The social media tribulations of GP Dr Jereth Kok .

medical policy or medical science is neither forbidden nor gagged but should reflect the writer ’ s expertise and a competent assessment of the valid evidence .

This goes back to those claims by a tiny , but vocal , group of doctors about the COVID-19 vaccines and their belief that , in some way , they have been gagged by AHPRA from speaking out .

Dr Sue Ieraci Emergency physician in Sydney , NSW .

GREAT divide between doctors resurfaced recently , when GP Dr Jereth Kok faced a tribunal over 85 of his social media posts , including one in which he described abortion doctors as “ contract killers ”.

As we know , Dr Kok was suspended five years ago under the Medical Board of Australia ’ s emergency powers , accused of inciting genocide and denigrating , demeaning and slurring other doctors , racial groups and the LGBTQI + community online .

Misinterpreted ?

An evangelical Christian , he denies

the claims , saying the board has misinterpreted his dark humour when discussing what he regards as deeply ethical issues .

On the first day of the hearing , Dr Kok ’ s lawyer described the case as the most important to be put before the tribunal in the past 30 years .

It would determine the right of doctors to speak about matters of conscience , the lawyer said , and whether regulators should sanction doctors for speaking out in the “ public square ”.

During his hearing , Dr Kok apologised for some his wording , such as calling abortion doctors “ contract killers ”.

But is AHPRA , the statutory regulator , trying to gag the profession ?

Are doctors being disciplined just for having an opinion ? I don ’ t think so .

Australian Doctor ’ s report of the first day of the hearing attracted 84 comments from readers , highlighting disagreement about expectations of doctors on social media .

As a long-term and frequent user of social media , I have been interested to watch these exchanges play out .

Communicating in the public space requires sound judgement

but is nowhere near as tricky as clinical care , which we are all certified to provide .

Free speech

Why , then , can it go wrong ?

First , there is the concept of so-called free speech . Here , people often confuse the US constitutional right to free speech , as outlined in the First Amendment to the US Constitution *, with Australian law .

In Australia , there is no constitutional right to free speech .

Our principles generally reflect international human rights standards through our various laws , including the criminal law ( mainly relating to terrorism and secrecy ) and antidiscrimination laws .

For example , the Racial Discrimination Act prohibits “ offensive behaviour because of race , colour or national

Despite the extent of our training , very few of us are experts in pandemic management or vaccine development .

or ethnic origin ”, which is — please note this part — “ otherwise than in private ” and is both likely to “ offend , insult , humiliate or intimidate another person or a group of people ”.

The Act also defines the difference between private opinion and public expression .

It uses the term “ public place ” — which , to summarise the verbosity of the Act , includes the internet .

Those rights and restrictions apply to all Australians .

PICTURE CREDIT

Dr Jereth Kok .

Higher standards

Registered healthcare providers are

held to an additional standard of professional conduct through the National Law .

In addition , doctors are advised to comply with the board ’ s code of conduct , which acknowledges that all doctors have a right to express their personal views on medical and clinical matters while stressing they must consider how their public comments “ reflect on your role as a doctor and on the reputation of the profession ”.

So , how to negotiate that tricky path between expressing personal views and remaining on the right side of the board ?

It is not as difficult as it may appear .

Navigating commentary

General commentary is neither forbidden

nor gagged but should be written with both the conventions of civil society and the medical code of conduct in mind : politely , using evidence where available and avoiding personal attacks or incitement .

Similarly , commentary on

Few of us are experts

My first point is that , as doctors ,

despite the extent of our training , very few of us are experts in pandemic management or vaccine development .

That means the expression of a dissenting view , or even a concern , requires acknowledgement of that fact .

It also requires a genuine attempt to understand the rationale behind the decisions you are criticising .

We know , for example , about the tiny percentages of vaccine-related thrombosis with thrombocytopenia syndrome or of myocarditis .

But it is one thing to say , “ I have seen X happen in my patients and have reported it to the TGA but have not done a study to confirm causality ,” versus , “ I will lose my registration if I report this because AHPRA is deliberately gagging doctors who question the pandemic response .”

It is not that hard to see the difference . The outcome of the Dr Kok case is important . It may well help define the limits of what is and is not acceptable for doctors to say in the public domain .

But the argument cannot be that freedom of speech in the public domain should extend so far that it becomes acceptable for doctors to say anything they want at all .

* Contrary to popular opinion , the US First Amendment does not provide for unrestricted expression . It limits acts or expressions that can be summarised as “ incitement , defamation , fraud , obscenity , child pornography , fighting words and threats ”.

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