a brief look at the professional issues relating to social media. This is related to a talk aimed at Medical Professionals in the Republic of South Africa.
1. GIVING
PROFESSIONAL
ADVICE ON
SOCIAL MEDIA
A Review of the implications and legal burden of doing so
Photo by manuscript:Unknown
scan used in book: Foto de la Biblioteca Vaticana
scan from book: User:Rmrfstar / Public domain
2. Contents
• Components – Morals v Ethics
• Legality
• Social Media, the professional and ethics
• Benefits and Risks of Social Media
• Statutory Regulation
• Examples, including the Noakes matter
• Conclusion;
• Questions.
3. Components
• Morals v Ethics (definitions):
– Ethics and Morals are both used in the plural and are often
regarded as synonyms, but there is some distinction in how
they are used. Morals often describes one’s particular values
concerning what is right and wrong, whilst Ethics can refer
broadly to moral principles. One often sees it applied to
questions of correct behaviour within a relatively narrow area
of activity
• In essence, morals come from personal values of a group /
community and ethics emanate from more difficult or
subtle questions of rightness, fairness or equity.
• Example of legal ethics v morals (murderer confesses to
his counsel and counsel’s duty thereafter).
4. Legality
• Ethical misconduct may lead to sanction or
disqualification by a professional body but not necessarily
lead to legal action;
• Legal sanction may lead to sanction or disqualification by
a professional body, but not necessarily so.
• The greater majority of legal action taken against
professionals is accordingly delictual (Tort) in nature which
is based in negligence (or intent).
– The SAMA presentation in 2015 (“Health Care Professionals,
Social Media and Ethics”) presentation focused on Crimen
Iniuria and Defamation.
– Also mentioned were the various rights to equality, dignity,
freedom and security of the person and privacy in terms of
the Bill of Rights.
5. Social Media,
the Professional
and Ethics
• Whilst the above are important considerations in the
matter, the implications from a professional perspective
can be truly massive on a persons career;
• There are a number of important guidelines published by
the HPCSA which appear to focus on confidentiality ,
privacy and doctor patient violations.
• The BMA (British Medical Association) provides guidance
at
https://www.bma.org.uk/advice/employment/ethics/social-media-
• The Medical Journal of Australia published an insightful
argument as far back as 2011 :
https://www.mja.com.au/journal/2011/194/12/social-
media-and-medical-profession
6. Social Media,
the Professional
and Ethics
• Remember that you are a professional using social media;
• On Facebook alone there are an estimated 2 Billion
monthly active users;
• Accordingly anything said, however mundane, is open to
interpretation;
7. Social Media,
the Professional
and Ethics 2
• What you may believe to be mundane may be perceived as something potentially
harmful;
• If you identify yourself as a specific type of professional, people may accept that it is
a professional opinion;
• Be aware of your organization’s policy on social media alternatively, ensure that
there is such a policy;
• Refrain from making any personal commentary about any individual or groups
unless the comment is the truth (and is not privileged) ;
• Do not discuss any symptoms of a specific person or groups of people in a large
forum;
• Personal and professional cannot always be separated;
• Maintain professional boundaries;
• Maintain confidentiality;
• Consider having a personal social media account and a professional account;
• Understand the privacy settings of whatever social media environment;
• Rather post on generalized issues rather than specific;
• Advise parties who have specific issues to rather make an appointment with
whichever professional they choose – there is a risk of touting too!
8. • Doctors’ use of social media may benefit patient care by:
– Engaging people in public health and policy discussions;
– Establishing national and international professional
networks
– Facilitating patients’ access to information about health and
services
– Sharing of research ideas
– Health advocacy
• The risks are as mentioned herein, but include potential
conflicts of interest.
– Messages posted are subject to the same laws of copyright
and defamation as any other publication, whether made in a
personal or professional capacity.
9. Statutory
regulation
• The Constitution;
• Employment Law;
• Consumer Protection;
• Intellectual Property;
• Precedent and Law Reports;
• Whilst there is no all – encompassing statute relating to social
media, the law of defamation has certainly taken some strides.
• In this regard see Hechter v Benade*
– In this matter, Ms Benade defamed Mr Hechter by calling him a
perverse neighbour, an idiot and an ugly piece of sh**.
– The court awarded Mr. Hechter an amount of R 350 000
• Formerly publication was the only requisite;
• Now a person can be held liable for re-publication e.g. liking a post,
retweeting a post etc.
