think I would have a problem with what you have posted. Here in the states, there is now a federal law about "Protected Health Information" with severe consequences for offenders. This has made me very hesitant to post much about my patients. However, it's more because I would do very poorly in jail rather than for moral reasons.

Michele sent me.

 
At 11:32 am, Blogger Thumper said...

The Spouse Thingy talks about his surgica cases in his blog, and at least once someone has asked if he was violating HIPPA...basically, he doesn't say anything he wouldn't in a professionaly published journal. I'm pretty sure that without case and location identifiers, it's ok to talk about. I think...

Here via Michele's!

 
At 11:38 am, Blogger FuzzBuck Fuzz said...

It seems I have caused offense for which I immeadiately and unreservedly apologise. It was neither my intent nor my thought to suggest through direct or indirect implication that you were IN ANY WAY a "totally immoral cow".
It's just that reading it made me feel uncomfortable. What if that were one of my relatives? What if it were me? I would have issues with details of my relative's cases (or mine) being discussed in any form of open format whether or not they were identifiable regardless of any law on the matter and regardless of whether that particular place was visited by health professionals or not. I realize this will not add to my popularity and make many think I'm prudish, but I would not be comfortable with it. You are probably correct in the assumption that it is the stigma attached to mental health issues that is behind this discomfort. If there were no stigma it wouldn't be an issue. Having said that on reflection I'm not so keen for my medical practitioner to be blogging about my broken leg either. I'd be prepared to discuss that one and if their reasons were valid then maybe, but if I had a mental health issue I wouldn't. I asked my friends if it was ok to mention making a cup of tea at someone's house before I blogged about it. You may consider that to be oversensitive, but if any of them had had a problem with it I wouldn't have written that particular article. The scary thing in this situation is that your patients have no means by which they can communicate their approval or disapproval. If my doctor blogs about my broken leg & I see it I can ask him to remove the post. If I am locked away in a secure wing and someone blogs about it I may never know. If that person is my doctor I percieve it (according to my own morals) to be wrong. If you do not agree with this I fully accept your right to disagree, but I intend absolutely no slur on your own morals or judgement. I also intend no offense. It's something I would have an issue with and could not read without commenting on the discomfort I allowed myself to experience. Again I apologise for any offense caused.

 
At 11:42 am, Anonymous Melina said...

Hi Yaeli! Michele sent me...I'm in San Diego, where it's 5:34 p.m.

I recently blogged about my niece ditching school and getting caught by her sister and her dad read the post (didn't know he knew my blog existed) and she got busted, but not really in trouble b/c her dad's good-natured and thought the whole thing was funny.

Now I feel kinda bad, but w/e! She shouldn't have been ditching in the first place!

Anyway, I am being overly sensitive, but oh well. Hope Sunday's great in your part of the globe!

 
At 12:07 pm, Blogger Yaeli said...

Fuzzbuck, no offense was taken and I know that none was meant. I completely understand where you are coming from and I respect you opinion. Thank you for respecting and trying to understand mine. :o)
I hope you keep on coming back mate. :o)

 
At 12:13 pm, Blogger Oreo said...

Hippa(?) laws are a bunch of crap in my opinion!! What are these people doing that they're so worried someone is going to find out about? Simple solution...stop doing it!! Here from Michele's.

 
At 1:10 pm, Blogger la la la I can't hear you said...

Hi Michele sent me.

I wouldn't care if my dr. talked about me as long as they didn't identify me. Of course, I'm not crazy either. But even if I was, I don't think I'd care. Maybe I'd care even less in that case.

Unless I was paranoid...

 
At 2:11 pm, Anonymous Teli said...

I just read the post and don't think it's a problem. I have no idea who you're talking about and I fully understand that healthcare professionals have a life outside of work.

It's actually interesting in my opinion (psychology, especially abnormal, has been one of my long time interest).

Honestly, I'd say just make sure you're within the law and you're fine. Immoral - like you said, that's in the eye of the reader.

 
At 2:11 pm, Anonymous Teli said...

forgot t mention - Michele sent me :)

 
At 2:21 pm, Blogger Beanhead said...

Michele sent me. I think the post is fine. I mean if you posted names and places then it would be a violation of privacy but as it is I think it is fine.

 
At 2:30 pm, Blogger Carmi said...

I'm glad you raised the issue, because the discussion has been incredibly illuminating.

Although I'm not a health care professional - for the sake of the rest of the world, thank God for that! - many of these privacy issues come into play insofar as journalists and sources are concerned.

At the end of the day, our name is all we have. Nicely said, and nicely dealt with. Thanks!

(Back from Michele's again...sick of me yet?)

 
At 2:44 pm, Blogger Crazy MomCat said...

I don't think it would bother me to be mentioned, were I a patient of yours, as long as it wasn't easy to identify that you were talking about me. I would expect that most of your patients don't even know about this blog at all. I tend to write what's buzzing in my head at the time and I think that's all you were doing. No harm done.

Michele said hi!

 
At 2:54 pm, Blogger FuzzBuck Fuzz said...

