Sunday, September 7, 2008

The ethics and folly of indiscriminate ‘sms’s and e-mails…

“When learning about life and people, make no more assumptions than are absolutely necessary. Ask and observe.” ~ William of Ockham (c. 1285-1349), Philosopher

“Words are chameleons which reflect the color of their environment.” ~ Learned Hand (1872-1961), Jurist

"We are entering a period of human history that may provide an answer to the question of whether it is better to be smart than stupid." ~ Noam Chomsky, author, philosopher, social scientist

One recent MMC hearing involved a complaint against a doctor for sexual harassment—as a result of several sexually suggestive ‘sms’s received by a subordinate female worker at a medical centre.

The complaint was apparently brought up by the medical centre’s chief medical officer who had earlier had a personal fallout with that particular doctor, and when this complaint arose from a subordinate worker, he took prompt action by complaining that the doctor was in breach of his professional conduct. Erstwhile friends thus, ended up becoming uncompromising foes…

The involved doctor admitted his actions but explained that he was merely being ‘friendly’ with several of his co-workers and occasionally, when he received some of these saucy jokes would re-forward these to others for ‘fun’. He pleaded that he did so with no intention to sexually accost or embarrass anyone. He also claimed to have a good working relationship with the lady concerned.

Fortunately, because there were no other sexual overtures associated with this miscalculated action, and after much deliberation, the case was dismissed by the MMC as unproven.

The doctor was advised that he should be very careful of indiscriminate sending of sms’s and emails in this day and age.

Certainly he should refrain from assuming that every friend or acquaintance would understand his bawdy pranks just for ‘laughs’! There are simply too many interpretations and possible misuse and misconceptions that can arise.

The doctor was touched and deeply grateful for having been given the benefit of the doubt, and admitted to having had many sleepless nights based on this painful ordeal.

The case above illustrates the point that we do not always predictably know people, no matter how well we believe them to be our acquaintances or friends. It also underlines the fact that unthinking actions can lead on to many possible outcomes, some of which (especially unpleasant ones!) can occasionally redound on us when we least expect them!

Unbeknown to many of us, there is always that possibility that someone somewhere out there may wrongly misinterpret or may feel slighted by some of these injudicious actions. These unguarded misunderstandings can put the unsuspecting but imprudent doctor at risk of complaints which can not only sully his/her reputation, but may also put his/her career and professional work at severe risk of ethical breach or misconduct.

Besides, the agony and stress of having to undergo an MMC inquiry is a very trying and angst-laden experience—sometimes this might even severely undermine one’s sense of personal justice or self-belief.

Thus one has to be very circumspect when it comes to delivering or passing on messages or emails, which can lend themselves to different interpretations and possible misconstrued meanings.

In this era of easy and nearly free distribution of information, it is often convenient and unthinkingly dismissive to pass along forwarded mails, stories, gossips, even downright libellous juicy stories, with nary a thought of possible consequences.

Oftentimes, we do not care or bother to check with the authenticity or veracity, as long as these seem innocuous enough as fleeting titillating snippets to us.

We may not even consider the person or persons vilified or caricaturised by some such ‘stories’. And so we continue to forward along automaton-like, akin to many an unsolicited chain mail… and the circulation expands like waves in a pond, until possibly these bounce back to the person or persons themselves, when offence can then be taken!

It is said that these days, the world is so interconnected that it only needs 6 degrees of separation/communication, to find someone who might know or is related to an ‘utter’ stranger to begin with. So it is invariably easier for what goes around, to come around full circle!

Thus, never underestimate the power of mass circulation, particularly when these are of salacious nature, when even the most pious and religious among us might find the risqué distraction hard to brush aside or circumvent…

So, it is better to be wary and thoughtful. Perhaps it is good practice to always think twice before clicking on the send or forward button of either the pc or the mobile phone. When there’s any remote possibility of misapprehension, then desist from doing so, and stop there.

With the omnipresent swarms of messages circulating in the hyperspace of the airwaves and world wide web, one or a few distractions less won’t really matter. And unless something is really worth it, or carries a higher or more mood-elevating message, it might be good to simply withhold one’s eagerness to join in the all-pervasive torrent of the internet’s or telecommunication’s ‘white’ noise!

Remember Mother Teresa’s exhortations: “Kind words can be short and easy to speak, but their echoes are truly endless.” The converse is of course also true; inappropriate words may be callously expressed but can have endless reverberations and consequences!

Indiscriminate messaging with racy content overtones may be less innocuous than you think, and these can come back to haunt you, should anyone complain. In this regard, it is even more important not to embroil your patients or their relatives who might find offence if these were to be misunderstood or if there are unrequited attentions sought.

In our frequent connections with patients and their kin, it is not inconceivable that some may have crossed purposes, and occasional personal attractions may be sparked. No matter the temptations or the opportunity, the asymmetric relationship that empowers the physician an edge cannot be an equal or fair one. Thus, this kind of relationship is greatly frowned upon by ethical authorities from time immemorial.

Emotional or sexual involvement with patients or their immediate relatives are usually considered professionally unethical, and these have been well articulated in our Code of Professional Conduct and Good Medical Practice guidelines.

This becomes even harder to defend when unsolicited harassment or misconstrued attention is complained about when relationships go sour! So as physicians we have to be very mindful, and must stridently try to remove ourselves from such possible entanglements, even at its earliest outset. Don’t allow such seeds of possible misbehaviour to germinate, which can lead to professional suicide…

For those thumb-happy messaging fanatics out there, think before you blink… Forwarded messages and emails are not as harmless as you imagine. And sexual innuendoes and racy items are best avoided from needlessly propagating unchallenged in the airwaves…

“No aspect of healthcare should be considered outside the realm of ethics because all areas entail value choices that ultimately affect the well being of individuals. An ethical decision-making process ensures transparency to stakeholders. Not everyone will be pleased with the outcome, but they can be reassured that every effort was made to achieve a morally responsible solution.

"When an organization engages its decision-making process with this sort of ethical framework, it demonstrates integrity, strengthens its identity, becomes a place where people will want to work, and is embraced by the community.

"In short, ethics enables accountability, dignity and justice.”

~ Rev. Michael D. Place, President and CEO, Catholic Health Association of the United States, St. Louis.

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