Ethical guidelines and the use of social media and text messaging in health care: a review of literature

Social media is prevalent and increasing in usage in healthcare. Whilst guidelines have been developed to cover the issues concerning this topic, few have been based on an ethical framework. The purpose of this work was to undertake a review of the literature pertaining to social media use in health care and physiotherapy in particular. The results of the review identified five key themes, these were: privacy/confidentiality breaches; student use and the need for student guidance; the patient therapist relationship and boundary blurring; integrity and reputation of the profession; and a lack of institutional guidelines. Cases from the New Zealand Health Practitioners Disciplinary Tribunal and Health and Disability Commissioner relevant to the topic were used to explore the themes identified. As a result of the review it is recommended that these cases be used as educational tools in ethical decisionmaking. The findings of this review recommend the implementation of American Medical Association (AMA) guideline into New Zealand practice. However, it would need to be contextualised to ensure relevant local ethical, cultural and legal obligations are covered. Before professional bodies establish their own guidelines, it would be useful to survey health practitioners as to their current views, attitudes and awareness of social media use in a health care setting.