{"id":2299,"date":"2020-04-07T10:00:12","date_gmt":"2020-04-07T09:00:12","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=2299"},"modified":"2021-07-23T09:45:18","modified_gmt":"2021-07-23T08:45:18","slug":"naming-and-shaming-covid-19-and-the-medical-professional","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/07\/naming-and-shaming-covid-19-and-the-medical-professional\/","title":{"rendered":"Naming and Shaming: Covid-19 and the Medical Professional"},"content":{"rendered":"

Blog by Luna Dolezal and Arthur Rose<\/strong><\/p>\n

On Saturday the 7th of March, Australia\u2019s state of Victoria\u2019s health minister Jenny Mikakos declared that she was \u201cflabbergasted\u201d that a Melbourne GP had continued to see patients while he had \u201cflu-like symptoms\u201d. The doctor in question, Dr Chris Higgins, had returned from a trip to the US with a runny nose. He treated 70 patients before testing himself for Covid-19 \u201cfor the sake of completeness,\u201d as he noted in a Facebook post. After he tested positive, he ceased working and notified all his patients. Nevertheless, in Mikakos\u2019s view his decision to go to work with any symptoms was negligent and should perhaps be referred to the Australian Health Practitioner Regulation Agency. However, Higgins did not meet the criteria for testing when he returned to Australia, and his symptoms had been very mild. As he noted in his message to Mikakos, defending his behaviour: \u201cI hesitated to do a swab because I did not fulfil your criteria for testing but did one anyway on Thursday evening \u2026 not imagining for one moment it would turn out to be positive.\u201d While Mikakos did not name Dr Higgins directly, she named his clinic and gave enough identifying information that it took no time for the media to discover his identity, thereby breaching his patient confidentiality. The immediate reputation damage from the media attention that followed, compromised his practice and livelihood.<\/p>\n

\"graffiti
Graffiti on a abandoned victorian townhouse, sherbourne and bloor; Anthony Easton\/flickr: PinkMoose<\/a><\/figcaption><\/figure>\n

Jenny Mikakos\u2019s attempts to publicly name and shame Dr Chris Higgins is by no means an isolated phenomenon. In fact, the story parallels a similar case in the UK in September 2019, when Jacob Rees-Mogg, Leader of the House of Commons, attempted to shame Dr David Nicholls, a critic of the UK government\u2019s no deal Brexit policy, through a comparison with the anti-vaxxer Andrew Wakefield. As in the Mikakos-Higgins case, Rees-Mogg\u2019s attempt to shame Nicholls backfired, as doctors rallied behind Nicholls. Both cases teach us a valuable lesson that is not unique to the Covid-19 situation. As frontline representatives of healthcare, doctors are particularly vulnerable to shame and shaming. Issues which directly affect a doctor\u2019s ability to deliver healthcare effectively, including long working hours, staff shortages, bed shortages, waiting lists and limited treatment options, can be perceived as shortcomings in the individual\u2019s performance, rather than part of wider systemic problems. In addition, our cultural expectations regarding doctors (fuelled by mainstream media representations of doctors and clinical encounters on TV programmes such Channel 4\u2019s Embarrassing Bodies <\/em>in the UK) are that doctors are infallible and superhuman; they must make flawless diagnosis and treatment decisions, leaving no room for doubt, error or imperfection. In addition, they must not be physically or emotionally vulnerable: they should not get sick, need to sleep on a shift, have mental health problems, or other personal needs while treating others. The overwhelming negative public response to cases where doctors have made mistakes, or are perceived <\/em>to have made mistakes, suggests that this expectation of infallibility and invulnerability exacerbates feelings of violated trust. We are outraged when doctors fail us by being human.<\/p>\n

