A Practitioner's Code of Ethics in the Age of Social Media and Partisan Politics

The Backstory

After a late night of Facebook bingeing (because sometimes, you really cannot tear your eyes away from the reactions of your “friends” to current events), I woke up one morning feeling a little emotionally bruised from the goings-on in our world, and more than a little weary to take on the onslaught of breaking news again. As any rational person would, I decided to avoid social media for a bit, in an effort to preserve my sanity.
Besides, I had work to do! I had plenty of errands to run, and patient files to review, so I started in on the first task of the day: checking emails. I was pleased to see that a potential patient who had been referred to me had decided to move forward in working together. Even better, the entire family had requested my care, and I was honored to be consulted on a cluster of such challenging cases.
After more emails were checked and some headway was made on the remainder of my to-do list, I decided a mindless Facebook perusal was in order. That’s when it happened, a moment that would throw me into an existential tailspin, and put into focus exactly what it means to be a healthcare provider in a world of instant global communication and a heavily divided political climate.
The patient with whom I had been conversing earlier that morning had requested to follow me on Facebook. I clicked on a link to his profile and found a very vocal opponent to all of the rights I hold dear, and an undying supporter of practices I find reprehensible.
I felt sick to my stomach with the ethical challenges presented to me. In today’s society, so many of us are fighting stressful battles to simply be heard and be seen–by our public servants, our communities, our friends, and sometimes even our own families. The clinical setting, however, presents an entirely different situation. When in practice, should we silence our internal activists and “serve without prejudice?” Is it even possible to serve without prejudice in situations like these? Is it more ethical to recuse ourselves from patient care when we are unable to mentally separate our clients from their moral convictions, or to forgo our own convictions and silently serve? Do we as practitioners have a moral obligation to care for all? The ethical questions swirled in my head. It was intense.

The Naturopathic Oath

When presented with challenging times in private practice or when I’m wanting to reconnect with the beautiful philosophy of our medicine, I remind myself of and reflect on the Naturopathic Physician’s Oath. I cannot help but be moved each time I read this gorgeous assembly of words:

“I dedicate myself to the service of humanity as a practitioner of the art and science of Naturopathic medicine.  
I will honor my teachers and all  who have preserved and developed this knowledge and dedicate myself to supporting the growth and evolution of Naturopathic medicine.  
I will endeavor to continually improve my abilities as a healer through study, reflection, and genuine concern for humanity.
I will impart knowledge of the advanced healing arts to dedicated colleagues and students. Through precept, lecture, and example, I will assist and encourage others to strengthen their health, reduce risks for disease, and preserve the health of our planet for ourselves, our families, and future generations.
According to my best ability and judgment, I will use methods of treatment which follow the principles of Naturopathic medicine:

First of all, to do no harm. (primum non nocere)
To act in cooperation with the Healing Power of Nature. (vis medicatrix naturae)

To address the fundamental causes of disease. (tolle causum)

To heal the whole person through individualized treatment. (tolle totum)

To teach the principles of healthy living and preventive medicine. (docere and praevenire)
I will conduct my life and the practice of Naturopathic health care with vigilance, integrity, and freedom from prejudice.* I will abstain from voluntary acts of injustice and corruption. I will keep confidential whatever I am privileged to witness, whether professionally or privately, that should not be divulged. With my whole heart, before this gathering of witnesses, as a Doctor of Naturopathic Medicine, I pledge to remain true to this oath.”

*The bolded emphasis is mine.

From Anger to Empathy

After a well-deserved nap (#selfcare), I listened to a TED Talk on Empathy, which got me thinking about what that word actually means. In this talk, Dylan Marron, a digital media creator, challenges himself to have offline discussions with people who send him online messages of hate. This coping mechanism has taught him something profound: that people spewing hate are in most need of empathy. But what, exactly, is empathy? He explains:

“Empathy is not endorsement. Empathizing with someone you profoundly disagree with does not suddenly compromise your own deeply held beliefs and endorse theirs. Empathizing with someone who, for example, believes that being gay is a sin doesn’t mean that I’m suddenly going to drop everything, pack my bags and grab my one-way ticket to hell, right? It just means that I’m acknowledging the humanity of someone who was raised to think very differently from me.”

As practitioners, we are called to a higher purpose in life–to serve humanity in all of its forms. We are held to higher standards than those in other professions–and for good reason! We are entrusted with the care of human lives, and it is our duty to shed the veil of our own experiences and cover ourselves with that of our patients, in order to use best our hearts and heads to help them. To be a practitioner is to answer the call to a true vocation, and it is not without its challenges. Cerebrally, we know what to do in situations that challenge us ethically–to serve fully and without prejudice–but sometimes the heart takes a little more convincing.
So, for as human as it may be to jump to defensiveness or anger toward someone whose fundamental beliefs clash with ours, it’s equally human, albeit more difficult, to eventually arrive at empathy. In situations like these, approaching with empathy may be the only way to move things forward. For as much as we may not feel up to it, we must dig in our heels and work toward a place of empathy together, because I’m pretty sure it’s the one thing the world needs most right now.

Some Final Thoughts

I encourage you to watch the full video or read the full transcript of “How I turn negative online comments into positive offline conversations,” found here.
…and in case you’re wondering, I put my money where I wished my mouth was, and donated the entirety of my patient visit fees from the aforementioned family to RAICES, because there’s always a way to follow your head and your heart.


Sarah E Ouano ND

After graduating from National University of Health Sciences (IL) as a Doctor of Naturopathic Medicine in 2011, Sarah completed a residency in Seattle, WA, which focused on infectious disease and Autism Spectrum Disorder. While there, she also served as a volunteer physician at an LGBTQIA homeless shelter, acting as a primary care physician for both youth and adult patients. In 2016, she completed a term of AmeriCorps VISTA service, and has since become heavily invested in the intersection of public health and social justice, and how an individual’s health picture shapes a community.