Sweeping mines and sweeping statements
Online “friendships” with patients may also alter the patient-physician relationship
The writer is a lawyer pursuing an LLM from Columbia University. He tweets @brainmasalaar
Long before boredom was fought by crushing Candy and clashing Clans on smartphones, there was the no-nonsense Minesweeper that, to most, made no sense. Users randomly clicked away at small grey boxes, hoping against hope not to set off a bomb. A week ago, Sharmeen Obaid-Chinoy laid out a minefield of her own. The three tweets, by now etched in the nation’s collective memory just about as vividly as a biscuit ad during a cricket series, read much like a game of Minesweeper.
There are zero boundaries in #pakistan! Last night my sister went to AKU emergency & the doctor who tended to her tried to add her on FB.
I don’t quite understand how doctor tending 2 emergency patients thinks it’s ok to take a female patient info & add her on FB! Unethical.
Unfortunately the doctor messed with the wrong women in the wrong family and I will definitely report him! Harassment has 2 stop!
An understanding of Minesweeper is not necessary to predict the aftermath of these tweets. Boom went the dynamite!
The protocol is, ordinarily, fairly predictable. Depending on the issue in question, the Lord Protectors of Whattabouttery Ltd must first approve whether or not you may discuss a particular issue based on a sacred uncodified hierarchy of importance. Global warming comes after Syria, which comes after Kashmir, which comes after Mahira Khan smoking a cigarette.
But like a frustrating exception to a rule of grammar you thought you had finally mastered, this does not apply when the author had the audacity to win two Oscars. When it comes to acid attack victims, the nation’s collective fetish for treating the nation like a carefully curated Instagram account is immediately tickled. Milkshakes in Mason Jars are in; disfigured women are out. Positive images only. #Blessed
“Why didn’t she make a documentary about Edhi instead?” ponders the misunderstood anti-hero Waqar Zaka, stoically weighing in on the issue between sermons on why you should only buy bitcoin from him.
Minesweeper is less complicated. You click a box; it shows you a number. The number indicates how many mines are in the adjacent boxes. Through a process of deduction, you flag potential mines and click on safe boxes until you have a clear picture.
Simple enough, yes? Let’s play. Get to the point without blowing anything up (or out of proportion).
“…the doctor messed with the wrong women in the wrong family” is beginner level stuff. That is a ticking bomb in every sense of the word, and Obaid-Chinoy acknowledged as much in a subsequent clarification. Not essential to the larger picture. Flag and move on.
Other boxes are on the opposite end of the spectrum. There is definitely something not “ok” about adding a female patient later on. Exactly how not-ok is a murky question, but that can come later. Click and move on.
Clicking on through until the three tweets are reduced to a single, 140-character tweet:
Last night my sis went to the AKU ER. Her Dr later used her private info to send her a FB friend request. #Inappropriate! Will definitely report!
Phrased as simplistically as possible, “The doctor abused his patient’s trust and took advantage of his position. And that is wrong.”
Subsequent inquiries — such as what constitutes harassment, and what constitutes commensurate punishment, are no less important. But they follow after acknowledgment of this.
Yet, in misplaced pity for his fathering four children the public itself transformed into an obstinate child — repeatedly setting off bombs, and ignoring the larger picture. Wrongdoing should not be rewarded with employment offers. There are no extra Candy Crush lives in the real world.
So, what, then, of the question of harassment? That is a harder puzzle. And blanket statements must be looked at with skepticism. Take Facebook’s own community guidelines for starters.
As we learned in Obaid-Chinoy’s clarification, the friend-request was accompanied by several comments on pictures as well. The guidelines provide that repeated friend requests and messages, both, constitute harassment. A single friend request is tricky (though still nowhere nearly as outlandish as some made it seem), but multiple comments are a lot harder to defend.
At the same time, the PMDC code of ethics provides an exhaustive list of what constitutes harassment by a medical professional, and this situation does not fit. But what rules would a disciplinary board look at? Potentially, there was an attempt to ‘gain from information received in a confidential context’. The same paragraph that rules out harassment also prohibits using a professional position to pursue a relationship of an emotional nature. While a prominent newspaper ran an article, categorically saying there was no violation of the code, the notion seems rather misleading.
The code also incorporates the World Medical Association’s (WMA) declaration of Geneva — the modern version of the Hippocratic Oath. The same WMA, this month six years ago, recommended that ‘special attention’ be given to:
Online “friendships” with patients may also alter the patient-physician relationship, and may result in unnecessary, possibly problematic physician and patient self-disclosure.
Finally! A reference so direct that it obviates the need for nuance altogether. If only this were more than a recommendation.