12. Statutory
regulation 2
• The (now former) Minister of State Security, David Mahlobo has
mooted the regulation of social media;
• This would mean that the Department would have to start a
process whereby new legislation is drafted specifically dealing with
social media.
– To put this into perspective, Facebook started in February 2004 –
there was social media before such as Myspace, but it is practically
inconceivable to quantify the changes in use since then.
– The proposal to regulate has proved to be controversial considering
the politics of the country at present and the perception that
government appears to be regulating its’ citizens rights;
– A question to be raised is freedom of speech vs the existing common
law regulations in respect of social media
– A further question relates to the large access to the free market vs
who will restrict what for which reason (and why)
13. Examples
• In the matter between the HPCSA and Prof.Tim Noakes (“Noakes”), a hearing
was called due to advice given to a mother that she should wean her child on a
low carbohydrate high fat (LCHF) diet
– The complaint was lodged by the Association for Dietetics in South Africa
as a result of giving professional advice onTwitter
– Ostensibly existing guidelines did not promote the LCHF diet;
– HPCSA stated that Noakes acted in a manner that is not in accordance
with the norms and standards of the profession
– The charge was “that you are guilty of unprofessional conduct or conduct
which when regard is had to your profession is unprofessional in that
during the period January 2014 and February 2014 you acted in a
manner that is not in accordance with the norms and standards of
your profession in that you provided unconventional advice on
breastfeeding babies on social networks (tweet).”
14. Examples
• Amongst a plethora of complaints and evidence at the hearing the
following allegations are pertinent (pp 3786 – 3788):
– “The inherent nature of Twitter and its restrictions and the size
of Twitter messages makes it an inappropriate medium for a
medical practitioner to practise medicine in accordance with the
provisions of the Health Professions Act, its regulations and the
ethical guidelines for good practice in healthcare professions.”
– “Privacy and issues of confidentiality shall arise”
• The matter was extremely long winded and lasted from
approximately 2014 to 2017.
15. Examples
• The decision was that such a relationship as between doctor and patient could not
be imputed.
• The reasoning was as follows:
– Firstly, it is to the best of our knowledge the first of its kind at the HPCSA
involving the use of social media as well as one of the first of its kind in
South Africa involving social media in general.
– Secondly, the use of the various platforms of social media by healthcare
professionals have not been directly regulated by the HPCSA in legislation,
regulations, ethical rules or guidelines. As an aside,the HPCSA would
appear to be seriously lagging in this regard.
– The respondent has not practised clinically as a medical practitioner for
many years.
– He is not a specialist physician nor a paediatrician, neonatologist or
dietician by training.
16. Examples
– The standard of reasonableness by which his actions as a medical practitioner must be
measured in terms of South African law is that of a reasonable medical practitioner acting in
the same set of circumstances.
– Certain matters are indeed a question of fact which this committee can decide.
– Other aspects of the charge, for instance whether or not the alleged advice was
unconventional, falls within the realm of expert evidence and this committee would be hard
pressed to make any decision without the assistance of experts.
– After all, it is not babies and infants who are tweeting, reading tweets or deciding which diet to
follow amidst a confusing minefield of information and divergent opinions, it is their adult
mothers…
– Thirdly, the pro forma conceded that adult nutrition is not totally unrelated to infant nutrition,
and fourthly, on all the expert evidence tendered the relationship between infant and adult
nutrition would appear to be somewhat controversial.
17. Examples
• He may, however, be forgiven therefor as he appeared to hold the view, not entirely without reason,
that most people at the HPCSA and the Medical and Dental Board actually knew that he was a
scientist, author and LCHF proponent and would perhaps have known or assumed that he was acting
in his capacity as such due to his public status…
• There is simply no indication that Ms Leenstra regarded herself as a patient of the respondent or
regarded, addressed or appointed him as her medical practitioner not expressly, not tacitly.
• Had he regarded Ms Leenstra as his patient, he would hardly have also addressed the tweet to Ms
Creed. It is thus obvious that he recognised the possibility of others having opinions, albeit similar or
different from his own and partaking in the tweet thread and he
• Twitter discussion based on their own expertise and training. This was also in accordance with his
testimony and is precisely what happened. Such is the nature ofTwitter.
18. Examples
• It is quite apparent in the context of the entireTwitter thread
• that the initial tweet and the respondent's response thereto were
part of an information gathering process by a consumer, nothing
more significant and no more medical an action than googling on
the worldwide web before making an informed decision and
taking a course of action.
