I have been talking with Niels Olson of Haversian Canal about approaches to building a learning community site for Tulane School of Medicine. As I wrote before, HealthVoices is designed to grow beyond blogs into a broader health community site. I wanted to see if our concept might be of use to Niels' project and in the process discovered some key issues.

Our ideas of medical openness are not really new and have roots in what we already see with blogs and other "Web 2.0" services. All HealthVoices is doing is trying to figure out how to apply them in healthcare to do something useful. Openness sounds like mother and apple pie, but where should we put the limits? How much privacy and control should one have in a connected world?

The answer is YES.

Ability to connect with a "global village" does not mean granting anyone a right to invade your life. Individuals and groups deserve to have control over how much privacy to give up in exchange for connectivity and trust, and what line cannot be crossed to avoid violating law and ethics.

In case of a med school community that might mean things as simple as restricting copyrighted course materials to the private groups, limited to class enrollees, under control of professors. At the same time every community member can still have access to private school / club areas and global public groups, through the same interface.

However, if you choose to drag someone to the public square, you should be prepared to give up some of your privacy.

Doc Around the Clock reports a case of a rogue patient demanding that doctor cover up his infidelity. Doc does the right thing and gets hit with a baseless complaint. I do not know what the law says on that, but I think if a complaint is to go on a record all pertinent information should be made public to let anyone decide who is right or wrong.

In cyberspace, such policies are yet to be written. I think the fair thing is let anyone have as much privacy as they wish, until they start infringing on the rights and reputations of others.