Speaking Truth to Power

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2020 seems a long time ago now but the world is still caught in the grip of the COVID19 pandemic. While vaccinations have brought an exit strategy, the Omicron variant and the need to catch upon on over a year of reduced non-COVID health activity have made healthcare systems feel as tightly squeezed as they did in the first wave.

Certainly, scientific and political debate seems as polarised as it has always done. There appears to be no room for nuance and uncertainty. This adds to the physical and emotional fatigue of dealing with COVID both at home and at work.

The psychology of the human response to COVID is fascinating and there will be many PhDs written on the subject I am sure. The pandemic has been going on long enough now that it is possible to start looking back at previous events and trying to contextualise them. Whether it is possible to do this objectively is a very different matter but the current spike in cases throughout the world is prompting the question – have we learnt nothing from before?

Speaking Truth to Power” is a concept discussed at almost all leadership and development courses. Wikipedia will tell you that the phrase originated with a pamphlet, Speak Truth to Power: a Quaker Search for an Alternative to Violence, published by the American Friends Service Committee in 1955 but became popularised when ascribed to the actions of leaders such as Gandhi. It’s not entirely clear what Speaking Truth to Power specifically entails but it is described as a non-violent political tactic. I understand it as a process of encapsulating the reality of harmful, distressing or inequitable processes in a non-judgemental format for those who have the authority to do something about it. It is an easy phrase to use even if very little is achieved, especially on social media. And certainly, the action of speaking out against an injustice in a public manner is deemed by some to be ‘speaking truth to power’ even if the message hasn’t actually been directly delivered to the authority that can action something.

Speaking Truth to Power also has negative connotations – a belief that those in leadership positions won’t stand up to those in authority for fear of the implications it would have on their own careers. Consider the recently knighted Professor Chris Whitty, the Chief Medical Officer of England, constantly having this allegation levelled at him. His detractors feel he had a moral responsibility to distance himself from government decisions that appeared in conflict with scientific advice – more than distance himself, perhaps resign, rather than stand on a media platform with politicians and, in essence, validating their decisions. His supporters would argue he has been a constant in the pandemic, an authoritative voice whom the public trust and to have distanced himself would have resulted in potentially more divisive policy and the lack of a credible scientific figure for the public to relate to.

Everyone will have their own example of when they have spoken ‘Truth to Power’ or perhaps felt guilty when they have not done so when they should. I have plenty of my own examples of both. I also recognise that ‘truth’ is in the eye of the beholder and the ability to deliver it to the ‘power’ variable. Passions have run high over COVID and what people have believed to be ‘right’ has ended up being almost opposite things. Those who believe it is the ‘right’ thing to close schools or the ‘right’ thing to vaccinate under 12-year-olds face an equal lobby of those who believe these are completely the wrong thing to do. But outside of national policy decisions, these debates also occur at a very local level. What is the right way to staff a department? What is the right safety culture to protect patients and staff? Should there be mandated pathways of care? Very rarely are processes black or white. There will be both patients and staff disadvantaged by written or implicit rules.

‘Your’ truth is, therefore, dependant on how it affects you. But, critically, your ability to speak it to Power is also advantaged, or limited, depending on a multitude of socio-economic and hierarchical factors. Events of the last 18 months have highlighted how unequal our society is. Those with the most important truths to tell are the most limited in their ability to tell it. Conversely, those whose truths are subject to the greatest bias, are the closest to those in power.

Whatever part you play in your community, being an advocate for those with truths to tell will have never been more important than in 2022.

About the authors

  • Damian Roland is a Paediatric Emergency Medicine and Honorary Associate Professor. His research interests include scoring systems in emergency and acute care and educational evaluation. Damian also chairs PERUKI (Paediatric Emergency Research United Kingdom and Ireland), which gives him and the team an opportunity to raise awareness of the important of research and evidence based practice at scale. The list of the many things Damian hasn’t done or achieved is far longer but through these he learns and develops new ideas.

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