• There is no way in which one can infer that by tweeting an open-
ended general question that she was hoping for some version of
a free medical consultation.
• One cannot impute a doctor/patient relationship to either the
patient or the doctor given the available evidence in this case.
There is no evidence of such a relationship.
19. Examples
• The minority ruling, read by Dr Liddle focussed on the fact that the
advice was unconventional in that it was not evidence based and
that he (Dr Liddle) would have found Noakes guilty.
• Recently a nurse, Carolyn Strom was found guilty of professional
misconduct where she both criticised and praised certain staff
members at the hospital where she worked. She was fined $26000.
• The matter is being appealed by her but so far there is no result.
20. Conclusion
• Social Media presents a potential powder keg to any
professional who wishes to provide advice in their capacity as
such.
• It could also present great opportunity if utilised correctly
considering the extremely large worldwide market.
• In using social media a person must be aware of the dangers
that may be perceived or real in terms of acting
unprofessionally in any manner and thereby creating a
regulatory and possibly unlawful dilemma.
• Gone are the days where a professional can remain
anonymous.
21. Conclusion
• Institutions should have policies on the uses of digital media.
• Education about the ethical and professional use of these tools is critical to
maintaining a respectful and safe environment for patients, the public, and
practitioners.
• As patients continue to turn to the web for healthcare advice, practitioners
should maintain a professional presence and direct patients to reputable sources
of information
• Practitioners should be proactive in managing digital identity by
• reviewing publicly available material and maintaining strict privacy settings
about their information. Practitioners must be familiar with these technologies to
guide themselves, and their patients, as they navigate the online terrain.
23. Works cited
1. MerriamWebster online dictionary: https://www.merriam-
webster.com/dictionary/moral
2.Moral, ethical, virtuous, righteous, noble mean conforming to a
standard of what is right and good. moral implies conformity to
established sanctioned codes or accepted notions of right and wrong.
the basic moral values of a community⟨ ⟩ ethical may suggest the
involvement of more difficult or subtle questions of rightness, fairness,
or equity. committed to the highest ethical principles⟨ ⟩ virtuous implies
moral excellence in character. not a religious person, but virtuous⟨
nevertheless⟩ righteous stresses guiltlessness or blamelessness and
often suggests the sanctimonious. wished to be righteous before God⟨
and the world⟩ noble implies moral eminence and freedom from
anything petty, mean, or dubious in conduct and character. had the⟨
noblest of reasons for seeking office⟩ (Ibid)
3. Advocate may not purport that the client is innocent as that is a breach
of professional ethics, but may still test the evidence that the state has
against the accused
24. Works cited
4. SAMA -
https://www.samedical.org/files/conference_presentations/2015/19_Presentation.pdf
5. https://www.statista.com/statistics/264810/number-of-monthly-active-facebook-users-
worldwide/
6. https://www.statista.com/statistics/264810/number-of-monthly-active-facebook-users-
worldwide/
7. http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-
over-banting-tweet-20150421
8.Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct
Committee;Vol 25 pages 3765 – 3849:
http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04
9. Example logo provided by Neuriconsulting UK: https://neuri.co.uk/specbyexample.html
10.
http://www.saflii.org/cgi-bin/disp.pl?file=za/cases/ZAGPPHC/2016/1018.html&query=hechter%20ben
11. http://www.gmc-uk.org/Doctors__use_of_social_media.pdf_51448306.pdf
12. Pinterest post by Synthia Green- Saloman – benefits and Risk
13.The remainder of sources are also quoted in the notes
Notes de l'éditeur
My name is Adv LG Van Der Merwe from the Johannesburg Society of Advocates and my Chambers are in Sandton. My practice consists mainly of commercial matters with a specific focus on mining related issues as I was the operational corporate lawyer for a large mining concern and I am here to talk about ethics and social media.
