Conclusion

Innovations in Internet information technology (IT) are revolutionizing both entertainment and information delivery, altering their production and consumption, and transforming our social lives and behaviors as citizens. While many argue that the new technology surrounding e-mail, online discussions, and web-powered information diffusion interest aggregation will lead to a more informed, engaged, and influential mass public, many are left still left pondering whether the Internet will launch us into a more engaged and participatory society or one comprised of easily manipulated and impersonal people (Nie and Erbring 2000).

Whether the impact of the Internet on society is positive or negative is still widely debated, but despite the controversy, one thing is certain: the Internet is a powerful vehicle for change. Hopefully our work thus far has made this reality evident.

The growth in health information and resources on the Internet, the impact of the Internet on education, and the development and evolution of blogs have all served to impact the daily lives of “netizens.” Consumers, or Internet users, have increased their access to education through online developments in healthcare and education, and weblogs now provide a new and unique medium through which users can present, share, and discuss information quickly and inexpensively. Nevertheless, despite the potential of these resources, their nascent states have led our explorations into largely uncharted territory. But while there is little policy currently surrounding these emerging fields of interest, their potentials for further growth and development certainly have some significant implications.

Health Information on the Internet

Some health websites are primarily and information-based and targeted directly to the consumer, providing generic medical and health information addressing specific user questions. However, as patients increasingly turn to the Internet for health-related information, they are finding health sites that provide more than just basic information. Many of these sites offer varying degrees of advice, and some even provide services that were once only available through a face-to-face encounter between patient and doctor (Chin 2002).

When we discussed the impact of the plethora of online health information on the traditional physician-patient relationship, we emphasized that these new Internet resources were transforming such relationships. At first glance it may seem as though the Internet does not have the capacity to foster the traditional relationship, but it is important to realize that the element of physical presence, as traditional as it might be, is not the essence of the patient-physician relationship (Chin 2002). In reality the existence of the relationship rests on whether the service being provided falls within the scope of medical practice. Medical practice typically includes treatment, prescription, diagnosis, and patient-specific medical advice and information. The telephone has served as a vehicle to create a professional relationship between doctors and patients for quite some time now, and so long as physicians use it within the scope of medical practice, so too can the Internet (Chin 2002).

Because health plans have yet to recognize cyber-services as legitimate health resources and thus reimburse consumers for them, it is likely that the online health advisory information will continue to serve as a “second opinion” of sorts as opposed to a replacement for traditional physician care.

The mere publishing of health information or provision of generic advice is similar to the duty owned by a book publisher who has no general legal duty to investigate the accuracy and contents of the books it publishes (Nevers 2000). A site like CyberDoc, however, which provides patient-specific advice, has the potential to create a patient-doctor relationship sufficient to find a duty of care.

Many doctors are not worried about medical liability risk surrounding online consultations. Obviously those physicians who are merely providing generic information do not feel at risk, as they are not diagnosing, treating, or prescribing online. Furthermore, many of these physicians will post disclaimers on their sites, clearly explaining that they provide medical information, not medical advice. Still yet, other physicians have managed to arrange for their liability insurance to cover work on the Internet because their consultations are with established patients.

Nevertheless, despite the confidence of the aforementioned professionals, others are less sure that disclaimers shield physicians from potential liability. The medical liability risk associated with an online consultation will not be known until a lawsuit is filed and there is a court ruling (Chin 2002).

Until caselaw establishes a precedent and/or appropriate policy, however, members of the eRisk consortium, including the American Medical Association, have developed guidelines to help physicians working online minimize potential liability risks. In addition to consulting online with established patients, these guidelines also include obtaining the patient’s informed consent for a fee-based online consultation (Chin 2002).

There has also been some concern surrounding privacy of health information on the Internet. Many of the bigger health sites allow users to create a personalized web page where they can acquire medical information tailored specifically to their age, gender, medical history, and other factors (Browser Beware!).

Controversy arises when we consider who has access to this information. The California HealthCare Foundation recently examined the privacy policies and practices of twenty-one popular health sites, including DrKoop, drugstore.com, and WebMD. In this study researchers realized that visitors to these sites are not anonymous, and that many leading health websites do not practice the privacy policies they preach. While the Health Information Portability and Accountability Act (HIPAA) requires the US Department of Health and Human Services to adopt national standards for the confidentiality of electronic transmission of health information, online medical privacy regulations and common practices are still fairly unsettled (Browser Beware!).

The Internet and Distance Education

As the Internet continues its rapid penetration into households, education in the form of virtual universities and distance education continues to develop. And similar to the story of health information on the Internet, the relatively new advancement of distance learning on the Internet may have involve some issues that need to be regulated through the creation and implementation of new public policies.

There are two main areas of legal concern for those institutions that provide distance-learning programs. The first involves obtaining whatever approvals are needed from the states in which the institution plans to offer a program, and the second regards obtaining the rights to use intellectual property involved in a distance learning program and protecting that material from misuse (Steinback and Lupo).

