Without hyperbole, it can be argued that mass access to electronic data transfer presents an order of change in communications that ranks with the development of the automatic printing press. Like that of the wide availability of cheaply printed books and gazettes, the impact of the Internet won't be clearly understood until our use of it has evolved further. The limited distribution of the results of a medical investigation, whether in part or whole, can easily expand through redistribution. Although it is a point of professional etiquette that no correspondence can be recirculated on electronic mailing lists or posted on bulletin boards without the express permission of the author, it is difficult to enforce professional etiquette. Moreover, anyone with access to one of the electronic gateways to the Internet has access to most of the electronic information storage available on the Internet.
Discussion groups are open-ended.
No matter how esoteric the specialty orientation, nonspecialists often browse the lists or message data bases. They may include medical journalists, concerned patients, and sensationalists. However, your assertion that information published on the Internet is intrinsically susceptible to alteration by the recipient is untrue. There is no mechanism for altering the document's contents on the server by unauthorized parties. Regarding the concern that nonmedical personnel will misinterpret Internet medical information, this phenomenon already occurs with information from libraries, newspapers, radio, and television and is not unique to the Internet nor sufficient reason to throw out the baby with the bath water in advocating the widespread restriction of Internet medical publication.