The culture of shaming doctors, as toxic as it is within the workplace, becomes particularly noxious when it becomes unbounded by its dissemination through various media. Mikakos\u2019s comments provoked users to shame Dr Higgins with comments such as: \u201cPersonally I’m ‘flabbergasted’ at Dr Chris Higgins arrogance. HE should be the one that needs to apologise! Seeing 70 clinic patients and then visiting a Nursing home, shame on him\u201d. But it was Mikakos who was principally subjected to online shaming from the Australian medical community. Numerous posts were made on social media by prominent Australian medics defending Higgins and in turn shaming Mikakos for undermining confidence in the Australia\u2019s doctors. More than 11,000 people signed a petition calling for Mikakos to officially apologize, while #IStandWithChrisHiggins and #Flabbergaslighting trended on social media.<\/p>\n

Online shaming is pernicious. Not only can it lead to irreparable reputation damage, it also frequently has deleterious effects on one\u2019s mental health and self-perception. As the philosopher Bonnie Mann has noted, the \u2018scene of shame\u2019 has changed dramatically in online arenas. Online shame is unbounded by geography or temporality, dislodged from any particular social community. As such, online shaming has the capacity to follow an individual everywhere <\/em>and indefinitely<\/em>. When Mikokos was pressured to apologise to Higgins, after being subjected to her own public shaming for her \u201cdisappointing\u201d comments, many observers approved of this \u201cgood\u201d use of shame. Shame, in this sense, became a useful tool for speaking truth to power. However, it is worth noting that we could not predict how the shaming of either Higgins or of Mikakos might have played out. The problem with shaming, whether in medicine or in politics, is that its effects are unpredictable. Shaming can sometimes lead to prosocial behaviour and positive change, but it is more often associated with negative consequences, such as defensiveness, aggression, depression and anxiety and, in extreme cases, even lead to suicide. This incident highlights the culture of \u201cfear and shame\u201d that circulates in healthcare for medical professionals (e.g., see the NHS Staff and Learners Mental Well Being Commission Report, Feb 2019), while also pointing to the broader shaming culture that has become commonplace in politics and the public sphere. Both are problematic.<\/p>\n

The Mikakos-Higgins case, like that of Rees-Mogg and Nicholls before it, teaches us valuable lessons that hold for situations beyond the current crisis. If anything, the recent surge in support for healthcare professionals makes it increasingly unlikely that politicians will attempt such overt shaming for the near future. In this regard, the Mikakos-Higgins case, though less than a month old, already feels rather dated. At the same time, the rise of shaming terms like COVIDIOT (a person who selfishly hoards food or who ignores public health warnings) shows that the crisis is not defusing shaming practices or the shame they cause. Rather, it is transferring the shame usually reserved to healthcare professionals, or those subjects supposed to know better, to individuals within the general populace. As public expectations about each individual\u2019s knowledge of Covid-19 begins to rise, we can only expect such shaming practices to increase, and to strike victims who do not necessarily have the epistemic or institutional armour to deal with it.<\/p>\n

 <\/p>\n

Luna Dolezal is a Senior Lecturer in Philosophy and Medical Humanities at the University of Exeter; Arthur Rose is a Vice Chancellor\u2019s Fellow in English at the University of Bristol.<\/p>\n","protected":false},"excerpt":{"rendered":"

Blog by Luna Dolezal and Arthur Rose On Saturday the 7th of March, Australia\u2019s state of Victoria\u2019s health minister Jenny Mikakos declared that she was \u201cflabbergasted\u201d that a Melbourne GP had continued to see patients while he had \u201cflu-like symptoms\u201d. The doctor in question, Dr Chris Higgins, had returned from a trip to the US […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15070],"tags":[15068,15104],"class_list":["post-2299","post","type-post","status-publish","format-standard","hentry","category-blog","tag-blog","tag-covid-19"],"yoast_head":"\nNaming and Shaming: Covid-19 and the Medical Professional - Medical Humanities<\/title>\n<meta name=\"description\" content=\"Read about naming and shaming practices in relation to COVID-19 in Luna Dolezal and Arthur Rose's blog post.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/07\/naming-and-shaming-covid-19-and-the-medical-professional\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Naming and Shaming: Covid-19 and the Medical Professional - 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