文、eng/ #zoe
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前陣子，網路上討論得很熱烈的一個話題：心理師、醫師、護理師等臨床專業人員是否可以在社群媒體上分享關於個案或病人的故事。
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其實這個問題我也思考了很久。
一直以來覺得好多個案的故事想要跟大家分享。
一方面覺得可以讓社會大眾更認識臨床的病徵、理解個案們的心境。另一方面，這也可以推廣音樂治療，因為故事總是特別吸引人，也紀錄著專業上的進步，
而這些也是臨床工作者個人生命成長的一部分。
但每次細想後，都覺得應該先徵求個案的同意。即便出發點是善意，這樣算不算是一種變相利用個案的經歷來增加「流量」或「曝光度」呢？
當治療結束後，直接問個案：「可以在社群網站上分享你的故事嗎？」這樣的對話聽起來也讓人感到尷尬。更何況，很多個案都是兒童、口語表達或認知上有困難的。即使有機會讓他們提前審閱文案，等到下一次治療再詢問：「我寫了關於上次治療的文章，你覺得我可以發嗎？」好像也是有點怪。
發出去後，面對網友們的留言，面對自己的經歷被討論著，又或者較不友善的留言，個案看到後，是否有其他的保護措施呢？
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回到網路上的討論，大多數臨床專業人員認為，在社群平台上分享個案的故事（在以不曝光個案/病患個人訊息前提之下），能讓大眾更理解疾病，並提升社會的同理心。同時，這也是臨床人員在工作中的一種自我成長的表現。但從個案的角度來看，可能會想：「雖然沒指名道姓，但我信任你，怎麼把我或我親友的故事公開了？」這樣的隱私與信任之間的張力，讓人難以拿捏。
在美國求學時，醫療倫理一直不斷是督導和教授們不斷強調的議題。
最完美的狀況——關於個案/病患的事，在工作場所以外的場地和非同事，絕口不提。如果要在非醫療或教育的情況下分享，必須保證沒有任何能識別出個案的資訊，比如年齡、性別、病情、地點、治療細節等。問題是，如果什麼都不能提，或需稍加修改，那故事本身的完整性就很難保留（也因此後來較少分享個案故事）。就連我們自己的受訓的過程，我們很大一部分也是透過過往的案例更好地理解臨床實務，
畢竟課本上的文字是生硬的，而人的生命是多樣的、是無法預測的。
所以，這個問題就卡在一個微妙的平衡點：分享個案的故事可以教育大眾、推廣音樂治療，但同時也需要尊重個案的隱私和信任。我想很多臨床工作者都會有相同的掙扎和考量，畢竟我們的初衷都是好的，不想因為分享而失去專業的分寸或個案的信任。
身為醫事人員， 你覺得可以在社群上分享個案/病患的故事嗎？
身為病患/個案，你會介意自己的故事被分享嗎？
還是有想到不錯的解決方式呢？
歡迎用你的角度留言或私訊告訴我你們的想法吧！
Recently, there has been a heated online discussion on social media in Chinese speaker community:
Could clinical professionals such as psychologists, doctors, and nurses share stories about their clients or patients on social media?
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This is a question I’ve been pondering for quite some time.
I've always wanted to share so many stories from my cases.
On one hand, I believe it can help the general public better understand clinical symptoms and empathize with what clients go through. On the other hand, it can also promote music therapy, as stories are particularly engaging and these experiences also reflect the personal and professional growth of clinical workers.
However, each time I think more deeply, I feel that it’s necessary to first obtain the client's consent. Even though the intention may be good, could this still be considered a form of exploitation, using the client’s experience to increase "traffic" or "exposure"?
After treatment concludes, directly asking the client, “Can I share your story on social media?” sounds a bit awkward. Moreover, many clients are children, or they may have difficulties in verbal expression or cognition. Even if they had the chance to review the content in advance, asking them at the next session, “I wrote an article about the last treatment, do you think I can post it?” still feels a bit strange.
Once it's posted, how do we handle comments from netizens, especially negative ones? Could seeing clients' own experience discussed, or reading unfriendly comments on the Internet, have further consequences or precaution for the client?
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Back to the online debate, most clinical professionals think that sharing client stories on social media (as long as personal information is not disclosed) can help the public better understand illnesses and foster greater empathy in society. At the same time, it can serve as a form of personal growth for clinical workers. However, from the client’s perspective,“Even though the name wasn’t mentioned, I trusted you, so why did you make my / my family/friends' story public?” The tension between privacy and trust is difficult to balance.
While studying in the U.S., medical ethics was a topic that supervisors and professors constantly emphasized. The ideal scenario is that any information regarding clients or patients should never be discussed outside the workplace or with non-colleagues. If sharing is to take place in non-medical or educational settings, it must ensure that no identifying information about the client is disclosed, such as age, gender, illness, location, treatment details, etc. The problem is, if nothing can be revealed, or if certain details need to be altered, the integrity of the story becomes hard to preserve (which is why I’ve gradually shared fewer case stories). Even our own training heavily relies on learning from past cases to better understand clinical practice, as textbook material can be dry and rigid, while real human experiences are diverse and unpredictable.
So, this question remains at a delicate balance: sharing client stories can educate the public and promote music therapy, but at the same time, we must respect the client’s privacy and trust. I believe many clinical workers face similar struggles and considerations. After all, our intentions are good, but we don't want to lose our professional integrity or the client’s trust through sharing.
As a healthcare professional, do you think it's okay to share client/patient stories on social media?
As a client/patient, would you mind if your story was shared?
Or do you have a good solution to this dilemma?
Feel free to share your thoughts in the comments or message me privately from your perspective!