Abstract Background Social media has become an increasingly prevalent platform for exchanging health information, facilitating professional networking, promoting education, and fostering public engagement. For surgeons, its benefits—rapid dissemination of knowledge, community building, conference amplification, advocacy, and recruitment—coexist with heightened ethical risks, including breaches of confidentiality, blurred professional boundaries, misinformation, conflicts of interest, and inequities in access. This SAGES Ethics Committee white paper provides an ethics-focused overview of surgeon social media use and offers practical recommendations aligned with core bioethical principles, incorporating previous work from the SAGES Social Media Committee, the SAGES Facebook Taskforce, and the SAGES Ethics Committee. Methods/Approach We synthesize existing professional guidance and the peer-reviewed literature on social media in healthcare and surgery to identify recurring ethical dilemmas across stakeholder groups (surgeons, patients, institutions, and society). We organize these issues using the four principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice—and translate them into actionable standards for professional conduct, content stewardship, and institutional oversight. Results Key ethical domains include the following: (1) professionalism and identity management in blended personal/professional spaces; (2) confidentiality and the Health Insurance Portability and Accountability Act of 1996 (HIPAA)-informed safeguards when sharing clinical images, videos, and case discussions; (3) disclosure and conflict-of-interest management in self-promotion, marketing, endorsements, and “non–evidence-based” content; (4) boundaries in patient interaction, emphasizing that social media should not be used for direct patient-provider communication in lieu of secure, trackable clinical platforms; (5) respect for patient privacy, including a general expectation that clinicians should not search patients’ social media absent compelling, disclosure-supported exceptions (e.g., emergent identification needs); (6) consent standards for recording or posting media involving patients or clinicians; (7) equity considerations, recognizing that reliance on social platforms can worsen disparities for individuals lacking access or digital health literacy; and (8) societal-level implications such as clinical trial recruitment, crowdsourcing, misinformation correction, wellness harms from excessive use, and emerging risks/opportunities from artificial intelligence (AI)-enabled amplification and data mining. Conclusions Ethical social media engagement by surgeons is feasible and often beneficial when guided by transparency, accuracy, confidentiality protection, boundary maintenance, and equity. We recommend clear disclosures, separation of personal/professional accounts when feasible, institutional and society-level monitoring frameworks for official messaging, strict consent and de-identification standards for clinical content, avoidance of social media as a clinical communication channel, and ongoing review of AI-driven changes to platform dynamics and privacy risk.
Fong et al. (Mon,) studied this question.