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The American Academy of Neurology (AAN) recommended that neurologists and other neuroscience professionals have an explicit, systematic awareness of issues and ethics about using social media in medicine.

The new , from the AAN's Ethics, Law, and Humanities Committee, spans everything from tweeting about research to online harassment, and addresses patient education as well as patient privacy.

"Existing ethical principles and norms of professional communication can and should serve as the framework for guiding the professional use of social media by neurologists and other clinicians," wrote Katharina Busl, MD, MS, of the University of Florida in Gainesville, and colleagues in Neurology.

The AAN (CPC) formalizes professional behavior standards for AAN members, the authors noted. The new position statement aims to complement the CPC by reviewing how social media has transformed clinical practice and providing an ethical framework for neurology professionals and trainees to consider.

"We created this new position statement to build a framework of how to apply commonly accepted ethical principles -- beneficence, nonmaleficence, autonomy, and justice -- to a form of communication that is rapidly developing and ever-changing, but at the same time separate that very strictly from giving explicit advice on how to utilize certain forms or platforms of social media, because that is something very different," Busl told 番茄社区.

"With the easy accessibility of social media, the temptation may be to dive in before fully considering what this form of communication entails and how to approach it," Busl said. "This pertains both to potential harms, however unintentional, and potential benefits."

Online interactions can foster a false sense of privacy and anonymity, the AAN authors noted. For example, a of #ShareAStoryInOneTweet showed that patient names were mentioned in 2% of tweets by clinicians; among 348 tweets that did not use patient names, up to 47% of people were likely still identifiable.

"These potential privacy violations are concerning because the reach of social media posts is potentially unlimited in geography and time, and because posts are often effectively irreversible once disseminated," Busl and colleagues observed.

Social media posts also can be taken out of context and rephrased in adversarial ways, they noted. "Some have been well-orchestrated, methodical, and intended to cause deliberate harm," Busl and co-authors wrote. "Bound by physician-patient confidentiality, physicians may be unable to post replies in their defense."

The AAN statement also provided a list of "do's" and "don'ts" for using social media, including cautions about not providing individual medical advice over social media, not engaging in harassment or vitriolic attacks or posting offensive or intimidating material, and not posting or reposting false or misleading information.

Posting false or misleading information falls under the jurisdiction of the CPC, which states AAN members must not represent themselves to the public in an unprofessional, untruthful, misleading, or deceptive manner. "Social media-related complaints pertaining to or against AAN members are addressed like all other member complaints -- i.e., in accordance with the AAN's Disciplinary Action Policy," Busl and colleagues wrote.

"Social media use is something that any neurologist may consider, and they may also discuss the pros and cons with patients when indicated," Busl said.

"For example, broader outreach and professional networks may help in connecting with colleagues who are sharing similar interests within neurology," she pointed out. "Social media can be used to follow journal publication outputs in real time and hear about therapeutic approaches. For patients, networks may be able to provide access to support groups, increase knowledge, and allow for communication."

"At the same time, going into social media use with a thought-out strategy is important," Busl added. "Taking a moment to reflect on communication and ethical principles is something that may be helpful in many situations and does not only apply to social media use."

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