吳敏倫﹕政府機構與專家 在多元社會的責任
Dr. Ng spoke as the capacity of the Vice Chairman of Hong Kong Sex Education Association. He started by an analogy: if a Government organization runs a talk or training for Social Workers about “Counseling teenagers of ethnic minorities”, and the speaker invited was the chairman and chief psychiatrist of an organization known as the “Hong Kong Ku-Klux-Klan” who is well-known as the organization spreading racism and apartheid. Should we be surprised if there is outcry in the public ? If that organization claims that the take was not to “instruct” social workers on ” racism and apartheid”, but simply offer “more information”, that psychiatrist say he has not encouraged racism or ethnic minority teenagers to “voluntarily segregate” from the rest, only “counseling them”, will only offer them assistance and counseling if “they want to voluntarily segregate from the majority race”, and tell them their success rate is 20%, do you find those arguments absurd ? You see a clear parallel of the very same arguments happened recently — the talk was organized by Social Welfare Department, the topic is not “ethnic minority” and “apartheid”, but “homosexuality” and the so called “reparative therapy” that claimed is “effective in curing homosexuality”…. Recently Government’s tendency to use “include multiple perspective” as a “reason” to allow absurd ideas in education is worrying, and totally disregarding their responsibility and role — the society expects Government departments to act responsibly and with good evidence and reason. “Reparative therapy” is already been discredited by mainstream medical and psychiatric organizations worldwide, just like an ineffective or harmful drug; if a government department used the excuse “include multiple perspective” to invite the pharmaceutical company that produces those harmful drugs to “educate” the public, it will be worrying — people will have serious doubt about that government department’s professionalism and credibility. “Reparative therapy” — discredited, a treatment that has no therapeutic effect and is shown to be harmful The Government may want to allow a voice from a different position to debate or to exchange the idea, but the purpose must be stated clearly. Most importantly, by what capacity is the speaker present, and what is his role, because different roles and capacity directly affects the audience’s perception and understanding. In this talk organized by the SWD, the speaker is the chairman of an organization known to be claiming homosexuality is a disorder and promote “reparative therapy”, i.e. this person is an preacher as well as a psychiatrist. So in what capacity was this person giving that talk ? Had SWD made it clear? Even if SWD made it clear, why insist having a person with this dual role to speak on the topic ? For any social worker a confusion of role will often cause adverse result in the process of helping a client, which the SWD is well aware off. If they so insisted “multiple perspective”, then why not invite a speaker with single role, one solely the capacity of a preacher, another one a psychiatrist ? This problem of role confusion can be clearly seen in what that speaker referred to as “counseling”. A friend can counsel his friend, a parent to children, a teacher to student, a physician to a patient — between friends they can talk freely, if a preacher counsels a believer the preacher can talk about “homosexuality” as a “sin”, but for a psychiatrist to his client, when giving advice on treatment, they have to adhere to principles and practices in the medical profession, to ensure that the client is well informed about the kinds of treatment he/she is about to receive, so that the client can make an informed decision about the treatment based on complete and accurate information. So if the speaker wants to recommend “reparative therapy” he must, based on intellectual integrity, disclose to the client that fact that this treatment is discredited by medical, psychological, psychiatric profession in writing, and the so called 20% cure rate in strict medical terms its efficacy. That psychiatrist cannot claim because he is a preacher he can be exempted of his responsibility. We need also to consider the circumstances, if he provide counseling services in a hospital, clinic or a medical facility, or he is wearing the doctor’s robe, then he is giving the service in the capacity of a psychiatrist, then he cannot be excused from his professional responsibility. 吳敏倫﹕政府機構與專家 在多元社會的責任 【明報專訊】如果有政府機構舉辦一個以社工為對象的「少數族裔青少年輔導講座」，邀請以提倡「種族隔離」聞名的「香港三K黨」會長兼精神科醫生做講者，社會人士應否嘩然反對？又如果該機構辯稱該講座並非教唆「種族隔離」，而只是為社工提供更多有關資料，而那個醫生也自辯他並無鼓勵少數族裔青少年自我種族隔離，只是向他們提供輔導，如果他們想自我隔離，便輔導和協助他們，告訴他們在隔離後身心康泰的成功率約20%，他們這些辯解是否荒謬絕倫？但是，類似的行動和辯解，剛在香港發生過，講座由社會福利署主辦，只不過主題不是「少數族裔」和「種族隔離」，而是「同性戀」和聲稱可把它治療成異性戀的「拗直治療」。 近來一些政府機構在教育工作上，慣以支持社會多元為藉口，放任地容許各種奇怪聲音來替他們做教育，卻忘記了自己的角色和責任。社會對政府機構有一個合理期望，即是它們行動的每一步都合情合理，以證據為基礎。「拗直治療」已被世界上多個最權威的醫學和心理學會反對使用，它的地位就等於一種已被公認無效或有害的藥物，若有政府機構仍以支持多元為藉口，邀生產該藥的藥廠代表繼續推銷此藥及有關的言論和資料，是否令人極度擔憂？此機構的理性、專業和公信力還剩多少？ 拗直治療 公認無效或有害的藥物 或許，仍可以邀請這些「不同聲音」來作辯論、交流，但活動性質和主題便必須明確，尤其要說清楚來賓是以什麼身分角色來參加，因為不同身分可以影響聽眾接收的角度。譬如社署這次主辦的「同性戀講座」，被邀講者是以宣傳同性戀是病和提倡「拗直治療」聞名的某宗教團體會長（即是一個傳道人），但也是一個精神科專科醫生，那麼，他是以哪個身分來演講的？有說清楚嗎？即使有，為什麼社署覺得必須請一個有雙重身分的人來講？社工在幫助人時身分模糊最易引起誤會或不良後果，社署的領導層不可能不知，然則，若堅持要多元，分別請一個單一身分的傳道人和精神科醫生來各自表述不是更好嗎？ 同樣一個身分角色的問題，出在那個講者醫生所說的「輔導」上。任何人也可以「輔導」任何人，朋友之間、父母對子女、老師對學生、醫生對就診者……但社會對不同角色之間的輔導都有不同要求。朋友之間的「輔導」可以隨意吹水，神父「輔導」信徒可儘管大談處女生子或同性戀是罪，但精神科醫生輔導求助者，向他提供醫療資料，便必須嚴守醫學準則，保證求助者在接受醫療上能做個充分知情、合理和自願的決定。所以，若介紹「拗直治療」，便必須說明這治療已被權威界明文報廢，和他所說的20%治療成功率，以嚴格醫療研究標準來說是屬於有效還是無效。而醫生也不能隨便轉向說當時只不過是以傳道人或其他身分作輔導來逃避責任，因為事實如何，主要看環境證據，如果他做輔導時是在醫院或診所內穿著醫生袍的，那他便是以醫生身分來做，不能抵賴。 作者是香港大學前精神醫學系教授，現家庭研究院副總監， 香港性教育會副會長