.....um...kind of a bit afraid to now i'm the bad guy ;)

Ahh well. Was ok while it lasted.

 
At 5:49 pm, Blogger Lish said...

I once screened the pap smear of a celebrity, but I can't tell anyone who she was. Or maybe it was a he. Hmm?

 
At 11:45 pm, Blogger utenzi said...

Michele sent me your way, lovely Yaeli, when I thought I was going to visit Judy.

Like others have mentioned, here in the States we're ruled by HIPPA. I don't have to deal with it much since most of my clinical samples are tumor cells from people that had surgery years ago, sometimes more than 50 years. I don't see anything wrong with what you said, but there's always going to be alarmists out there watching everyone else. Personally I find that sort of thinking very annoying.

Thumper's comment is interesting. Her husband gives a lot more detail than you do, Yaeli. More than once I've been surprised at how much he'll say about a patient that comes into the OR.

 
At 12:07 am, Anonymous mar said...

Well, I missed some interesting discussion last night. I don't see a problem writing about anonymous people who cannot be identified. If I'd worked for a mental health institution , I'd need to let things out just to keep myself within sane boundaries... You have a great blog, Yaeli. Cheers.

 
At 12:32 am, Blogger The Mistress of the Dark said...

I think it's a hard call morally and from the standpoint that it could get you fired. I know it's happened in some instances.

But it's your blog, so do as you see fit.

Take care....Here via Michele's

 
At 12:44 am, Blogger kenju said...

Yaeli, you are not disclosing any personal information - so what's the problem? I see nothing wrong wiht telling the story as long as you don't identify the person or the facility!

Michele sent me.

 
At 1:45 am, Blogger Aginoth said...

Hi Yaeli,

Found you via Utenzi's blog...

I don't see any problem with what I've read, so far, you aren't giving any details that could identify anyone.

blogrolled you btw, makes it easier to find you again so I can read your Archive :o)

 
At 5:12 am, Blogger dena said...

It's perfectly find to write about the people we come in contact with. You didn't identify them by name, or exact location. I was intrigued by your story, and hope you continue to post about your cases. I don't need to know their names, but I find your line of work very intersting reading.

 
At 11:11 am, Blogger David said...

Michele sent me

 
At 11:13 am, Blogger Train-Guy said...

you like fuzzbuckfuzz. Michele snent me.

 
At 11:20 am, Anonymous Daisyhead said...

Hi! Michele sent me. I need to read more on this Fuzzbuck. ;-)

 
At 11:55 am, Blogger Captain Typho said...

I don't think you're doing anything wrong. Besides, I want to hear more about your wacko patients. ;)

Michele sent me!

 
At 11:56 am, Blogger Maggie said...

Hello:
I've often wondered people who works in this field, how do they separate themselves from getting too involve withthe patients?
If you can answer that will be great.
Michele sent me.

 
At 12:08 pm, Anonymous netchick said...

If going by the American HIPAA compliancy, you'd still be completely within guidelines.

Besides, you didn't post anything that would allow someone (probably even someone you work with) to pinpoint your patient.

Good grief. Work takes up much of our life -- If we can't generalize about the basics, we don't have an outlet for a large part of our days.

It'd be a lot different if you were being unprofessional about it... You weren't.

 
At 1:25 pm, Blogger ~Cathy~ said...

I agree.... as long as no names or identifying info are mentioned, I don't see a problem with it.

Here via Michelle's!

 
At 1:45 pm, Blogger Michelle said...

Hello! Thanks for coming by my site and blogrolling me! I agree with Cathy. Have a good night!

 
At 4:23 am, Blogger ... jacek ... said...

being that this is the only Ozzian blog I read, and that youre in Oz, I figured I'd share with you that I just recently saw an Ozzian movie "undead" a zombie sci-fi flick, and that I greatly enjoyed it, in fact you Ozzians tend to make make much better flicks then us Americanos (per capita that is). Anywho... looking forward to a sequel. - Sorry I know this has nothign to do with youtr post...

 
At 5:38 am, Anonymous mar said...

Just visiting to wish you a good week. Michele sent me.

 
At 1:32 pm, Blogger Alisha said...

Very eloquent! I am hesitant to write about my work due to the pressure we are under here in the States due to HIPPA and the like. However, I feel my blog friends are missing out on such a vital part of me. Unfortunately, there is no way I could blog about it without identifiable info. because the stuff I would write is the funny stuff that they would immediately recognize! I commend your stand on things, and think that was an undeniably perfect display of therapeutic communication!

 
At 6:21 am, Blogger Writing idiot said...

the way i see things is that as long as there is no way for any patient to be identified then cases should be discussed. its both interesting and informative to know about certain illness' which we would never know about if never discussed. can you imagine what the medical state of any country would be like if patient cases were never discussed?
a doctor will discuss with other doctors a patients problems to get help. so too if i had a friend or i myself had certain symptoms reading about other peoples cases can (and in alot of cases) help me to know what me or my friend is going to go through or even what might be wrong with us. keep up the good blogging ;)
and for the record im here from Fuzzbuck fuzz's blog.

 
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