Ethical humanism: life after #medbikini and an approach to reimagining professionalism

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So long as you are trying to fit in, you will never feel like you belong.

When the travesty of a “research” publication titled, “Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons” seemingly metastasized overnight into what will forever be immortalized as the sordid saga that unwittingly catapulted the hashtag #medbikini all across the internet ether, in every way possible this “study” exposed the unsavory truth about the still very much jaw-droppingly discriminatory, stigmatizing, judgmental, and many might even say bigoted reality of the current medical establishment.

After the initial shellshock, tears, and disillusionment towards the insidiously prejudicial system of moving parts that were and are still in place to have even allowed such a paper to be, under any jurisdictions, deemed acceptable to publish and even to inform the diagnostic calculus used by administrators, employers, and patients at medical institutions and corporate establishments for determining if something is “unprofessional” or not, I took tremendous solace in the fact that this debacle was met with such swift excoriation among medical doctors such that the paper was eventually retracted. However, while the paper may be gone from the journal, the vestiges of pain and the damage it caused will never be forgotten.

If anything, this paper and #medbikini galvanized a nationwide reexamination of what “unprofessional” and “inappropriate” covertly (and overtly) mean. This publication unmasked the pernicious brokenness in how we have come to denote and standardize this nebulous, human-made social construct of “professionalism” in our cultural and societal consciousness and by extension, our dire need to revisit, reassess, reimagine, and reinvent the social, cultural, ethical, and moral parameters that frame our perceptions of what makes something “unprofessional” or “inappropriate.”

It is worth mentioning that for eons, “unprofessional” and “inappropriate” have been weaponized in the form of calculated, camouflaged language to perpetuate social inequality and institutional inequities masqueraded as a desire for workplace sociocultural conformity and preservation of a “good,” “clean,” and “pure” image by anathematizing a myriad of proscribed behaviors under the aegis of morality and the mantle of ethics, both of which are, by nature, imperfect modalities of judgment informed by highly subjective, variable standards.

For example, just among current medical students and physicians I know personally, the following have been deemed “unprofessional” or “inappropriate” by a medical institution, employer, or patient before in and out of the workplace: black and brown medical students having an afro or dreadlocks, Muslim medical students wearing a hijab, gay male medical students behaving “feminine,” trans medical students dressing in gender non-conforming ways, marginalized doctors advocating for social justice on their public social media accounts, physicians being seen at the bar drinking alcohol after work, doctors using profanity online without the use of grawlix, women physicians breastfeeding in public. The power of the words “unprofessional” and “inappropriate” comes from their infinite pliability to, with a wide latitude of impunity, outline and encompass anything and everything that comports with an employer’s or institution’s biased value-based convictions and judgments.

But most of all, this disaster of a “research” redirected and refocused our attention to several fundamental questions: who gets the sanctimonious moral high-ground to decide the criteria for passing professionalism muster? How are these criteria selected and agreed upon? Why do we even accept these terms and those who created them, as being legitimate? And at what point do we as a collective profession say, “Times up. This is unacceptable. Enough is enough. Things MUST change.”?

It is appalling that in 2020 we are still neck-deep in the illicit trenches of holding physicians and medical students to a viciously dehumanizing double standard of living and existing in this world that actively shames, strips away, and vilifies our individuality, humanity, and personhood, and our ability to publicly embrace our own authenticity, agency, and humanness—the very things we devoted our lives to restoring and empowering in our patients. It seems there is an inconsistency in the clemency we are willing to confer upon our patients, and what we are willing to confer upon ourselves and those in our own profession, each and every one of us who is a patient of several doctors ourselves.

Medicine tries so desperately to consecrate us to an unrealistic, unreasonable, and simply untenable status of sainthood, and to hold on to the antiquated, suffocating veneer of a noxiously puritanical, contrived, and draconian notion of prim and properness that are, in many ways, discriminatory and emotionally draining at best, and psychologically lethal and livelihood-ruining at worst. The current system tells us every day that our greatest strengths and assets (e.g., the qualities and experiences in our personal lives that make us human and relatable) are actually conversely our greatest weaknesses and liabilities in our profession should they ever become publicly visible.

To add insult to injury, what’s even more nefarious is that many of these toxic, oppressive attitudes and practices are, in fact, perpetrated by our own fellow colleagues in medicine, as has been revealed by this paper. When are we, as a community, going to stop this despicable doctor-on-doctor crime of crucifying one another for the things we choose to do in our personal lives that have absolutely no impact on our ability to be competent, caring physicians, and instead, start supporting each other and defending each other against anyone (e.g., employers, institutions, hospitals, and patients) who takes umbrage at how we choose to live out our best lives that have zero negative consequences on those we serve?

Medicine constantly sends the message that to be unapologetically human in a publicly accessible way is to somehow inherently be at odds and irreconcilable with being a doctor. When will we stand up to this false dilemma of having to choose between being a doctor and being human?

This is why the future of medicine, if it is to truly be committed to respecting and dignifying the personhood and humanity of medical professionals, necessarily requires a complete overhaul of the present framework we use to assess professionalism and a replacement with a standard rooted in ethical humanism: the secular philosophical stance that holds supreme the value and agency of human beings, both individually and collectively. Thus, under this new “professionalism” paradigm, the only things that would ever be considered “unprofessional” are things that any reasonable person would feel are actions that directly or indirectly incur harm onto the people we serve: our patients.

Jay Wong is a medical student. He can be reached at his self-titled site, Jay Wong, and on Twitter @JayWongMedicine.

Image credit: Shutterstock.com

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