But here, Minesweeper fails us. Because in the real world, while squares may be neatly drawn, not everything falls as neatly into them. And when the diverges too far from the ought, the need to redraw the lines becomes evident.
Any question that gets us there is a question worth paying attention to — regardless of the words that it may be expressed in.
Published in The Express Tribune, November 3rd, 2017.
There are zero boundaries in #pakistan! Last night my sister went to AKU emergency & the doctor who tended to her tried to add her on FB.
I don’t quite understand how doctor tending 2 emergency patients thinks it’s ok to take a female patient info & add her on FB! Unethical.
Unfortunately the doctor messed with the wrong women in the wrong family and I will definitely report him! Harassment has 2 stop!
An understanding of Minesweeper is not necessary to predict the aftermath of these tweets. Boom went the dynamite!
The protocol is, ordinarily, fairly predictable. Depending on the issue in question, the Lord Protectors of Whattabouttery Ltd must first approve whether or not you may discuss a particular issue based on a sacred uncodified hierarchy of importance. Global warming comes after Syria, which comes after Kashmir, which comes after Mahira Khan smoking a cigarette.
But like a frustrating exception to a rule of grammar you thought you had finally mastered, this does not apply when the author had the audacity to win two Oscars. When it comes to acid attack victims, the nation’s collective fetish for treating the nation like a carefully curated Instagram account is immediately tickled. Milkshakes in Mason Jars are in; disfigured women are out. Positive images only. #Blessed
“Why didn’t she make a documentary about Edhi instead?” ponders the misunderstood anti-hero Waqar Zaka, stoically weighing in on the issue between sermons on why you should only buy bitcoin from him.
Minesweeper is less complicated. You click a box; it shows you a number. The number indicates how many mines are in the adjacent boxes. Through a process of deduction, you flag potential mines and click on safe boxes until you have a clear picture.
Simple enough, yes? Let’s play. Get to the point without blowing anything up (or out of proportion).
“…the doctor messed with the wrong women in the wrong family” is beginner level stuff. That is a ticking bomb in every sense of the word, and Obaid-Chinoy acknowledged as much in a subsequent clarification. Not essential to the larger picture. Flag and move on.
Other boxes are on the opposite end of the spectrum. There is definitely something not “ok” about adding a female patient later on. Exactly how not-ok is a murky question, but that can come later. Click and move on.
Clicking on through until the three tweets are reduced to a single, 140-character tweet:
Last night my sis went to the AKU ER. Her Dr later used her private info to send her a FB friend request. #Inappropriate! Will definitely report!
Phrased as simplistically as possible, “The doctor abused his patient’s trust and took advantage of his position. And that is wrong.”
Subsequent inquiries — such as what constitutes harassment, and what constitutes commensurate punishment, are no less important. But they follow after acknowledgment of this.
Yet, in misplaced pity for his fathering four children the public itself transformed into an obstinate child — repeatedly setting off bombs, and ignoring the larger picture. Wrongdoing should not be rewarded with employment offers. There are no extra Candy Crush lives in the real world.
So, what, then, of the question of harassment? That is a harder puzzle. And blanket statements must be looked at with skepticism. Take Facebook’s own community guidelines for starters.
As we learned in Obaid-Chinoy’s clarification, the friend-request was accompanied by several comments on pictures as well. The guidelines provide that repeated friend requests and messages, both, constitute harassment. A single friend request is tricky (though still nowhere nearly as outlandish as some made it seem), but multiple comments are a lot harder to defend.
At the same time, the PMDC code of ethics provides an exhaustive list of what constitutes harassment by a medical professional, and this situation does not fit. But what rules would a disciplinary board look at? Potentially, there was an attempt to ‘gain from information received in a confidential context’. The same paragraph that rules out harassment also prohibits using a professional position to pursue a relationship of an emotional nature. While a prominent newspaper ran an article, categorically saying there was no violation of the code, the notion seems rather misleading.
The code also incorporates the World Medical Association’s (WMA) declaration of Geneva — the modern version of the Hippocratic Oath. The same WMA, this month six years ago, recommended that ‘special attention’ be given to:
Online “friendships” with patients may also alter the patient-physician relationship, and may result in unnecessary, possibly problematic physician and patient self-disclosure.
Finally! A reference so direct that it obviates the need for nuance altogether. If only this were more than a recommendation.
But here, Minesweeper fails us. Because in the real world, while squares may be neatly drawn, not everything falls as neatly into them. And when the diverges too far from the ought, the need to redraw the lines becomes evident.
Any question that gets us there is a question worth paying attention to — regardless of the words that it may be expressed in.
Published in The Express Tribune, November 3rd, 2017.