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A Piece of My Mind
June 27, 2017

Porous Boundaries

Author Affiliations
  • 1Department of Pediatrics, and Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, New York
JAMA. 2017;317(24):2487-2488. doi:10.1001/jama.2017.1589

Each fall, first-year medical students are introduced to the basics of confidentiality. The question is posed: “How many of you would friend a patient?” Watching from the back of the auditorium, I have yet to see a single hand flutter, much less shoot confidently into the air.

I am waiting, I think, for the moment when the culture shifts before my eyes. Like my students, I feel a crawling discomfort at the thought of invading cyberspace to contact a patient online. I came of age with the internet: that is, old enough to have attended college Facebook-free but young enough to have been regularly chastised about the professional perils of social media. Unlike my students, however, I no longer hear it as a polar question. I accepted a friend request from a patient’s parents, and it forever changed my understanding of the practice of medicine.

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