6 - Who needs a health librarian? Ethical reference transactions in the consumer health library

Abstract

In the increasingly consumer-driven world of health care, individuals are called upon to share decision-making with health care providers regarding their own health or the health of someone they love. These consumers may have limited health literacy, and lack the resources needed to communicate with medical professionals effectively. As a result, many take advantage of the free access to an ever-growing amount of health information (with varying degrees of accuracy and reliability) on the Internet, often without the skills needed to find and evaluate the information they seek. Consumer health librarians can be instrumental in helping patients and their families navigate the maze of medical decision-making though ethical reference transactions, enabling these consumers to become active participants in their own medical care. Accurately identifying patient information needs through a reference interview, and locating reliable usable resources to meet those needs are key features of the librarian's role. However, a number of ethical dilemmas can surface during reference transactions in the consumer health library, challenging the fiduciary relationship between librarian and patron. Patients attempting to self-diagnosis illness is a common, but risky, venture, and librarians asked to participate must decide how best to proceed. Patrons seeking information about nonconventional and/or experimental treatments look to the librarian to ensure the safety and efficacy of these options, when existing sources of related information are limited or questionable. When facing these dilemmas, the consumer health librarian can help health care consumers to avoid the wrong answers and develop purposeful questions to ask their health care providers.