Hippocratic hypocrisy

Most of us will continue to be ‘guilty’ of hypocrisy as we spin the plates of professional and personal lives

Photographs of Leo Varadkar’s appearance at a festival in London – on the same weekend the Electric Picnic festival had been due to take place – were a Rorschach test for your politics: Either it was a storm in a teacup, or another enraging display of political disconnect.

Some people argued the intrusion was justified because, in their eyes, it exposed hypocrisy; others pointed out that he had been more proactive about reopening hospitality than most politicians and could hardly bulldoze through Laois County Council’s decision.

When the hue and cry settled, though, it did raise an important question. Are our private lives sacrosanct from public
judgement (illegal acts aside)?

While most of us are not public figures, I think the question has relevance for doctors. Firstly, the combination of camera phones and social media make it easier to publicly judge others than ever before. Secondly, whether we like it or not, there is a perception of doctors as pious moralisers. Telling people what to do and what not to do is an occupational hazard. That makes us vulnerable to the public sphere’s most juicy sin of all: Hypocrisy

Nothing can provoke righteous rage more reliably than stories about those who do not practise what they preach. Think of the collective nerve touched by Haughey’s excesses,after telling the nation we were living beyond our means. Or, more recently, of British epidemiologist Neil Ferguson having a visitor to his home during lockdown (although he didn’t technically breach any regulations). Given the misery inflicted on society in 2020, it is unsurprising that any scent of double standards raised hackles.

Many of us know respiratory physicians who smoke, gastroenterologists who drink, or even psychiatrists who dabble with mind-altering substances. Working in oncology is worse, as virtually everything enjoyable in life also causes
cancer. Ireland has strong form in this regard: surgeon Oliver St John Gogarty was part of the furniture in Dublin’s
pubs, and was banned from cycling tracks for bad language. I look back on my college years and shudder to think
of the kompromat that would exist on the class of 2013 if camera phones had been more widespread.

Do we need to check ourselves outside of working hours? The Medical Council focuses its scope outside of the job
to serious criminal offences and substance abuse, which seems sensible: Nobody wants a kidnapper co-ordinating
the multidisciplinary team and alcohol dependence poses obvious concerns for your practice.

What about lesser wrongdoing? This is a broad church, encompassing everything from being rowdy in a pub to taking ecstasy. In college we were told that doctors have a special position of trust among the public, earned through much sacrifice, and that we all have a responsibility not to undermine that. The British Medical Association advises students of their responsibility to “avoid acting in ways that bring the profession into disrepute”.

Working in oncology is worse,

as virtually everything enjoyable

in life also causes cancer

I think this is to misunderstand why that trust exists in the first place. It doesn’t arise from doctors being moral paragons, because clearly we are not. Individuals develop trust in the profession when they witness compassion and honesty at a time of need. Society’s trust is simply a composite of a million experiences like that – and is not easily eroded. The reasonable person does not expect us to have an existence on par with Mother Teresa and, I think, would prefer the person caring for them to have all the recognisable imperfections that come with being human.

And so, we should keep this in mind whenever we feel the pressure to be hemmed in by window squinters and curtain twitchers. In decades past, Ireland stood out for elevating authority figures like priests and doctors on a pedestal, and for sanctimony towards anyone considered to have moral shortcomings. These features were two sides of the same coin and it’s a currency we could do without.

When British climate activist George Monbiot was accused of hypocrisy, he embraced it. “Hypocrisy is the gap between your aspirations and actions. The alternative to hypocrisy isn’t moral purity, but cynicism.” Most of us will continue to be guilty of hypocrisy as we spin the plates of professional and personal lives. We shouldn’t worry too much about it.