Developing a Professionalism and Harassment Policy for Organized Neurosurgery.

Annual conferences, educational courses, and other meetings draw a diverse community of individuals, yet also create a unique environment without the traditional guard rails. Unlike events held at one's home institution, clear rules and jurisdiction have not been universally established. To promote the open exchange of ideas, as well as an environment conducive to professional growth of all participants, the leading neurosurgical professional organizations joined forces to delineate the expectations for anyone who participates in sponsored events. The One Neurosurgery Summit Taskforce on Professionalism and Harassment developed a foundational policy that establishes common expectations for behavior and a unified roadmap for the prompt response to untoward events. We hope that publishing this policy will inspire other medical organizations to establish their own meeting and conference policies. More importantly, we wish to bring greater attention to everyone's responsibility for ensuring a safe and respectful space for education, scientific debate, and networking during organized events.

As neurosurgeons, we are dedicated to maintaining the highest standards of professionalism. This applies to our interactions with patients, colleagues, and others. Maintaining these high standards requires ongoing professional development facilitated through annual conferences, educational courses, and other meetings. To the benefit of all, these events draw a broad community of individuals who bring a diverse array of experiences and perspectives. They also create a unique environment without the traditional guard rails. Unlike events held within and attended by those of one's home institution, clear rules and jurisdiction have not been universally established. What one person believes to be acceptable can be offensive to another. For some, being away from their home environment provides a sense of liberty to engage in behavior they may not otherwise.

Much emphasis has been laid on issues of discrimination and harassment in healthcare as part of the #MeToo movement,[1] with recent studies documenting continued high incidence.[2] However, far less attention has focused on these issues within the distinct context of professional conferences. Many technology and science meetings have reported incidents of attendee harassment.[3-5] It would be naïve to think that medical professions, and neurosurgery in particular, have been immune to incidences of sexual harassment and discrimination during sponsored events. While several hundred science and technology organizations have adopted antiharassment policies,[6] the establishment of clear policies and codes of conduct for attendees has been sparse in the medical field.

To promote the open exchange of ideas, as well as an environment conducive to professional growth of all participants, the leading neurosurgical professional organizations believe it vital to delineate the expectations for anyone who participates in sponsored events. Representatives of the American Academy of Neurological Surgery (AAcNS), American Association of Neurological Surgeons (AANS), American Board of Neurological Surgery (ABNS), Congress of Neurological Surgeons (CNS), and Society of Neurological Surgeons (SNS) convened to form the One Neurosurgery Summit Taskforce on Professionalism and Harassment (Taskforce). We began by committing to the establishment of common expectations for behavior and a unified roadmap for the prompt response to untoward events. While each organization must formally adopt policies in accordance with individual by-laws or charters, we nevertheless wished to affirm our unified standards for professional behavior that should apply at all events sanctioned by one of the organizations.

The Taskforce then looked to other organizations to learn from their experience. The American Astronomical Society has been at the forefront of these issues, having formally adopted its initial antiharassment policy in January 2008.[7] In this document, the group set forth clear definitions of misconduct and a pathway for reporting/adjudication. Despite this foundational work, broader adoption of policies has been slow. The technology and open-source computing fields were the next to take on the mantle. In 2010, the Ada Initiative and Geek Feminism wiki published an example conference policy online, providing it to the public domain for free adoption by any organization that wished to do so.[8,9] This spawned the adoption of conference policies across the technology field, with well more than 100 published policies by 2015.[6]

The American Medical Association (AMA), the largest organization of physicians and medical students, adopted its “Anti-Harassment Policy” in 2017.[10,11] This policy specifically expanded the AMA’s code of conduct to apply to conferences and other events sponsored by the organization. To our knowledge, the AMA remains among a small number of medical organizations to have established policies that apply to medical meetings and conferences.[12,13]

The Taskforce leaned heavily on these and other resources[14] in developing our policy. In addition to setting forth clear standards of behavior, we wanted to make clear that these expectations extend to satellite events, regardless of being directly sanctioned by the host organization. Moreover, the Taskforce wished to create the foundation of a fair and efficient process for addressing complaints without fear of retaliation. Though each organization's harassment policies will vary by necessity, the unified approach taken with this One Neurosurgery Summit model policy should be interpreted as a clear statement that organized neurosurgery will not tolerate harassment in any form. That the leading neurosurgical organizations unanimously endorsed this model policy reflects the understanding that individual neurosurgical organizations would create specific policies and procedures unique to their needs and capabilities.

We hope that publishing this policy () will inspire other medical organizations to establish their own meeting and conference policies. More importantly, we wish to bring greater attention to everyone's responsibility for ensuring a safe and respectful space for education, scientific debate, and networking during organized events.

Funding

This study did not receive any funding or financial support.

Disclosures

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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