Some insight into the thinking of those who attempt to suppress free expression in health care may come from a recent case at Johns Hopkins University, parent university for one of the world's most renowned medical schools and academic medical centers. The recent controversy started when a JHU undergraduate student posted an invitation on the web to a campus party which included crude language. Some found the language offensive, if not racist. It was not surpising that the student received fierce condemnation. However, the university then charged him with “failing to respect the rights of others and to refrain from behavior that impairs the university’s purpose or its reputation in the community,” violating the “university’s anti-harassment policy,” “failure to comply with the directions of a university administrator,” “conduct or a pattern of conduct that harasses a person or a group,” and “intimidation.” His punishment was a year's suspension, and that he complete 300 hours of community service; read 12 books and write a reflection paper on each; and attend a workshop on diversity and race relations.
The University's actions were condemned by the FIRE (Foundation for Individual Rights in Education), which has stood up forcefully for free speech and academic freedom in US institutions of higher education. A FIRE spokesperson stated, “Hopkins’ unconscionable treatment of [the student] ... should shock anyone who values free speech,” Furthermore, “Johns Hopkins must not be allowed to promise free speech to its students and then deliver heavy-handed repression.”
However, JHU President Dr William R Brody attempted to justify the university's actions in an article in the Johns Hopkins Gazette. Although he condemned past attempts by the university to suppress speech "of a substantive and serious nature," he then argued:
But I think we all know that it stretches our credulity to assert that two crude and tasteless invitations to a fraternity party posted on an Internet Web site rise to this standard of seriousness of purpose or intent. What I see here is not a courageous trespass of taboo speech but rather a fundamental breach of civility of the sort that is so commonly displayed in disparagement, mockery or epithets drawn along racial or ethnic lines. It is, simply put, common name-calling. This is what I believe we should agree is unacceptable in our community of free and open discourse. Let us not forget that true civility is not a program of fair treatment for this or that constituency but rather an underlying and fundamental commitment to showing respect for everybody.So Brody asserted that only "substantive and serious" speech is protected. And Brody reserved to himself the right to determine what speech is "substantive and serious." Brody's "community of free and open discourse" would not protect discourse which its leader deemed to be only "common name-calling," or a "fundamental breech of civility." Yet, claims that free speech is protected ring hollow when the only speech protected is that which the powers that be find acceptable.
The Torch, the blog sponsored by FIRE, provided this telling quote from FIRE's Guide to Free Speech on Campus:
[John Stuart] Mill addressed one of the major rationales for imposing constraints on free speech on campuses today, namely that speech should be 'temperate' and fair.' Mill observed that while people may claim they are not trying to ban others’ opinions but merely trying to banish 'intemperate discussion…invective, sarcasm, personality, and the like,' they never seek to punish this kind of speech unless it is used against 'the prevailing opinion.' Therefore, no one notices or objects when the advocates of the dominant opinion are rude or uncivil or cruel in their denunciations of their detractors. Why shouldn’t their opponents be equally free to show their disdain for the dominant opinion in the same way? Further, Mill warned, it always will be the ruling orthodoxy that gets to decide what is civil and what is not, and it will decide that to its own advantage.Although the particulars of the current case at Johns Hopkins University seem far afield from the issues of concern to Health Care Renewal, Dr Brody did not limit the application of his argument to party invitations posted by undergraduates to the internet. His ability to punish any speech not deemed to be sufficiently "substantive and serious" should thus give pause to anyone at JHU who might publish clinical research that could offend vested interests, blow the whistle on health care quality issues, or question hospital or university administrators. Dr Brody's ability to punish such speech also seems to contradict the University's mission statement, which aims to "foster independent and original research, and to bring the benefits of discovery to the world."
Finally, I should note that Dr Brody's writings may also give insight into how little leaders of commercial health care organizations respect free speech, free expression, and academic freedom. Note that Dr Brody leads not only Johns Hopkins University, but also, as a Director, Medtronic Inc, "the global leader in medical technology." According to Medtronic's 2006 proxy filing, Dr Brody's yearly compensation as Director is $80,000 in cash, and $70,000 in stock options. Dr Brody currently owns more than 72,000 shares or the equivalent in the company's stock (worth more than $3,900,000 at the stock price of $54.28 /share today). Yet, I wonder if he would regard any questions about whether this part-time job, entailing fiduciary responsibility to a company which has "research and/or business relationships" with JHU, and which "periodically makes donations and/or grants" to JHU, constituted an important conflict of interest as not "substantive and serious," but mere "common name-calling?" I doubt anyone at JHU will try to find that out.