There is a controversy in Oregon over a proposed change in the ethics rule from the Oregon Medical Board. At issue is the use of “microaggressions” to discipline doctors and to make reporting such transgressions mandatory for all doctors. It seems before you can give stitches, you have to join snitches under one of the most ambiguous categories of prescribed speech.
I have been a critic of microaggression rules on college campuses and discuss this trend in my book out this week, The Indispensable Right: Free Speech in an Age of Rage. In past debates over this category of offensive speech, I have objected that it is hopelessly vague and highly controversial.
That ambiguity creates a threat to free speech through a chilling effect on speakers who are unsure of what will be considered microaggressive. Terms ranging from “melting pot” to phrases like “pulling oneself up by your own bootstraps” have been declared racist. Some of those have been identified by Columbia professor Derald Wing Sue, cited by Oregon’s state government as a “microaggressions expert.”
Professor Sue considers statements like “Everyone can succeed if they just work hard enough!” as an example of a microaggression. Sue’s work on “microassaults,” “microinsults,” and “microinvalidations” are being effectively adopted by the Board.
Notably, when I have objected to this category, advocates have insisted that they are merely voluntary and instructive, not mandatory. I have long argued that they are used in a mandatory fashion by triggering investigations of professors and would inevitably be made mandatory.
That appears to be happening in Oregon. A couple of conservative sites have covered the controversy.
Under the new ethics rule from the Oregon Medical Board, “unprofessional conduct” (over which a doctor can lose his or her license) will include microaggressions:
“In the practice of medicine, podiatry, or acupuncture, discrimination through unfair treatment characterized by implicit and explicit bias, including microaggressions, or indirect or subtle behaviors that reflect negative attitudes or beliefs about a non-majority group.”
The new section “J” ranks microaggressions with fraud, sexual assault, and ordering unnecessary or harmful surgeries.
Oregon Medical Board states that
“The proposed rule amendments update the definition of “unprofessional conduct” to include discrimination in the practice of medicine, podiatry, and acupuncture, which would make discrimination a ground for discipline. The proposed rule may favorably impact racial equity by making discrimination a ground for discipline for OMB licensees. It is not known how the other proposed rule amendments will impact racial equity in the state.”
The incorporation of microaggressions under the new ethic rules is precisely what some of us have been warning about for years. As is often the case, activists begin by insisting that language monitoring is purely instructional and optional before codifying those rules in mandatory terms.
We have seen the same trajectory in other areas like land acknowledgments where the line between the optimal and the mandatory is hard to discern. As discussed in my book:
“What began as voluntary statements have become either expressly or implicitly mandatory…George Brown College in Toronto requires faculty and students alike to agree to a land acknowledgment statement to even gain access to virtual classrooms. While such statements are portrayed as optional, they are often enforced as compulsory. The University of Washington encouraged faculty to add a prewritten ‘Indigenous land acknowledgment’ statement to their syllabi. The recommended statement states that ‘The University of Washington acknowledges the Coast Salish peoples of this land, the land which touches the shared waters of all tribes and bands within the Suquamish, Tulalip and Muckleshoot nations.’
Computer science professor Stuart Reges decided to write his own statement. He declared…’I acknowledge that by the labor theory of property the Coast Salish people can claim historical ownership of almost none of the land currently occupied by the University of Washington.’ … He was told that, while the university statement is optional, his statement was unacceptable because it questioned the indigenous land claim of the Coast Salish people. Reges’s dissenting statement was removed, and the university emailed his students offering an apology for their professor’s ‘offensive’ opinion and advising them on ‘three ways students could file complaints against’ him.”
Federal courts have ruled in favor of academics in disputes over microaggression rules, but the movement is expanding beyond campuses, as shown in Oregon.
I have no objection to the sharing of views of others on how certain phrases are received. I have dropped certain terms or phrases even though I did not see why a term or phrase is insulting. When others have a reasoned basis for objecting to language, I err on the side of caution to avoid making others uncomfortable. Yet, this category of speech was created to encompass a broad, ill-defined range of speech that falls below outright discriminatory or harassing language. That makes for a dangerously vague standard for a mandatory reporting rule.
