One of the most vexing aspects of the case against Dr. Roger Ian Hardy, the former medical director of the Fertility Centers of New England who recently gave up his medical license following allegations of the sexual molestations of female patients dating back to the 1990s, is why nurses in his practice apparently failed to report him. An investigation by the state Board of Registration in Medicine revealed that the nurses in the practice either failed to report what they had witnessed or were ignored when they brought their concerns to supervisors. The organizational culture of the clinic, according to one psychologist involved in the investigation, encouraged a “code of silence.”
Codes of silence within professions, such as the police, are often rooted in shared beliefs that outsiders could never understand the pressures and moral ambiguities of difficult jobs. But in medical settings, the code appears based more on intimidation, fear of reprisal, and inflexible hierarchies.