Ok, I pulled my post while considering ethical issues, viz this conversation:

Dianne, PAL:

I’m out of my depth here, so could you address what the ethical boundaries are for describing a case (even without personal identification) on an open board?

I’ve always dealt with that one by Just Don’t — and I know it’s overly conservative. And I promise to not take you as too authoritative, but it’s an interesting subject …

Posted by: D. C. Sessions | October 15, 2008 9:09 PM

Well, it’s an interesting issue. Generally, cases are fine to present as long as enough details are changed. Given that I’ve lived/practiced in a number of different cities/states, and that the only real identifying info is that the patient is a male in his 60s (which may or may not be true), and i’ve presented a picture that may or may not be the actual patient, the ethics seem to be in my favor.

NEJM, for example, is a publicly available journal, and regularly presents cpc’s without identifying info.

Curse/bless you for bringing this up.

Case presentations are not in and of themselves unethical. The ethical issues involve what is in the patient’s best interest. If a patient is not identifiable, there should be no ethical issue.

Except when there is.

Some would argue that a patient can be ethically harmed even if they are not identified, as the information about them belongs to them, and is theirs to hold or release. This, I think, is where the issue of mixing up case details comes in. If the details are not traceable to a particular patient, then there is no harm.

However, since I am talking about a path report, one could argue that there is an ethical problem.

There is also a question as to what benefit a patient may or may not derive…


Posted by: PalMD [TypeKey Profile Page] | October 15, 2008 9:16 PM

Discuss amongst yourselves while I consult my betters….