A momentary lapse of reason?

In the wake of a doctor’s termination from a well-known private hospital in Karachi – for sending his patient a friendship request over the social networking application, Facebook – a social media uproar in the last few days has questioned the severity of the verdict, with one side castigating the hospital and the complainant for overreacting, and the other supporting the doctor’s dismissal in support of the patient’s claim to having been harassed.

At the heart of the debate lies the accusation of harassment, the moral and ethical dimension of the doctor-patient relationship, not to mention the ethics governing internet communication. Of course the public attention the issue has garnered is also a result of the fact that the complainant, the patient’s sister, was the internationally acclaimed, award-winning documentary maker, Sharmeen Obaid-Chinoy. In the wake of the doctor’s faux pas, Chinoy took to Twitter, promising dire consequences for the doctor’s failure to recognise that he had irked the ire of the ‘wrong woman and the wrong family’.

Let us examine the various aspects of the issue under debate here: first, the ethical rules governing the doctor-patient relationship are clearly designed to ensure that a doctor’s behaviour and practice in providing medical treatment remain strictly professional to ensure that quality medical care – the right of a patient – is delivered objectively, in keeping with the highest professional standards of the medical profession and the hospital. In this reckoning, the doctor’s behaviour can only be labelled as unprofessional, unethical and in poor taste. No matter how compelled he felt and for whatever reason he decided to solicit the attention of a female patient through a social networking application, it would have been correct and prudent to perhaps only make such an overture once his professional medical association with the patient had been concluded.

On the other hand, we must consider the ethics surrounding internet communication. Facebook, is designed to connect people globally. In its Statement of Rights and Responsibilities, clause 9 of section 5, titled “Protecting Other People’s Rights”, only prohibits the tagging of users or the sending of email invitations to non-users without their consent. There is nothing within the statement, however, that bars a user from approaching another user through the means of a friendship request. This is probably because, as a user, I have the right to decline a friendship request, block the person from ever sending me another friendship request, control whom in the general public can approach me over Facebook – along with a host of other security measures available within the application that are designed to protect a user’s privacy. It would follow then, that the mere solicitation of friendship over Facebook using the means provided by the social networking application – the friendship request – as not prohibited and would therefore not fall within the definition of harassment as it exists in the public domain of the internet.

Consider another aspect of the above: Facebook is a networking application designed in the US, and Section 16 of its Statement of Rights and Responsibilities, titled “Special Provisions Applicable to Users outside the United States”, offers the disclaimer that, while the application strives to create a global community, it also strives to respect local US laws. Now, in order to serve this purpose it is stated that all user and non-user information is processed in the US, subject to its local laws. This complicates matters: by signing up for Facebook, I’m therefore cognizant of and in agreement also with the social and cultural mores of engagement (that are increasingly global social and cultural mores) as they exist between individuals in the liberal West.

Are we then to consider the issue of harassment within the context of social engagement between opposite sexes in the Western world, or should harassment perhaps be redefined considering our conservative, patriarchal socio-cultural setting, with generally poor standards of accountability over the actions of men? As an example, a man approaching a woman in a bar in the US offering to buy her a drink would be considered perfectly normal, the woman having the option of either accepting the offer or declining it – whereupon the matter would stand closed. This would not be deemed harassment, but it is also certainly not the cultural norm in our country. By this rationale, should we then consider a ban on the use of Facebook in Pakistan?

And this leads to the problem that has caused the social media uproar in the first place: that of the accusation of harassment. It is clear that the doctor’s act was wholly inappropriate considering the code of ethics he has sworn to abide by in the practice of his profession. But it is also clear that the response of the complainant is not commensurate with the digression: a Facebook friend request is not harassment. For an act to be described as harassment, particularly sexual harassment, it would involve lewd misconduct of a verbal, intellectual or physical nature, characterised by repetitiveness and a failure to respect the right of refusal of the aggrieved party. From the evidence available in the public domain in respect of the issue at hand, this has not happened. And so the social media backlash centres on the position that had the same complaint been made – recognising Chinoy and her family’s right to complain – quietly and privately outside of the public domain, would the doctor have been merely reprimanded for unethical behaviour, or would he still have been sacked?

Which leads me finally to another problem we face in Pakistan concerning the use of social media and its mass effect. Social media is increasingly a medium utilised irresponsibly, and for the proliferation of inaccurate, often slanderous and at times even derogatory information, feeding a ravenous public’s appetite for sensationalism. Chinoy’s Twitter statement – while it was neither derogatory nor inaccurate – nevertheless amplified her anger, her resulting vindictiveness, not to mention the upper class pelf and power of celebrity she enjoys, through the megaphone of mass digital communication.

The impending public relations crisis led a conservative institution, it appears, to stringently apply its policy of zero tolerance on ethical digressions, and reportedly terminate the guilty employee as the best means of damage control available. Was it a momentary lapse of reason on the part of Chinoy or the doctor who behaved unprofessionally? That I leave you to decide, dear reader. The tumult on social media may quiet down in a few days, but it raises important questions about the morality and ethics surrounding internet use, the radical transformation in the modes of engagement between members of the opposite sex through the proliferation of cyber communications, and how all this fits the conservative, patriarchal and still feudal character of our social and cultural spaces.

And here’s the final downside of the cyber public domain and social media: in all this wailing and gnashing of teeth, the actual issue – that of the enforcement of a code of ethics in the medical profession – will soon be lost in the ether.

The writer is a freelance columnist.

Email: kmushir@hotmail.com

Twitter: @kmushir