The Trial of the Tim Noakes Tweet

You are living on a desert island if you have not yet heard of the hearing currently underway for the aforementioned Tim Noakes, proponent of the diet commonly known as “I think my Palaeolithic ancestors ate lots of meat (even though they had no recourse to modern agriculture) so I will too.” Noakes medical license is currently under review after a complaint pertaining unconventional medical advice. At least, that is what his proponents are painting the story. A trial of the efficacy of the diet. Hence a trial of Tim Noakes. It is none of those things.

Now, the “Banting” diet, as it is known, is not being questioned. What is being questioned is the fact that Noakes may have given solicited medical advice over Twitter. Yes, Twitter. Who would have thought that one could give good advice on anything using only 140 characters? Specifically, Noakes tweeted to a mother who wanted advice on weaning her baby:

“Baby doesn’t eat the dairy and cauliflower. Just very healthy high fat breast milk. Key is to ween baby onto LCHF [Low Carbohydrate, High Fat diet i.e Banting].”

Never mind the grammar mangling, the question is: does this tweet count as “medical advice” or not? Noakes has no expertise in infant weaning, health, or diet, practical or academic. In this regard, his interest in diet, whether adult or infant, is more like that of an armchair academic replete with lots of books published ($$$) and posturing on the subject. Whether followed by the mother or not, if the tweet is considered “medical advice” this could land him in hot water. Twitter as a social media outlet is in the “public domain”, so people are free to exchange ideas, but this does not mean that they are automatically freed from legal obligations. In fact, by being accessible to all, what you post on Twitter theoretically makes you legally culpable were you to break any laws using your Tweets. For example, if you encourage someone to rob a store, and they actually do so, you could theoretically face criminal charges. Don’t forget: free speech entails responsibilities as some have found after posting embarrassing comments on social media about their workplace.

Doctors, or those with a license to practice medicine, frequently get asked medical advice by friends and acquaintances. Safe to say, no one constitutes this as a medical consultation. Does the same apply to a tweet? In an informal setting such as a dinner, all parties are aware that whatever advice they receive is not in a consultation setting. So the same could apply to a tweet. However, it would be unusual for a doctor to unanimously say to someone asking advice about their diet that “my views are the ones you should follow without question.” If a gynaecologist withheld crucial information about contraception to an unmarried young woman because he or she believed that unmarried women should not have sex, this would be grounds for bad medical practice. Likewise, a tweet concerning the diet of an infant is not suitable without the expected caveats of “you should consult your doctor/dietician.” That’s standard practice for doctors who are not specialist in that field, even in dinner party settings. If you had urinary tract problems, any sensible doctor friend would advise you to see an urologist.

In summary, Noakes gave medical advice to the mother of an infant based on his views of what makes a good diet without knowing anything about infant nutrition (let alone the infant in question) or indicating so. Can Twitter be construed by any participating parties as a medical consultation? Probably not, as in the case of medical advice given during a dinner party. Does Twitter allow for anyone to post anything under the guise of free speech? No, as hate speech or incitement to commit a crime using Twitter can be used as evidence against you in a court of law. Could Noakes have given better advice? Yes, as in the case of a GP advising a friend to visit a specialist when the solicited advice is outside their area of expertise. Evidently, the tweet itself is weak grounds for Noakes to lose his medical licence, but should prove a warning that what you say and even tweet is, and should, be taken seriously especially when serious harm can result.

NB: I have written about Banting before here.

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