WMA Statement on the Professional and Ethical use of Social Media

Adopted by the 62^nd WMA General Assembly, Montevideo, Uruguay, October 2011
and revised by the 73^rd WMA General Assembly, Berlin, Germany, October 2022

DEFINITION

 Social media is a collective term for the different interactive platforms, websites and applications intended for digital networking, that allow individuals and organizations to create and share user-generated content digitally.

The objectives of this policy are to:

• Examine the professional and ethical challenges related to the increasing usage of social media by physicians, medical students, and patients.
• Establish a framework that protects their respective interests.
• Ensure trust and reputation by maintaining high professional and ethical standards.
• Promote the availability of quality information across social media.
• Stand against misinformation and disinformation on social media.

The use of social media has become a fact of life for billions of people worldwide including physicians, medical students, and patients.

Interactive, collaborative tools such as wikis, social networking platforms, chat applications and blogs have transformed passive Internet users into active participants. These tools are means for gathering, sharing and disseminating information, including healthcare and science information, socializing and connecting with friends, relatives, professionals etc. They can be used to seek medical advice, and patients share their health and healthcare experiences. They can also be used in research, public health, and education.

The positive aspects of social media should be recognized such as in promoting a healthy lifestyle, the dissemination of medical knowledge to society and in reducing patients’ isolation.

Areas, which may require special attention include:

• Sensitive content, photographs, videos, other personal materials posted on online social forums often exist in the public domain and have the capacity to remain on the internet permanently. Individuals may not have control over the ultimate distribution of material they post on-line.
• Patient portal, blogs and tweets are not a substitute for one on one consultation with physicians but may widen engagement with health services amongst certain groups. Online “friendships” with patients may also alter the patient-physician relationship, and may result in unnecessary, possibly problematic physician and patient self-disclosure.
• Each party’s privacy may be compromised in the absence of adequate and conservative privacy settings or by their inappropriate use. Privacy settings are not absolute; social media sites may change default privacy settings unilaterally, without the user’s knowledge. Social media sites may also make communications available to third parties.
• Misinformation and disinformation often spread more rapidly through social media than fact-based accurate information. It may cause harm to the health of individuals as well as to public health and foster doubt and distrust towards professionals seeking to promote truth and science-based evidence.
• Appropriate disclaimers to include in biographical information (e.g., “my opinions are my own”, “posts are not personalized medical advice”, etc).

The dissemination of medical knowledge, best practices and treatment options on social media can increase and expedite access to new and valid information among medical professionals. However, individuals or companies can take advantage of these channels in misleading ways, including to market or promote their medical products or treatments.

RECOMMENDATIONS

The WMA urges National Medical Associations (NMA) to establish social media guidelines for their members addressing the following objectives:

1. To maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just as they would in any other context.
2. To ensure that no identifiable patient information is posted in any social media by their physician, by increasing the understanding of privacy provisions of social networking sites and their limitations while considering intended audience and the technical feasibility to restrict access to the content to predefined individuals or groups.
3. To exercise care when using applications that might compromise the security of the data, including when consulting with colleagues.
4. To promote and apply the principles in the WMA Guidelines on Promotional Mass Media Appearances by Physicians to all social media activities by physicians.
5. To encourage physicians to routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others is accurate and appropriate.
6. To prevent the use of technological devices from diverting our attention during direct consultation with the patient.
7. To provide factual, concise, understandable information, declare any conflicts of interest and adopt a sober tone when discussing professional matters.
8. To avoid inappropriate use of the networks, frivolous, insensitive attitudes or light-hearted opinions on medical matters.
9. To draw the attention of physicians to the fact that social media content posted by health professionals may contribute to the public perception of the profession and should be done in accordance with the principles in the WMA Declaration of Geneva and the International Code of Medical Ethics.
10. To include education on the use of social media in medical curricula and continuing medical education.
11. To behave in the media and on social networks with the same scientific rigor and the same approach as in a consultation and show the same respect to patients and colleagues.
12. To create mechanisms for accountability in professional settings when inappropriate behavior on social media is observed and reported.
13. To promote health literacy and knowledge among populations and with individual patients by using objective and evidence based messages in accordance with the principles in the WMA Declaration of Geneva, the WMA International Code of Medical Ethics, and the WMA Statement on Healthcare Information for All.
14. To combat misinformation, disinformation, and the promotion of pseudoscience and pseudotherapy on social media, all of which can result in negative health outcomes for patients and communities.
15. To counsel fellow physicians who engage in misinformation, disinformation, or violation of patient trust on social media and/or report to relevant authorities for ongoing deliberate acts of the same.
16. To raise awareness among physicians and medical students about the possibility that information shared on social media could be used in misleading ways by individuals or companies.