To: Ethics Advisory Board
From: Concerned RN
During the COVID-19 pandemic, patients are asking me about symptoms they’re experiencing and my opinion about information they’ve found on the internet and in social media. I find that I’m also seeking information about symptoms on the internet and am self-diagnosing. What can I tell patients about the accuracy of health information found online?
From: ANA Center for Ethics and Human Rights
Nursing continues to be considered the most trusted and ethical of professions, according to annual Gallup polls. Patients frequently ask nurses about symptoms and about whether to believe and act on health information they find online. As nurses, we also tend to self-diagnose. Self-diagnosis can be defined as the process of identifying healthcare conditions in oneself using various resources, including those found by searching the internet and social media.
The World Health Organization has referred to the explosion of information and misinformation as an “infodemic.” Risks and benefits are associated with using online information. Some can be helpful and accurate; however, some is misleading and inaccurate. Taking hydroxychloroquine to cure COVID-19 is a recent example of misinformation that’s put people in danger.
How can the Code of Ethics for Nurses with Interpretive Statements (the Code) (nursingworld.org/coe-view-only/) provide guidance in this issue? Provision 5 states that “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety.” Provision 5.2 emphasizes the importance of nurses being role models for health maintenance and health promotion measures. For nurses and patients who use the internet as a tool for self-diagnosis, it’s important to determine whether websites are trustworthy and reliable sources of health information.
In general, health websites that are sponsored by federal government agencies, such as the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, and the Centers for Medicare and Medicaid Services, are reliable. Other trustworthy sources include the National Institutes of Health and its website from the National Library of Medicine (MedlinePlus.gov), Mayo Clinic, WebMD, and university health websites. In general, one should be knowledgeable about the questions to ask when evaluating a website, such as identifying the sponsor, authors, and contributors to the site, its overall purpose, and whether it’s current.
Valid and reliable websites also will display the designation of a credentialing organization (Health on the Net code). This code indicates the site has been certified as providing accurate, credible, and ethical health information.
Nurses must be knowledgeable about the criteria by which a site’s information is vetted, both when evaluating oneself as well as when helping patients find accurate information. Above all, the information must be based on science and use data as the source for evidence-based solutions. The internet can be a good starting place to finding useful information; however, it shouldn’t replace a visit with a healthcare professional.
— Response by Linda L. Olson PhD, MBA, MSN, RN, NEA-BC, FAAN, member of the ANA Center for Ethics and Human Rights Advisory Board.