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Blurring commercial and client /student relationships with social media

I remember as a child watching television and this toothbrush ad would come on, there would be this man’s back (because of course a dentist would be male) and we were told we could not see his face because he is a dentist.  As a child I would be perplexed by why a dentist cannot show his face, and was that also the reason why they wore masks at the dental surgery.  My parents tried to explain ethics, endorsements and testimonials to me and it has been an interest ever since.  It is for this reason that social media has intrigued me, and I wonder what has happened with the explosion of images and personal information on very public forums particularly given the specific nature of the relationships of practitioner and client/patient and students.

Facebook has only been available to the general public, for those over the age of 13 years, since 2006, and the iphone was only launched in 2007. In the decade since, the world of social and public relationships has changed and it is appropriate for us to consider these changes in the light of the broader social concepts of ethics.

The ethical aspects for pilates and movement teachers are quite diverse and complex, but that should not be a reason for us not to  explore them. This article is written to prompt discussion and the development of guidelines within our various communities and organisations, especially those that do not have strong regulatory bodies such as medical associations or AHPRA (Australian Health Practitioner Regulatory Authority). The primary question explored in this article is about the nature of the relationships that are challenged or exploited when we bring social media into a class or even a workshop or educational setting.

The purpose of this article is not to go into the legal requirements of disclosure forms, etc. when you ask people to participate in social media.  The article is intended to raise questions in practitioners minds about when, why and the appropriateness of social media and the boundaries of relationships. I remember a lecturer once saying to me in an ethics tutorial during my legal studies that there is “the ikky factor”.  The best way to define this is when you think about a “dilemma” often there will be a point at which you instinctively go ikky that does not feel right.  Probably, the best example I can imagine of the ikky factor is when we talk about cloning humans in order to produce organs for organ donation, the most common response is a grimace as we struggle with the complexity of all the implications. This article is about us stopping and actually thinking about the instantaneous and often thoughtless use of social media. When one actually reflects on issues raised in this article you will realise there is an ikky factor and we either in our small business relationships or in our broader community relationships need to stop and explore the difficult questions to answer, is that “really the right thing to do?”

A refresher: What are ethics ?

Ethics are an essential element of civilized life and without them our relationships and social structures deteriorate. When we consider questions of ethics, we are essentially required to examine:

//   Our relationships with others and ourself;
//   What it is to have a well-informed conscience;
//   What it is to be  true to the idea of who we are and what we stand for;
//   If we have the courage to explore difficult questions;
//   Are able to accept the cost of doing what we think is right;

Finally it is about asking one simple question – ‘what ought I to do?’

(The Ethics Centre)

A refresher: The objectives of Facebook (as an example of social media)

One perception of Facebook is that much of it is about making new connections. According to Zuckerberg, this has never been a Facebook objective. He states in an interview with Time Magazine that its objective was always to build a community for people who were already connected in real life. The site’s style and applications are also based on the way people naturally communicate, according to the founder. One of its objectives is building the size of that community. In competition with Twitter, both networking sites announced an objective of reaching a billion users.

(Techwalla)

What is a connection and what is a relationship?

We then need to ask ourselves what is the difference between a “connection” which is part of the social media concept and what is a relationship which is what ethics are concerned with.  I would submit that a connection is similar to a physical or virtual touch, it is superficial and requires very minimal trust. A relationship infers a sense of depth in which knowledge or trust is shared and there is an implication that this is not misrepresented, abused, betrayed or commercialised.

In an era when people are rewarded for revealing their worst behaviour on reality television, it is probably the issue of commercialisation of a relationship that is quite tricky for many people to comprehend.

Relationships with others

When a person walks into our business and they are wanting help with their sore back or recovery from cancer and so forth they are presenting us with:

//   Confidential medical information;
//   Trust that we will be working with a “duty of care” to help them recover their health and so forth;
//   Trust that their interests of physical and emotional security are our priority and not compromised by our own unreasonable self interests.

The person is creating a relationship with the provider, one that is more than temporal in nature.   Yes the person is paying us for our services, but the service is quite clear and defined. That is, the provision of pilates, yoga, dance  gyrotonic, etc.  The person is protected by law that we will act with a duty of care in the delivery of that practice and that we will work within our scope of practice. The person is also expecting us to comply with privacy requirements as well.

When we start to alter that commercial relationship with things such as social media the lines become blurry and we have to think about:

//   The “special nature of the relationship” and the need for informed consent;
//   The balance of power in the relationship;
//   Privacy considerations.

Scenario: Mary the client

Mary has been coming to see a teacher for many years following her breast cancer and she is grateful to the teacher for all the help that she has received over the years.  She feels that she has been able to attain movement and better health because of all the work at the studio.  The owner of the studio is wanting to do some promotional work to get more clients.  She asks Mary to star in a social media campaign.  Mary is reluctant to say no because she is so grateful for all the help she has received.  She feels uncomfortable about telling people about her cancer because that was in the past.  She goes ahead with it all because she feels obligated because of the nature of the relationship.

In our work many people are grateful for the help they receive and do feel obligated when asked a favour. However, if we consider the basis of our relationship with Mary, we should be asking are we about to compromise her needs for physical and emotional security for our unreasonable self interests. I would submit that a commercial advantage is an unreasonable self interest when it comes to our relationship and self prioritization with someone like Mary. We are asking Mary to do something outside of our relationship with her in order to advantage our business interests.

It is submitted that to avoid these uncomfortable situations we should not be asking clients to give testimonials where they can be identified by their image.  This should minimise the risk of disputes about informed consent. Most health regulatory organisations strictly prohibit the use of testimonials for this reason.

