Smart Blogging

There's been an ongoing discussion in the medical blogosphere about the ethics of blogging. Much of it centers around patient privacy issues, authenticity and authority (l'affair TNT), and commercial transparency. There have been several attempts to formulate honor codes in the name of "ethical blogging", with varying degrees of penetrance and relevance to the general medical blogging public.

I'd like to suggest that conduct not in keeping with these codes -- blogging about identifiable patients without their consent and such -- is more unprofessional than "unethical." Some kinds of blogging -- about court cases in real time, for example -- are just stupid.

Several months ago there was an upheaval of sorts as a few bloggers disappeared, but many more got all bent out of shape and either pulled or curtailed their blogs. In the fullness of time, some of these latter have come back, supposedly "more careful" than they (thought they) had previously been.

Much of the ado is about anonymity. As we all know, there is no such thing as anonymity on the internet. In reality, though, the only way to get in trouble with attempted anonymity is to take it too seriously.

Many anonymous bloggers have an overinflated sense of how much the general public gives a shit about their real identity. In the process of going on and on about how worried they are that they may be outed, they do one of two things to their readers:

1. They bore them.
2. They annoy them.

Neither is good.

In the first case, readers will go elsewhere to read blogs where people are actually saying something of interest. In the second case, it's annoyed readers who are sometimes moved to "out" the blogger just because they can. Though bloggers may not realize it, it's almost as if they're daring readers to expose them.

The vast majority of bloggers -- including doctors -- have to realize that as long as they don't say stupid things on their blog, perilously few people actually care about their identity. As a rule of thumb, anyone who really NEEDS to be anonymous probably shouldn't be blogging in the first place.

What of the exceptions? I believe Barbados Butterfly was the victim of an overzealous and/or controlling employer. And Flea (sorry to put it like this, buddy) was just stupid; like a little kid thinking no one can see him because he's got his hands over his eyes.

In the final analysis, whether you choose to amuse yourself with the game of anonymity or not, the issue isn't one of ethical blogging vs. unethical blogging: it's smart blogging vs. stupid blogging. Don't be stupid, and everything will be fine.

(Dedicated to Dr. K.)

(edit: To clarify further on Anonymity:)

Anonymity only has meaning when people care about who you really are, which far fewer people do than most bloggers think. If you think about it, what makes people care who you are: You've said something that can be used against you in the real world (Flea) in which case the people who want to use it against you will move heaven and earth to find you; or you've annoyed the hell out of someone, and they try to out you to get back at you for being so annoying. So the bottom line is don't piss people off, and don't be stupid.