The Ethics of Professional Ratings

We’ve talked a lot in this space about people using the online rating systems on Amazon, Yelp, and various other virtual communities to commit what is essentially vandalism; damaging the reputation of people or products (or occasionally entire companies or communities) simply because they can – and because there is no way to hold people accountable for such behavior. In some cases there is a recognizable profit motive involved (people will attempt to damage the competition in order to further their own sales), but in many cases it’s nothing more than the impulse to throw a brick through a window just to hear the glass break. Things have gotten so bad in some sectors that businesses have begun fighting back, as in the case of doctors who are requiring patients to sign confidentiality agreements before agreeing to begin treatment (see one of the original stories here if you want to)…

For the moment, these online postings are still considered to be protected speech, at least to the same extent that any other published writings are. That is, knowingly publishing something that defames the subject is considered libel, and legal action can be brought against whoever wrote it if his or her identity can be confirmed in the first place. The problem here is that a single online post made by a single disgruntled patient can, at least in theory, destroy the reputation a doctor (to take the obvious example) has spent decades establishing. Moreover, the patient wouldn’t have to publish any information they know to be false; the same effect could be achieved entirely through statements of opinion or simple dislike. It would be the equivalent of a patient in pre-Internet times taking out an ad in a national magazine saying that a specific doctor is a jerk, or that his bedside manner makes you wonder if he spent his formative years working in the stockyards – except that very few print publications have ever had a circulation of more than a few million, whereas everyone on Earth with an Internet connection can read what you said about the doctor you don’t like…

Even worse, patient confidentiality laws would prohibit the doctors from commenting on anything their patients say about treatment, methods, or manner in the professional setting. Even something as simple as “I never did that!” might not be permitted, and explaining what they did or why would almost certainly be out of the question. There would be no effective way for any doctor to defend against any sort of online rumor-mongering short of a full-blown lawsuit for libel, and even that might not do anything to alleviate the damage. A libel suit is a civil (not criminal) action, so there would be no way to have the miscreant jailed, and if the defendant is broke (it doesn’t cost much to get online, and leaving comments on the Internet is usually free) there would be no way for the doctor to recover either compensatory or punitive damages. All of these factors might make you think that the “gag order” forms some doctors are insisting on are completely reasonable – until you consider that such agreements are not only a violation of your First Amendment rights, they’re also keeping you from telling other patients about REAL misconduct…

The real question would appear to be whose rights should be given priority in such cases. Or, if you like, do the rights of people to make unfounded and harmful charges against innocent practitioners supersede the rights of doctors to practice without worrying about innuendo? Or do the rights of people to say what they want and report on whatever happens outweigh the rights of practitioners to practice without having to watch their backs?

It’s worth thinking about…