Scenario: Jackson, Andrew and Angela – a group of clients

I have a class of 15 people.  Of those, Jackson is doing the most amazingly advanced variations and he looks fabulous , Angela is also doing amazing things and looks fantastic in her designer gear whilst Andrew is in the back of the class feeling a little intimidated as he is coming to the class  for his bad back.

Situation one:   The teacher just takes a quick little  instagram shot did not ask for permission

Situation two:   Jackson’s boyfriend walked in took a picture and put the image on their facebook page but other people were identified in the image

Situation three:   The studio owner took a picture put it on their facebook page saying we cover all sorts from the “basic and uncoordinated to the fabulous athlete”.

There is no dispute that in the course of our work as movement teachers we will come across confidential information about a client’s health status.  It is also important to remember that a person’s image could be considered confidential and the use of that image without consent problematic. In a health setting this becomes more difficult because of the question of whether or not the person is truly comfortable in providing their image.

My suggestion is to stop and reflect about the scenarios above and think which evokes the highly scientific “ikky response”  and what that tells you about the relationships and a sense of response.

Workshop participant confidentiality and permission for use of images

I have noticed an increasing number of situations where images of people participating in a workshop are displayed on social media and people are tagged.  I know on some occasions I have done this as well, but generally of all the people at the end of the course holding a certificate etc. Often though as I go through the process of the photography I am assuming that we have all consented to the posting of that image of us all, and do clarify that we would post this on our facebook /social medial etc. pages.

My concern is whether or not that this group shot, or the random shots throughout the class,  has been done with full consent and does it actually infringe on the participants understanding of attendance at the course and also the safety and privacy of individuals.  If we think about the reason a person is attending the course /workshop is for education purposes not for promotional purposes. When a happy snap is taken the workshop provider is trying to show how popular the course is, that people enjoy the course etc. etc.  Often these photos are taken quickly without people in the course fully aware of what is going on and one would consider that it distracts the course provider or teacher from the work they have been paid to deliver. Yes some students realise what is going on and run out of the pictures, all of which can be a distraction from the delivery of the course, you know, that thing the people have paid to participate in.

I also ask whether or not there is a special relationship between student and educator especially if the workshop is for certification purposes. I can imagine some students may feel compelled to say yes to having their image portrayed thinking it might impact on their pass mark.

Scenario: Josephone and Ari at a workshop

Josephine and Ari are attending workshops about the use of hip flexion in a movement class, and as a result are wearing tank tops and shorts. The teacher presenting the class is a well known international presenter and has a big Facebook following, we will call them “GURU”.

GURU  takes some photos of people doing the course, and tags the people in the course as they do various activities. Josephine has escaped a violent relationship and  no longer posts anything on her Facebook page and is very private but has not changed her name but changed her career and has moved states to get away from the former partner. She has not told any of her former work colleagues or friends why she has left the state and where she has moved to. The international teacher tags her in the photo and Jospehine does not realise that this has been done, but her former partner can now track her thanks to this action, and this is dangerous.

GURU thought nothing of their behaviour; surely they should be able to promote the GURU workshops and show their fabulousness and how happy everyone was! However, is GURU  entitled to violate a person’s privacy and safety through that careless action?

Lets consider Ari who is also attending the workshop. Ari is a pilates teacher at a well known training school in a different city. She had travelled to the different city to attend the workshop because she didn’t feel comfortable in telling her boss that she was attending this GURU workshop because her boss’s friend was presenting a different workshop that weekend and had  wanted Ari to attend that workshop. Ari had told the boss that she had other things to do that weekend related to her family in another state. Ari’s boss had seen the photos of the GURU workshop and was furious that she had been lied to and as a result Ari and her boss are quite unhappy with each other even though normally they get on.

In both these situations there were consequences of the workshop teacher simply tagging someone at her workshop. The teacher is probably unaware of the repercussions of her actions but should be held accountable or more aware of these potential problems.

Simple ideas and considerations that may help

In conclusion, I ask you to consider your relationship with people and your relationship with social media. Some simple ideas or considerations for us as we endeavour to live ethical lives and work ethically are:

//   What is the relationship between you and the other person?  Is it a relationship based on a professional trust and privacy of information and a duty of care, if that is the case then perhaps social media promoting your business can compromise that relationship;

//   Is there a power imbalance between the parties in the sense that the person may feel compelled to participate in social media, out of obligation or gratitude.  Therefore, is there informed consent to the participation?

//   If there is a commercial relationship between parties what does that relationship cover i.e. the provision of an educational service. When we use social media the relationship is about promoting ourselves and our businesses, therefore there is a different commercial arrangement.  Accordingly, consent to take photos of a client or student cannot and should not be implied;

//   Why do we use social media?  Is the use for our own advantage to sell product, etc. and therefore are we then compromising our relationship with our clients.  Do we in using them in our social media, place our interests above them and their needs?

//   What are the privacy and safety considerations for others when we tag them or display their image in our social media campaigns?

//   Should we be insisting on regulation by our associations to ensure that some of the ethical standards are maintained and incorporated into our training and mindsets?  For example, should accredited education bodies and associations agree to a standard of practice about social media and students, and if so, what are the consequences for failure to comply? Should the educational guidelines of all associations require a unit on ethics and social media to be taught or incorporated into educational curricula;

//   Should we be insisting on detailed consent and agreement at conferences about the use of attendees being displayed in the event organisers social media?

This article was written by Carla Mullins of Body Organics to prompt discussion and consideration about the use of social media.

Some good online reference articles for those wanting to think about this topic further:

https://plato.stanford.edu/entries/ethics-social-networking/

http://www.medscape.com/viewarticle/871187?src=soc_fb_161126-pm_mscpedt_news_biz%3Fsrc%3Dsoc_fb_share

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587037/