The free speech concern is how such microaggressive terms can be used to curtail or punish speech, including supporting complaints for formal investigations. Disciplinary actions often seem based on how language is received rather than intended. Schools need to be clear as to whether microaggressive language can be the basis for bias complaints and actions.
Consider again the language from the Oregon Medical Board. It would encompass any “indirect or subtle behaviors that reflect negative attitudes or beliefs about a non-majority group.” The standard is heavily laden with subjectivity. (Notably, it does not include making such comments about any majority group, presumably whites or males).
The board then amplifies the standard by making it mandatory for other doctors to report colleagues. Under the proposed ruled,
“a licensee must report within 10 business days to the Board any information that appears to show that a licensee is or may be medically incompetent or is or may be guilty of unprofessional or dishonorable conduct or is or may be a licensee with a physical incapacity.”
So doctors will have to police any “indirect or subtle behaviors” that “reflect negative attitudes or beliefs” . . . or face discipline themselves.
The hippocratic oath is based on the pledge that doctors will “first do no harm.” Unfortunately, that pledge does not appear to apply to free speech in Oregon. Rather than merely publish opinions on phrases or practices that can be seen as microaggressive, the Oregon Medical Board is about to impose an ambiguous speech regulation that is likely viewed by some doctors as turning them into social-warrior snitches.
The Oregon Medical Board should remove the microaggressive provision. Sometimes the best treatment is the least intrusive.
This column appeared on Fox.com
“. . . ‘microassaults,’ . . .”
Up next: Sub-microassaults, . . .
Those aggressions are so infinitesimally small as to be undetectable — except by those in power with a “special faculty of insight.”
Or there is another option in the State of Oregon. Now would be a great time for those who can not tolerate their environment for them to take advantage of Oregon’s Death with Dignity Act, aka cull the herd.
Oregon’s Death with Dignity Act
https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/index.aspx
When white, black and any other non-progressive doctors start to leave the state political leaders will introduce legislation for a DOCTOR EXIT TAX.
As a retired physician I have a few things to say here. I was known as a nearly incorrigible child which most teachers hated or had a great dislike for. And they were right. I talked back all the time to teachers and college professors and even to medical professors in Medical School. I’m sure this is no surprise to anyone who reads this blog. Strangely the professors in medical school could handle that very easily and if I stepped out of line they returned those words with equal gusto and savagery.
Medicine is not a field for shrinking violets and the intellects are high and minds are razor sharp (usually). At least up until the last 10 years. The conditions you find yourself in can be horrific, tragic beyond belief, points of true despair, and times of outright desperation.
IT GOES WITH THE JOB. You simply do not have the time to fool around with what you say except to make sure it is clear and unmistakable or someone dies. When people would pass out at an autopsy or surgery you just had the nurses drag them out of the way and continued with your work.
There were some professors who were outright abrasive and cruel but then so is life. I disliked those professors very much but they tended to also teach you to fire back, stand your ground, work through the assault and go on. You loved the inspirational teacher but you also needed the real jerk where you ended up saying “I’ll show that SOB” what truth really is and then you did your best job.
You also have to have a different personality for the office in comparison to the ICU, ER, Surgery.
In the office it is time to be a detective with questioning, weighing of symptoms, notice of subtle changes in gait, extremity movement, speech, inflections and changes over time if your are primary care (mostly). Time to build trust and honesty, reflection. But also where I had to make people very uncomfortable because they were on a slope to destruction and you needed to get their attention or you could see the upcoming crash getting closer and closer. Or I had to deliver news that was dreaded and awful. That never got easy.
In places like the ICU, or the ER, or Surgery, it is a battlefield and the rules are different. Time is everything. Dancing around snowflake speech is a luxury you simply don’t have. Especially in a cardiac arrest. As Physician in charge you have to conduct the orchestra of blood gases, intubate the patient, rapid decisions on what lab to draw, place large iv lines in veins under the clavicle or in the neck while knowing they sit right next to the carotid artery or subclavian artery and if you miss you can have your patient bleed out. You’re conducting several nurses, ekg tech’s, x-ray, and others. Words are sharp, quick and harshly clear. And maybe you will save a life. Or the patient in the next bed arrests and you have two codes to manage. Have done that.
