Twitter, for anyone left on the planet who doesn’t know, is a free social network on which users update their “followers” about where they are, what they’re doing or what they think — up to the minute.  Essentially, it is a way to shotgun micro-blogs about your life (called tweets) to an audience of email pals you gather.  Ashton Kutcher has over 1,000,000 people following his posts.  I think my babysitter has about 100.

Twitter sounds like fun.  It seems pretty harmless.  And it’s really catching on, with over 50 million monthly visitors and a growth rate far surpassing 1000 percent per year.

There’s something troubling about Twitter psychologically, though.  You could say the same for Facebook or MySpace and YouTube, but Twitter is potentially bigger trouble than any of the others.  That’s because it can turn people into instant, mini-reality show versions of themselves — into entertainers, removed a little bit or a whole lot from their real feelings, genuine thoughts and true connections to others.

See, sending out tweets to “followers” isn’t a lot different than reporting your life as though you’re your own member of the paparazzi.  It presumes that people care what you’re up to, which may not be entirely true and can be the growing place for narcissism.  Narcissism, by the way, is unreasonable self-love, and it’s reaching epidemic proportions in this country.  Young people think the world of themselves, even as their performance academically and in many other arenas declines.

Reporting on your own life story can also make you tend toward the dramatic in your daily existence.  After all, who wants to send out boring tweets?  You need to be reporting on adventure, romance, and, above all, conflict.  As any decent screenwriter will tell you, people tune out if there’s no conflict.  But when did we decide that being a human being, even an interesting human being, meant being “watchable” enough for people to “tune into” your broadcasts? 

We didn’t decide any such thing.  The yielding of humanity to technology, the bleeding of our true selves into fake profiles we manufacture for semi-public digestion has been a largely unconscious slippery slope.  Technology has pushed us there.  Media has pushed us there.  Celebrities hell-bent on making us worship them have pushed us there.  But more than anything, our own discomfort with being real people, our own anxieties about whether we really matter, doubts about whether we are lovable and fear of our own mortality has pushed us there.

Recently, surgeons have gotten into the Twitter game.  They are broadcasting complex surgeries with constant tweets written up by OR staff so families or the general public can get up-to-the-minute reports about kidney transplants and the like.  Doctors even do little PR tours about breaking new ground with their twittering.  Well, guess what?  I don’t want my doctor playing media darling while he or she is working inside my body.  And I don’t need nurses hoping to be mentioned on a tweet.  I want them focused on reality, on life and death, on me.

Here’s the really scary part.  Twitter isn’t the end of the self-broadcasting phenomenon.  There will be son of Twitter.  And we will be that much further along the slippery slope to being actors in our own life stories, devoid of anything real, looking only for drama.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

Today I read a story about a woman at the center of a controversial legal battle in Italy.

Eluana Englaro had been in a vegetative state since she was in a car accident 17 years ago. The media was calling Englaro “the Terri Schiavo of Italy,” because her case was similar to woman here in the United States. (Schiavo’s husband as legal guardian, wanted his wife’s feeding tube removed, but Schiavo’s parents fought their son-in-law for years to keep the tube in place).

Englaro’s father fought the Italian courts to remove his daughter’s feeding tube, which kept his daughter alive, saying it was not his daughter’s wish to be kept alive “artificially.”

This case sparked heated debate between parts of the Italian government and the Catholic Church, who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

This case sparked heated debate between parts of the Italian government and the Catholic Church who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

Unfortunately, the woman died before any of these legal issues were resolved, and I’m sure this is a controversial debate that will rage on among contending parties for years to come.

But one of the most interesting aspects of this story has nothing to do with lawmakers and government officials at the center of the debate. Rather, it’s the way the people in the region have taken matters into their own hands, and the ever-expanding role technology is beginning to play in the public’s interpretation of the law.

Over the weekend, some Italian citizens began creating living wills on YouTube, documenting their personal wishes with regard to “do not resuscitate” (DNR) orders, designation of health care proxies and any other modifications they feel are important, in the event they are rendered incapacitated. But the irony lies in the fact that in Italy, there is no legislation on end-of-life issues and no recognition of living wills as legal documentation of a person’s wishes.

Here in the U.S., it’s quite the opposite. As physicians, a standard question that we must ask all patients upon admission to the hospital is whether or not they have a living will. If they do, we request to see a copy of it so that it can described in detail in the patient’s chart.

But I have to tell you, in the last few years since this law was mandated, I can literally count on one hand, the number of patients that have answered yes to that question. For many of us, it’s human nature to try not to think about what could go wrong, so we often don’t take the time to plan for it.

So when I look at these people taking matters into their own hands, making a short video clip detailing what they would want done in a worst-case scenario, I’m curious about how these videos will be interpreted by the law in future ethical debates, and at the end of the day, if their wishes will be honored.

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