COMMENTARY

Our Uncivil Society and Internet Abuse: Time to End Anonymous Postings?

Ronald W. Pies, MD

Disclosures

July 30, 2012

The Internet: A Symptom and a Cause

Finally, there is the matter of the Internet -- that double-edged sword that can be wielded against a brutal dictator or aimed brutally at a lonely, marginalized classmate. As a psychiatrist who posts blogs on several Websites, I am appalled by the level of anonymous invective on many poorly monitored sites. I am comfortable with constructive criticism and have sat with my share of verbally abusive (and often intoxicated) patients, but sometimes the menacing comments I read online literally raise the hairs on the back of my neck. One colleague of mine, a humane and broad-minded soul who tried to "reach out" to online critics of psychiatry, found himself so vilified on one popular Website that he suspended his postings, at least until the site improves its screening policies. Christopher Wolf, an attorney who leads the Internet Task Force of the Anti-Defamation League, observes the following:

People who are able to post anonymously (or pseudonymously) are far more likely to say awful things, sometimes with awful consequences, such as the suicides of cyberbullied young people. The abuse extends to hate-filled and inflammatory comments appended to the online versions of newspaper articles -- comments that hijack legitimate discussions of current events and discourage people from participating. Anonymity also facilitates the posting of anti-Semitic, racist, and homophobic content across the Web. [1]

In my view, anonymous "flaming" on the Internet is both a symptom and a cause: It is a symptom of a society in which, all too often, "anything goes" and is a contributing cause of further abusive behavior. Declining levels of civility in our culture have encouraged anonymous, "drive-by" postings on the Internet, but these postings, in turn, encourage further abusive remarks, in a vicious cycle of reinforcement. Alas, physicians are far from immune to this contagion of incivility and too often contribute to it.

To be sure, as Wolf points out, "...we have had a great tradition of anonymous political speech" in this country. And there are occasionally compelling reasons for remaining anonymous or for using a pseudonym when posting blogs or comments on the Internet. Someone who risks physical abuse or stalking from a psychopathic ex-spouse; a political dissident who faces retaliation by an authoritarian regime; an employee who will probably be fired if the boss reads what he or she has posted online -- all of these people may have legitimate reasons for disguising their identities. In rare cases, it may also be necessary to disguise one's identity to protect 'someone else's safety or privacy -- for example, a patient whose case one urgently wants to discuss in an online forum. (Most such cases, however, can be sufficiently disguised by altering or omitting key elements of the patient's identity, such as age or other personal details, age, etc.[2])

Even so, I doubt that these considerations apply to most anonymous and occasionally abusive online commentators. For the abusers, maintaining anonymity is merely an excuse to unleash a barrage of insulting or hateful language at no cost. As a healthcare professional, I find it particularly galling when someone claims to be a physician and posts an anonymous, "flaming" comment directed against a named colleague. This is not merely obnoxious and irresponsible, it is also cowardly.

I was therefore greatly satisfied to learn of Medscape's new policy (June 27, 2012): "...we have removed the ability to post comments anonymously in our physician-only discussion forum, Medscape Connect, and in all Medscape blogs." A similar policy is also in place on the Psychiatric Times Website. On the other hand, I was shocked some months ago to find that the widely respected New York Times Magazine now publishes, in its print edition, anonymous or pseudonymous comments. In my view, this is a bad precedent for print journalism, but I fear that it is a harbinger.

A free society thrives on robust and passionate debate. I am not arguing that our online discourse should sound like conversation over tea and crumpets at Buckingham Palace. However, I am urging that our exchanges be marked by basic respect and civility and by a willingness to take responsibility for what we say and how we say it. Physicians ought to be in the vanguard of such an Internet reformation.

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