Snowflake speech, I suspect will go to die in Oregon. If not they may have no physicians left there and the ones that are left are whipped dogs that you would not want to see.
There is a little phrase I learned from being raised in the South long ago and which physicians in Oregon should direct to the medical board and then call Professor Turley to come represent them.
“Why Bless Your Little Heart”-translation “Go F__K Yourself”
Strange but I also always had a packed practice from the 1st year after starting practice til I retired. Also had some of the highest patient satisfaction scores in my 200+ group. People seemed to like an honest but somewhat blunt physician.
The medical board may be biting off something they may choke on but since any federal lawsuits will have to go through the 9th Circuit, it will take some time.
GEB said: “I talked back all the time to teachers and college professors and even to medical professors in Medical School. ”
Good for you! We need more students who challenge their teachers, not fewer. I should have challenged mine more often. My kids helped rectify that lack, and, from what I have heard, my grandkids are pursuing that effort with even greater zeal, so my wife and I must have done something right as parents (we encouraged debate in our household on any subject, and never cut it off with “you will do what I say” unless and until urgency precluded such debate).
My recollection may be a little fuzzy, but didn’t we used to call that the Socratic method? It was a good thing, I think.
GEB,
I hear precisely what you are saying. The difference between being blunt and frank in conversation rests on what is the fundamental character of the individual doing it. I do think people respond to tough love and understand leaders who don’t mince words, if their intentions are good.
My late father in-law was a battle hardened infantryman in the 90th Infantry Division (Tough ‘Ombres). His unit was attached to the 3rd Army after the Normandy breakout. He loved General Patton. They went through hell with him and had a lot of respect for him because they understood why he was the way he was. He and they liked winning.
There is a subset of those who are jerk’s because they are jerks. Such folks make extra work for themselves when they treat others poorly. However there no reason for additional rules.
” somewhat blunt physician.”
A somewhat blunt physician is a good physician. He says what must be said. Those who turn their words solely to satisfy the patient are those more interested in their future fees than in the patient. Sometimes, we see physicians selling things that cost a lot but do nothing or cause harm. Those physicians know how to turn the words most convincingly.
“. . . the Oregon Medical Board. At issue is the use of “microaggressions” to discipline doctors and to make reporting such transgressions mandatory for all doctors.”
Leave it to the Left to degrade everything with their cannibalistic policies: Education, the media, the law, business, sports, entertainment — and now (actually, starting with Covid) medicine.
It’d sure be nice to see a movie, practice medicine (or get a diagnosis), buy a product without the Left’s propaganda being smeared in my face.
I’m so old I remember when it was racist to speculate that covid came from a high-tech lab in China. The non-racist idea was that it came from Chinese people eating bats. 🙄
Professor Turley,
Do you not manifest the idea that voluntary rules quietly become mandatory in your statement that “I have dropped certain terms or phrases even though I did not see why a term or phrase is insulting. It was enough that others find certain language to be insulting and I do not want to make them feel uncomfortable?”
As you have brilliantly said over many years, the truth is sometimes offensive to some people. But it is nonetheless the truth.
By your statement above are you not submitting to the voluntary rules and making them almost mandatory in your own speech code. And leave your readers open to the idea of making them officially mandatory?
I have seen you speak on many TV interviews and read a fair amount of your writing. I have never felt offended by anything you’ve ever written or spoke so it troubles me that you feel obligated to so limit your speech. I would find it equally troubling in the most offensive speaker. I appreciate that there are often more than one way to express an idea, some more offensive than others, but invariably the least offensive way is less clear, so those most likely to take offense fail to understand the speech: less offended but also less educated. And it might mean that it’s the truth itself that some find offensive.
Nice piece, but there are a few typos that need correcting. (1) “…and would inevitably to made mandatory.” (2) “Under the new ethics rule from the Oregon Medical Board, “unprofessional conduct” (who which a doctor can lose his or her license) will include microaggressions:..” (3) “As if often the case, ” (4) “Yet, this category of speech was create to encompass…” (5) “Rather than merely publish opinions on phrases are practices that can be seen as microaggressive,..”
Rapists who target children are a minority group. Will the Oregon Medical Board discipline a doctor who exhibits, towards child rapists “indirect or subtle behaviors that reflect negative attitudes or beliefs about a non-majority group.” ?