Yet still, there are considerations beyond these two legal concerns. As the American Council on Education explains, “a core policy that must be examined is the institution's intellectual property policy. Thereafter, principal issues to be addressed include: intellectual property policies with respect to ownership of a distance education course; institutional and faculty rights and responsibilities after a course is created; faculty compensation, teaching-load and acceptance; student access and privacy; potential liabilities associated with distance education courses (including copyright infringement liability); and accreditation and approvals beyond state and national borders.”

Distance education serves to reverse social dynamics by bringing school to students, rather than students to school. Moreover, it changes the learning relationship from a common, centralized model to a more decentralized and flexible model. Nevertheless, while some do, in fact, describe the differences as being a centralized versus decentralized kind of opposition, they might better be described as faculty-centered versus learner-centered paradigm shift (Berg 1998). Indeed, in considering the potential future of distance education, we must recognize that, like many other arenas on the Internet, perhaps distance learning is representative of a widespread change in traditional education methods.

Distance education will certainly continue to grow more popular over the course of the next decade and even beyond then. It is imperative to remember, however, that before colleges and universities serve to expand the idea of distance learning by offering such programs, they must make sure they are acting in total compliance with the relevant laws and regulations.

Blogging as Social Change

"Blogging is the first journalistic model that actually harnesses rather than merely exploits the true democratic nature of the web" (Sullivan).

Weblogs have come a long way from the quirky navel-gazing of early web journals and personal online diaries. Today they are a veritable phenomenon. Although still largely used for personal communication, blogs have the tremendous potential to change what information we get over the Internet, and how we view it. The current state of blogs has, to a certain degree, taken technology and infrastructure considerations completely out of the equation, so that all that’s necessary are words and ideas.

So far, this medium has demonstrated a capability of complementing and enhancing traditional journalism. The ways in which blogs and blog communities work result in the democratization of information, so that individuals now have the power to reach the masses that up until recently was reserved for the few traditional media organizations in television, print, and radio.

The recent conflict in Iraq served as an excellent case study in evaluating how blogs are affecting what information we get, and consequently, how we use that information to make informed decisions about social issues. Blogs have long been the norm in tech communities, but it was only in the past couple months that the mainstream media has realized the advantages that blogs can bring. They have given unprecedented coverage to blogs as ways of obtaining either new and unique viewpoints they could not get anywhere else (Where is Raed? and Lt Smash), or blogs that give up-to-the-minute analysis of recent war developments complete with links to other blogs and media sources.

Policy Concerns

The main question that concerns blogs from a legal standpoint is this: is a weblog a personal diary or is it journalism? Each label confers certain protections, but the distinction is hardly clear. When someone publishes information to an open network that anyone can access, what implicates it as being one or the other? Content type? Intended usage? Perhaps there is no distinction at all and anything published to the web loses all protections reserved for personal speech? In such a litigious country such as ours, it seems inevitable that someone will get sued for liable or defamation because of something posted on a blog. As blogs continue to spread and toe the line between casual commentary and journalism, this issue may need to be resolved by the courts or through legislation.

Other uses for blogs

The main similarities among all blogs are that they are easily updated and encourage comments and discussion. This simple premise can be adapted for use in fields beyond the already discussed examples of journalism and commentary:

• “Blawgs” are weblogs that cover the field of law. Written and read by those in the profession, there has been at least one incident where factual errors caught by a blawger has caused a judge to correct a mistake in a ruling (Mayfield).
• Software developers have begun to use blogs to communicate with existing and potential customers, providing support and cultivating grassroots interest in products (Becker).
• People suffering from specific health conditions have set up blogs that chronicle their experiences. This woman has set up a blog detailing her daily experience with Human Growth Hormone replacement therapy. Some patients suffering from Alzheimer's disease keep blogs as well. The frank descriptions of symptoms given by these bloggers may set a trend in peer patient support over the Internet.
• Blogs can be used by scientists and scholars to collaborate on research. Joint weblogs can improve on e-mail communication by putting the research into a public space. Such sites could link to similar work being done by others, as well as allowing visitors to comment, thus receiving ideas from those that normally would not be involved (Lawley).
• The 2002 election saw the first ever blog campaign ("blogpaign"). Tara Sue Grubb, a 26-year-old resident of Greensboro, NC ran for Congress on an Internet and technology platform. On her blog, she wrote opinions on various issues, and allowed readers to send her questions that she would then answer. Her stated goal is to see every Congressman with a complete web presence that includes a blog. This prospect is truly exciting and if indeed implemented, would change the face of governance. Through blogs, candidates and elected representatives could explain their policy ideas and reduce the communication barriers that exist between constituents and their officials. Though the chances of this happening are arguably slim, blogs could create an unprecedented transparency of government and allow government representatives to more effectively advocate the causes important to the people they represent. This would be the pinnacle of democratized information, a result that could only be achieved through the unique capabilities of blogs and the Internet.