Is it ethical to tweet about a particular patient?
Only if you've asked for explicit consent otherwise you run the risk of breeching patient confidentiality and GDPR.
I find these tweets particularly interesting in the context of the recent Advertising Standards Authority which ruled:
www.theverge.com/2019/7/4/20682087/INSTAGRAM-TWITTER-CELEBRITY-30000-FOLLOWERS-ADVERTISING-STANDARDS-AUTHORITY-UK
Having 30,000 followers makes you a celebrity, UK advertising watchdog rules
The UK’s Advertising Standards Authority has ruled that 30,000 is the magic number of followers that makes you a celebrity. The decision means that if you have such a following then you have to obey the same advertising rules as traditional celebrities like David Beckham or Stephen Fry, particularly when it comes to product endorsements.
The regulator came to the decision after an Instagram user with 32,000 followers, ThisMamaLife, posted an ad for Phenergan Night Time sleeping tablets. Although they disclosed that the post was an ad at the beginning of its description, the ASA ruled that their follower count made them a celebrity, and thus banned from drug endorsements in the UK.
Now Harrop doesn't have 30,000 followers so this doesn't apply. However his follower base is very specific and of a particular demographic. It make you wonder if this is micro targeting a particular audience.
Harrop of course called the doctor above transphobic for using the term natal-male but as a doctor they should be able to do this in a scientific context - this is more thought policing medicine.
This group, we are of course repeatedly told, are exceptionally vulnerable.
Which might give the ASA or the GMC cause for concern even if Harrop isn't up to 30,000 followers.
I note the following paras from the ASA guidance on vulnerable audiences:
www.asa.org.uk/news/protecting-vulnerable-people.html
Protecting Vulnerable People
^CAP and BCAP maintain self-regulatory rules to protect those who are
vulnerable, including sections in both Codes devoted to the protection of
children. These rules fall into two broad categories: content rules designed to
minimise the potential for ads to cause harm to those with vulnerabilities; and
scheduling (in the case of broadcast)^ and targeting (in the case of non-
broadcast) restrictions which seek to ensure that vulnerable groups are not
disproportionately represented in the likely audience for certain ads.
^Rules in both Codes on harm and offence, children, promotional marketing,
medicines, weight control and slimming, financial products, food, gambling,
alcohol, e-cigarettes and tobacco contain examples of content and targeting
restrictions that are designed to protect those who are vulnerable.^
The ASA, in casework, and CAP and BCAP, in drafting Code rules and guidance, will always take account of the likely audience of ads and the available evidence on potential harm to identifiable groups within that audience.
Also
^The ASA’s Strategy commits the self-regulatory system to being active on issues
that cause social concern, particularly in relation to concerns about public health,
children and those who are financially vulnerable.^
^To help identify the regulatory ‘issues that matter most’, in line with the Strategy,
the ASA and CAP use a priority assessment tool, which assesses regulatory project ideas against three broad categories of questions: impact on people, market impact and institutional impact.^
It goes on to talk about the law on vulnerable people
The law reflected in the Codes provides protections for and duties to protect vulnerable people, and some of the key pieces of legislation can be summarised as follows:
The Consumer Protection from Unfair Trading Regulations 2008 (the CPRs)
Regulation 2(5) of the CPRs provides:
^(5) In determining the effect of a commercial practice on the average
consumer—^
^(a) where a clearly identifiable group of consumers is particularly vulnerable to
the practice or the underlying product because of their mental or physical infirmity, age or credulity in a way which the trader could reasonably be expected to foresee, and^
(b) where the practice is likely to materially distort the economic behaviour only of that group, a reference to the average consumer shall be read as referring to the average member of that group.
^The European Commission’s guidance on the Unfair Commercial Practices
Directive (which the CPRs implement in the UK) also refers to other potential
vulnerabilities, such as health problems, membership of a minority group, poor
credit history and gender.^
If I am reading this correctly this means the 30,000 for a 'celebrity might not actually be necessary, if you have a person in a position of trust such as a doctor, who had a smaller audience which was disproportionately vulnerable and had certain characteristics if it might cause them to change behaviour and purchase a product (I believe asking for a drug is in affect a commercial purchase just done through the NHS so it's relevant - I find it interesting that Harrop indeed mentions price so it really does feel like a sales pitch)
The ASA might well look at this as a case because it also features drugs AND a vulnerable group as part of it with some interest.
Especially if there were doctors who were pointing out the ethically dubious other stuff going on in those tweets.
And certainly making the point to the GMC about how there's lots going on here that is really ethically not cool, would be relevant.
I'd also be curious as to whether Harrop has links to any pharmaceutical company. He may well not do.
And I'd be raising questions if he is in private practice doing this too. Which I don't know.
All in all, this is very dodgy ground ethically speaking for a whole host of reasons.