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Merriam Webster online dictionary: https://www.merriam-webster.com/dictionary/moral
Moral, ethical, virtuous, righteous, noble mean conforming to a standard of what is right and good. moral implies conformity to established sanctioned codes or accepted notions of right and wrong. ⟨the basic moral values of a community⟩ ethical may suggest the involvement of more difficult or subtle questions of rightness, fairness, or equity. ⟨committed to the highest ethical principles⟩ virtuous implies moral excellence in character. ⟨not a religious person, but virtuous nevertheless⟩ righteous stresses guiltlessness or blamelessness and often suggests the sanctimonious. ⟨wished to be righteous before God and the world⟩ noble implies moral eminence and freedom from anything petty, mean, or dubious in conduct and character. ⟨had the noblest of reasons for seeking office⟩ (Ibid)
Advocate may not purport that the client is innocent as that is a breach of professional ethics, but may still test the evidence that the state has against the accused. A primary duty of counsel is not to mislead the court. Red Book:
“C.2
3.2
Duty to Court
Counsel’s duty to divulge to the Court material facts of which he has knowledge is governed on the one hand by his overriding duty not to mislead the Court, and on the other by his duty not to disclose to any person including in a proper case the Court itself, information confided to him as counsel. The application of this principle in particular circumstances and the question of when counsel may be said to have knowledge of facts may be difficult to resolve, and in such cases counsel should refer to the Bar Council for guidance.” Rule 4.11 at D.11 makes specific provision for this circumstance where a client makes a confession and how counsel can proceed – namely that Counsel may not in the proceedings assert that which he knows to be untrue nor may he connive at or attempt to substantiate a fraud or an untruth. He may appropriately argue that the evidence offered by the prosecution is insufficient to support a conviction and may take advantage of any legal matter which might relieve the accused of criminal liability.
He may not, however, set up an affirmative case which he knows to be inconsistent with the confession.
If the client, having been so informed, desires counsel to appear on the abovementioned basis, counsel should continue to hold the brief and act in accordance with the principles set out above.
If the client desires counsel to give up the brief, counsel must do so.
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Ethical misconduct pertains to ethical codes of the professional organization such as a professor not becoming too familiar with his/her student;
Legal sanctions could emanate from something other than the violation of the rules of a professional body for example, being convicted for reckless and negligent driving should not affect a medical doctor in his profession (usually)
SAMA - https://www.samedical.org/files/conference_presentations/2015/19_Presentation.pdf
Delict – my roommate at University stated that he understands the position in delict to be that I can swing my arms as much as I wish, but as soon as I hit you, the conduct must be wrongful. The actual elements of Delict are conduct, wrongfulness, damage, causation and fault. Conduct is a voluntary act or omission by a human being; Wrongfulness is where such an act or omission infringes a legally protected right or breaches a duty, damage is where there is provable loss to the Plaintiff – expressed in monetary terms the element of causation or the condictio sine qua non – condition without which means that there must be a causal nexus between the conduct (or omission) of the defendant and the harm suffered by the Plaintiff. Lastly, fault is the blameworthiness attributable to the Defendant. Obviously there are further rules and qualifications to interpret these elements. All of this is measured by the reasonable man test – a test that is qualified and in a professional’s case is the reasonable professional in that field. In delict there is a further assumption being the res ipsa loquitor doctrine which translates to “the facts speak for themselves (an event occurs which usually would not occur unless there was negligence or intent) but no direct proof of negligence” – this has generally not been applicable to the medical profession to date, yet it is now being strongly mooted in certain quarters.
Defamation -Any intentional false communication, either written or spoken, that harms a person's reputation; decreases the respect, regard, or confidence in which a person is held; or induces disparaging, hostile, or disagreeable opinions or feelings against a person. (Free Dictionary.com) -http://legal-dictionary.thefreedictionary.com/defamation
Crimen Iniuria - act of "unlawfully, intentionally and seriously impairing the dignity of another.” - https://en.wikipedia.org/wiki/Crimen_injuria
Constitutional general limitation of rights – s 36 – limitations must be reasonable and justifiable in an open and democratic society based on human dignity, equality and freedom.
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BMA most pertinent points:
As a doctor, using social media can help you to:Build your professional network
Share ideas and information
Offer and access professional and peer support
Campaign on issues important to you
Follow debates and developments around your work
Some interesting and inspiring uses of social media by doctors include:
The Twitter Journal Club: a virtual study group which meets on Twitter every Sunday at 8pm to discuss academic articles
The #HelloMyNameIs campaign, started by the late hospital doctor Kate Granger MBE, encouraging medical professionals to introduce themselves by name to patients in their care
MJA most pertinent points:
Inappropriate use of social media can result in harm to patients and the profession, including breaches of confidentiality, defamation of colleagues or employers, and violation of doctor–patient boundaries.
