I guess the best way I can sum up my response to your last post is to say that I am a big believer in the law of natural consequences. My response is my responsibility; their (whoever they are) response is their responsibility.

I don’t believe that the end justifies the means; I simply believe that doing the right thing is more important than doing the easy (or ultimately ineffective) thing.

In this case, I believe I made the right call for the client, and given a similar situation, I would do the same again.

I just hope that I don’t have to – but then again, I probably will have to.

You misunderstand. I am not talking about accountability vis a vis your profession, but with respect to your publishing information on your website. You have no accountability for this, as you can publish whatever you wish, whether true or not.

It appears that you may be having a good outcome from this. This is fortunate, as the result could have been unpleasant. I wonder how you would have felt if the health worker whose name you broadcast had committed suicide due to the pressure? This is not an implausible scenario. I accept that you thought you had no other alternative. I just think you were wrong – you had plenty of others, including the HDC.

The HDC 1 in 10 story is a red herring. 90% of the complaints sent to HDC are trivial and do not require investigation. They are sent to mediation to resolve them. And I reiterate once again that transparency and naming are not the same things. Naming private medical businesses and people is substantially punitive. HDCs attitude to naming is quite reserved for this reason. In general, for doctors and nurses, they prefer the disciplinary body to deal with this.

And if one of my family where your client I would indeed expect you to advocate for them, as I would advocate for my patients. But I still would not have approved of you using your website in this manner.

I am a member of three professional associations who can censure, sanction, or expel me from membership, and I have an external clinical supervisor I meet with on a monthly basis – I think I have the accountability issue covered. The fact that I have made a stand on this issue in full view of my entire industry is a salient fact that is not lost on me regards accountability.

The HDC investigate 1 complaint in 10, and then minimise true transparency in the cases they do investigate by NOT naming the individuals concerned. If the WDHB worker had not been named, there would have been no way that my client would have been so rapidly and positively attended to by the WDHB.

It wasn’t until the worker was named that the WDHB decided to act appropriately – up until then, the WDHB had been quite obstructive.

If you watch this you will see how initially obstructive the WDHB was in the duty of care to my client:

http://www.tvnz.co.nz/view/video_popup_windows_skin/1884428

My point is that naming the worker wasn’t the first resort – it was the last resort.

Consider this: if the client had been one of your family, and the client was subjected to what my client was…..how hard would you have expected me to advocate for one of your own?

Something to think about?

I think you are confusing professionalism with elitism. I am not saying you are too stupid to judge a doctor or nurse, I am saying that it is unlikely that you have a full appreciation of all the factors involved in a situation. This is due to asymmetric knowledge, rather than intelligence.

I am sure you are a good advocate for your client. The fact that you obtained a good outcome for your client by posting the information on your site is not relevant. The ends never justify the means. I note that legal pressure has been brought to bear on you in this matter – and so it should have.

The problem is simply that you have no accountability to anyone but yourself. You do not seem to be able to recognize the dangerous consequences of your actions. That you request me to prove that your behavior is not ethical only serves to emphasize my point.

Peer-reviewed tribunals are a much better way of dealing with mistakes and wayward behavior amongst professionals. It has worked well in medicine. The essential ingredient, missing from police and political peer systems is transparency. By transparency, I do not mean blazoning a name across the web, but having open procedures and systems, preferably with lay participation, and preferably with back up.

You could have taken the Waitemata health worker to HDC. If they had been a doctor, you could have even taken them to the medical council. Instead, you chose to publicly humiliate them.

Perhaps you would like to bring back the stocks – and lynch mobs?