Last week, the Harvard Medical School Division of Medical Ethics held a session on the ethical issues surrounding blogging by a CEO, particularly the CEO of a health care institution. Local examples were this blog and the one published by Charlie Baker, CEO of Harvard Pilgrim Health Care. Unfortunately, I could not attend, but I received a note from one of the attendees who told me about some issues that had been raised. I'll report on that and add the comments I would likely have made if I had been present.
One of the discussants identified four domains that he thought of as important in thinking about the ethics of a CEO blog, and about which he posed some questions:
1. Voice: Is the CEO blogger blogging as an individual or as the voice of the organization? Charlie's blog is hosted in the HPHC website and linked to HPHC marketing materials. Yours is on Blogger and not linked to the BIDMC site. But when the CEO speaks, what he or she says can't be separated from the organization.
My reply: Whenever I give a speech, or testify before a legislative or regulatory body, or give a media interview, or write an article (for this blog or a journal) people assume that I am speaking from a position of authority and responsibility for the organization. That is just something that cannot be avoided. I do my best to be aware of the institutional consequences of what I say, regardless of the forum.
2. Authenticity: Who is speaking? Is it a real human being speaking, or an avatar created by a ghost writer? Are comments posted as received or are there schills setting up softballs and deletion of tough questions? In other words, is it a real voice and a real discussion?
Reply: I think my readers know that the posts are mine alone. Certainly, the media relations people and lawyers at BIDMC know that! Likewise, the comments are yours alone. I post them all, unless they contain bad language or personal medical information or private personnel information. I keep looking for those softballs, but they are few and far between.
3. Reliance: From a legal perspective, to what extent does CEO blogging create obligations for the organization or claims that outsiders can make?
Reply: See #1 above. Concerning claims, there is little I say on the blog that does not exist in some other form in the hospital (or in my speeches, articles, or elsewhere) and therefore could be used by attorneys as discoverable information in a legal proceeding.
4. Privacy: When Charlie or you draw on communications from patients/members, even if these are de-identified, should consent be asked for from the person(s) involved?
Reply: I ask for consent from patients or their loved ones who write to me. I also de-identify the stories, unless the person involved prefers otherwise. I do not generally ask for consent to use material a staff member sends me about an issue or a process (for example, this one), but I would of course ask permission to print anything related to the personal life of a staff member.