The professional integrity of doctors and medical students can also be damaged through problematic interprofessional online relationships, and unintended exposure of personal information to the public, employers or universities.
Doctors need to exercise extreme care in their use of social media to ensure they maintain professional standards.
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https://www.statista.com/statistics/264810/number-of-monthly-active-facebook-users-worldwide/
Chinese population at 1.38 billion in 2017
This graph puts in perspective the potential reach of any comments made on social media
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Truth – e.g. : It appears to be rare that a person diagnosed with X is a carrier of Y
WhatsApp may be different if utilised one on one due to its encryption – specifically looking at a second opinion from another “trusted” professional. Probably still better to get informed consent and consult face to face in private
Personal and professional – I recently read a good example of this: say an elderly doctor gets pressure from his/her grandchildren to open a social media account. In it he has pictures of his family, staff and people who he interacts with. Patients attempt to befriend the doctor and in doing so have access to various personal aspects of the doctors life. Now assume that some of the patients request medical advice over social media – potentially this can be a nightmare, the risk being that everyone connected to that account can see the advice given. The doctor may feel obliged to provide help but thereby he breaks a critical rule of confidentiality. If a patient contacts you about their care or other professional matters through your private profile it is advisable that you explain to them that you cannot mix personal and professional relationships and, where appropriate direct them to your professional profile.
Maintain confidentiality -
Professional boundaries – speaks for itself
Personal – family and friends – a bit controversial because it may lead to discovery by patients and various invitations which must be politely declined. It must be kept in mind that communications intended for friends or family may become more widely available.
Linking to this are the various privacy settings on social media such as allowing only friends to see your post and disallowing “friends of friends” etc.
Generalised issues – do not make public anything that can identify a person or people
Specific issues – simply put we do not want to advertise ourselves as a professional with more knowledge than others – even if that is indeed so
The BMA published the following guidelines on protecting your privacy online:
Different social media platforms have different privacy settings. How secure or private you want to make your social media activity is up to you.
Facebook lets you fine-tune your privacy settings to choose exactly who can see your posts. You can also control how easily others can find your profile.
Twitter allows you to make your tweets private, visible only to users you approve.
Community websites and forums, like the BMA’s Connecting Doctors platform, offer a variety of privacy options.
Whatever options you choose, your privacy (and confidentiality) can never be guaranteed - even in closed groups or forums.
A good rule is never to share or reveal anything on social media that you wouldn’t be happy to see printed in a newspaper.
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Sourced from http://www.gmc-uk.org/Doctors__use_of_social_media.pdf_51448306.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103576/
Picture sourced from Synthia Green-Saloman and Pinterest
Conflict of interest – eg financial or commercial interest in healthcare organisations
Dr. Daniel R. George, Ph.D., M.Sc, Assistant Professor,* Dr. Liza S. Rovniak, PhD, MPH, Assistant Professor, and Dr. Jennifer L. Kraschnewski, MD, MPH, Assistant Professor posted in NCBI / PMC at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863578/# : (under the heading :The dangers of social media: “Generally, the popular media has been quick to pick up on stories of malfeasance and misjudgment in the medical world involving SM. Recent articles have featured such sensationalistic headlines as: “Medical students’ cadaver photos get scrutiny after images show up online”, “Nursing students expelled from university after posting pictures of themselves posing with a human placenta on Facebook”, “Fired for Facebook: ER personnel lost their jobs for online posts”, etc. Stories invoking the “dangers” of SM are particularly condemnatory of the misjudgments of errant health professionals; however, they also often implicate the privacy control problems that have dogged SM sites such as Facebook and proven especially hazardous to users from the health professions.”
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*http://www.saflii.org/cgi-bin/disp.pl?file=za/cases/ZAGPPHC/2016/1018.html&query=hechter%20benade
If an opinion reaches one other person it fulfils the requirement of publication
Constitution – Amler’s Precedent of Pleading 7th Edition (“Harms”) Butterworths Lexis Nexis states (pp 154-155) : The Bill of Rights protects human dignity. Defamation violates a persons’ dignity. The adoption of the Bill of Rights gave rise to some uncertainty in that the Bill protects conflicting rights, namely those of dignity and privacy, on the one hand, and freedom of expression (including freedom of the press and other media) and political rights on the other. To balance these rights and to determine their ranking in the field of defamation is difficult. Fortunately many of the problems have been solved…A party who wishes to claim for defamation must rely on the commonlaw rules and not directly on the Constitution. Only when the common law does not provide adequate protection does the Constitution come into play.