Can someone delineate for me the boundary line between a microgression towards the non-majority group of the obese and proper medical treatment?
If Dr. Now of “My 600 Pound Life” were practicing in Oregon and he tells one of his 600 pound-plus patients: “This is the list of foods to avoid. This is not your grocery list,” should he lose his license?
If my doctor gets after me for not wearing sunscreen and not getting skin cancer checks, should I report for these obviously racially-based microagressions?
If I was a white male doctor in Oregon, I would leave the state.
The insanity is well past 11 at this point.
I now wonder if it can be stopped.
I think the only inevitable outcomes are that many Dr.s will leave the states where these rules are imposed. When health care providers become strained and overwork and the healthcare system reaches it’s breaking point more draconian rules will be applied to system pushing it toward a cul-de-sac from which there is no return.
NeoMarxist political correctness is marching through universities and bureaucracies administered by the mandarins of the Deep State. The Medical Establishment, from Medical Schools, to State Medical Boards and the American Medical Association, have been particularly prone to this pernicious, and most unfortunate trend. How one’s political views affects one’s ability to practice competent, compassionate and caring medicine is an uncontrolled variable paving the slippery slope into the NeoMarxist, Kafkaesque bureaucratic abyss. Welcome to Ideological Dystopia.
If someone wants to be offended, they will figure out a way to interpret (twist) anything one says into an offensive statement. Microagressions exist primarily in the ear of the beholder.
They do!
“Sometimes the best treatment is the least intrusive.” A perfect summation!
Next we :kill the lawyers ?
Burn the books?
Smash the sculpture?
Get blm to burn the villages?
So…is calling “From the river to the sea” a micro aggression in Oregon?
EV Hall, your question, while a great one, sadly answers itself. Jews, a tiny minority, can be forced off of trains, in NEW YORK of all places, with impunity with what most would call a MACRO aggression, while other minorities are “protected” by benign messages from even well meaning people.
So called liberal or progressive university students scream at Jews to “go back to Poland” and receive no punishment, while a doctor in Seattle will now be punished for saying actual helpful things to other minorities.
It’s like 1984 and Animal House have been combined into one training manual.
Well, laughter is the best medicine, so they say, so the doctors in Oregon continue to provide us normal humans with plenty of reasons to remain healthy and robust. I recommend that we search out a “woke” member of this disturbed group every day and point at them in public, laughing loudly. But in Oregon, and probably New York as well, that would likely be considered the unauthorized practice of medicine and result in a jail term.
While I’m sure your intentions are honorable Jonathan, I would argue that the absurdity will continue as long as most Americans do what you did: “I dropped certain terms or phrases even though I did not see why a term or phrase is insulting. It was enough that others find certain language to be insulting and I do not want to make them feel uncomfortable.” It’s not up to the casual speaker to obsess about how every word is going to be interpreted by the listener, especially when the only people concerned about “microaggressions” are those with an ax to grind, or with a chip on their shoulder (all “microaggressions” herein are intentional and deliberate). The only way to safeguard free speech is to practice free speech. Self-censorship is as anti-free speech as state censorship.
Self-censorship is as anti-free speech as state censorship.
That right there, GioCon. Excellent. To borrow from Beria:
Show me the speaker and I’ll show you the microagression.
There is such a power-imbalance between speech and censorship. Free speech reaches only those listening. Censored speech reaches no one.
Put it another way; In the age old sticks and stones…names adage; the “names” element is free speech and it’s the “sticks and stones” element of censorship that actually does real harm.
So medicine, which is supposed to be a science, is now going to be controlled by the emotionally incontinent woke mafia. What could go wrong?
And when MDs start leaving the state, they/Dem/them will ask— how could that happen?
Democrats in some states are looking at passing exit taxes. If passed, anyone who changes residency from a state may face confiscatory exit taxes and multi-year state tax audits. Some of this is already happening.
Now you might think it unconstitutional, but the U.S. is one of two nations on Earth that has exit taxes. Yes, if you drop your U.S. citizenship, you pay big time.
The borders are open, and yet you can never leave. Hotel California is building an Iron Curtain.