General loss in impairment of dignity, Actio legis Aquiliae – special damages for patrimonial loss / pure economic loss
Equality Act 4 of 2000: Some of the provisions of the Act overlap with the commonlaw remedy. The Act also provides for additional remedies.
Employment Law: Labour Relations Act and the Basic Conditions of Employment Act – mostly refers to how employers and employees are expected to conduct themselves, ie may not defame employers or put a negative light on the practice.
Consumer Protection Act generally relates to the rights of a consumer of goods and services. Usually a patient is made to sign exclusionary clauses in order to protect the doctor or hospital. With the advent of the CPA and the development of our legal system this Act may override provisions deemed to be “unfair”. It may also relate to advice acted upon by a patient wherever derived, including social media. In an article on LinkedIn published on August 11, 2014 by Ashmore Burger Smidt of Werksmans, the author states: “In terms of the provisions of the Consumer Protection Act 68 of 2008 (“CPA”) > all patients are considered as ‘consumers’ from a legal perspective > This means that patients also enjoy the rights of the consumer > Health care practitioners may find themselves as ‘suppliers’ or ‘retailers’ as part of a supply chain and potentially liable for harm and loss suffered by a patient in terms of the no- fault liability provision > Health care practitioners are within the chain that extends from manufacturer to consumer” … the author goes on to state:” THE RIGHT TO FAIR VALUE, GOOD QUALITY AND SAFE GOODS > These common law principles conform to the provisions of the National Health Act. However, the new CPA deviates from the common law and the National Health Act > Health care practitioners can now not only be sued for negligence that resulted in harm to the patient, but also for supplying the patient with a faulty product that led to harm or loss > The CPA further states that a supplier of services, who in conjunction with performing the said services, applies, supplies, installs or provides access to any goods, is regarded as a supplier of those goods to the consumer for the purpose of this provision. This provision may impose strict liability on a range of health practitioners who supply, provide access to, or implant prostheses or medical devices.” (Extracts)
Intellectual Property – relates more to medical devices that are patentable – but also to publication relating to material that infringes on the rights of a patent holder
Precedent and Law Reports;
Hechter v Benade – a spat ensued between the parties and Hechter laid complaints with the Body Corporate against Ms Benade for keeping chickens in her yard. She reacted by advising other residents that he was untrustworthy, dangerous and not to be believed – this had the effect that he was injured in his reputation.
Although not strictly speaking relative to social media, The South African Law Reform Commission in its issue paper 33 project 141 dealt with the massive increase in medico legal claims. I show the statistics on the following page. Albeit a comprehensive report, one of the mini conclusions are: The increased quantity of medico-legal claims and pay-outs for such claims are not limited to the public sector. The private health care sector is also under pressure and insurance for private medical practitioners has risen sharply over the past few years.
The MPS, the largest indemnity backer of health care professionals in South Africa, estimated that ―the long-term average claim frequency for doctors in 2015 is around 27% higher than that in 2009,while the amounts claimed have escalated by an average of 14% per year from 2009 to 2015. Bateman, a contributing member indicates that medical negligence pay-outs in the private sector soared by 132% in 2009 and 2010. This leads to a large increase in subscriptions payable in riskier disciplines such as paediatrics, obstetrics and spinal surgery.
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The MPS, the largest indemnity backer of health care professionals in South Africa, estimated that ―the long-term average claim frequency for doctors in 2015 is around 27% higher than that in 2009,while the amounts claimed have escalated by an average of 14% per year from 2009 to 2015. Bateman, a contributing member indicates that medical negligence pay-outs in the private sector soared by 132% in 2009 and 2010. This leads to a large increase in subscriptions payable in riskier disciplines such as paediatrics, obstetrics and spinal surgery.
On the following slide, I will show the estimated duration for certain of the mattes that do, indeed, reach the court.
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These are matters that were not settled as most of them are.
Needless to say, if a party claims medical negligence when he/she believed they were acting on a doctor’s recommendation in terms of social media, and citing the Consumer Protection Act plus the common law remedies, new and seriously harmful matters will ensue. Albeit that a doctor would not necessarily have to attend each part of the proceedings, he or she as defendants would be expected to attend each day of the trial itself – something that can seriously harm his/her practice for the duration.
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Mail & Guardian, Aug 15, 2017
In the Daily Maverick of 7 March 2017, the author, Marelise Van Der Merwe, made the following observations: “We are contemplating to regulate the space,” he said. “Even the best democracies that are revered, they regulate the space.” This depends on what one means by regulation and what one means by democracy: stringent internet controls are more commonly associated with Zimbabwe, China, North Korea, Cuba, Myanmar, Syria and Vietnam, for example. Mahlobo’s reasoning sounded remarkably similar to that offered in Zimbawe’s Sunday Mail in 2016. “These measures are tailored to protect citizens’ rights following a surge in social media abuse through propagating falsehoods, defamation, character assassination and national security threats,” the report read. “Countries like China have similar regulations and have developed their own social networking sites. Sina Weibo, the equivalent of Twitter, is one of the most popular networks in China.” Mahlobo did acknowledge that such regulation might be “interfering with human rights”. For this reason it would be important to discuss the matter with the relevant bodies, he added. “We will be discussing how do (sic) we regulate it.”
The large access provided by social media allows for various opinions to be shared on certain issues – particularly professional issues and their interpretations/solutions/approaches in other jurisdictions – regulation may harm that.
Regulation may be prohibitively expensive and unenforceable
It is my opinion that the law that is already in place is adequate to deal with the various social media platforms and their uses.
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
Example logo provided by Neuriconsulting UK: https://neuri.co.uk/specbyexample.html
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
<number>
http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
<number>
http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
Dr. Liddle main points:
Advice was unconventional in the extreme and this was admitted by Noakes;
Noakes admitted that ill-defined messages on Twitter are open to millions of people and that the reader could interpret same to mean the discontinuation of breastfeeding;
The advice in pediatrics and neonatology falls outside of his scope of expertise;
A registered medical practitioner does not abrogate his ethical responsibility even on public platforms outside the dr/patient relationship. One needs to always be aware of statements made in whatever capacity but especially so on public platforms.
Prof Noakes, according to Adv Bhoopchand, fell short on each of the four pillars of bioethics. The further difficulty is the creation of the digital imprint on social media that remains permanently entrenched. The tweet remains still without any correction by author, A1 scientist, professor, Dr Noakes, who remains respected and revered by millions, including myself.
This clearly relates to a further issue in that a practitioner who identifies himself as a doctor is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.
Nurse: - Investigation Committee of the Saskatchewan registered nurses’ association and Carolyn Strom - https://www.srna.org/images/stories/RN_Competence/Comp_Assurance_Hearings/SRNA_Discipline_Decision_Strom_Redacted_Oct_27_2016.pdf
In October, the discipline committee of the Saskatchewan Registered Nurses' Association found Carolyn Strom guilty of professional misconduct. Strom posted that staff caring for her grandfather weren't "up to speed" on palliative care or how to "help maintain an aging senior's dignity."
This is mentioned for dr employers who do not restrict employees in terms of a policy regulating social media. However, one of the defences is that of “fair commentary”. Again, this must be balanced by other considerations such as the employment contract and the reputation of the particular institution.
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
Investigation Committee of the Saskatchewan registered nurses’ association and Carolyn Strom - https://www.srna.org/images/stories/RN_Competence/Comp_Assurance_Hearings/SRNA_Discipline_Decision_Strom_Redacted_Oct_27_2016.pdf
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http://www.health24.com/diet-and-nutrition/healthy-foods/tim-noakes-to-face-inquiry-over-banting-tweet-20150421
Judgment – p 79 HPCSA – Medical and Dental Professions Board Professional Conduct Committee; Vol 25 pages 3765 – 3849: http://www.adsa.org.za/Portals/14/HPCSA%20-%20Prof%20T%20Noakes%20Vol%2025%20(2017-04-21)%20(edited%2026-04-2017).pdf?ver=2017-05-05-095326-517
Investigation Committee of the Saskatchewan registered nurses’ association and Carolyn Strom - https://www.srna.org/images/stories/RN_Competence/Comp_Assurance_Hearings/SRNA_Discipline_Decision_Strom_Redacted_Oct_27_2016.pdfSource: Social media in the healthcare context: Ethical challenges and recommendations by C GroblerMB ChB, DOH, FC Psych, MMed Psych, MD Psych; A Dhal MB ChB (UND), FCOG (CMSA), LLM (UND), PG Dip Int Res Ethics at http://www.sajbl.org.za/index.php/sajbl/article/viewFile/464/456 in SAJBL May 2016, Vol 9, No 1
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