Katie van der Merwe
The coronavirus has had widespread effects, including enormous consequences on the culture and methods of professional work. This summer, I participated in a remote internship for an organization that operates throughout New York which offers free legal defense for involuntary psychiatric patients which I will call “Defend”. As soon as shutdowns began in March, the “Defend” offices required their employees to work from home. Additionally, hospitals no longer allowed visits from family, friends, or attorneys and the court systems of New York began online hearings. Although this setup was ideal for me because I was able to participate in all aspects of the work under my supervisor from another state, this setup was not optimal for most parties involved. The hospital that my supervisor and I worked at had a single iPad available to all patients, making it almost impossible for a patient to gain access to. Because of this we conducted all patient contact through the patient phones on each floor of the hospital (landlines).
Early in my first week, I realized the implications of this remote method of contact on patients, my supervisor, and myself. One patient in particular felt uncomfortable sharing information over the phone. The patient explained that although they had no reason to distrust me, the information we were discussing was personal and confidential and they requested that either I send them a survey to fill out in the mail or I come to the hospital directly. Another patient had a similar concern and stated that there were other patients in the hallway who that they felt were eavesdropping, causing that patient to refuse to disclose anything to me. This meant that client contact was partial and incomplete in providing information necessary to our cases. My advisor felt similarly uncomfortable with this patient-contact setup. They expressed concern over confidentiality and frustration over the inability to get in contact with a patient, to hear or understand them over the phone, or to gain their trust through in-person contact. In fact, the first time they would “see” the patient was at the start of their hearing, when the Skype court was in full swing and the patient was about to testify. Although some judges allowed time for my supervisor to greet their client and introduce themself, others did not allow for this contact.
These interactions in court made me realize just how influential in-person contact can be and how widespread anonymity has become during the pandemic. I also wonder how this anonymous patient contact might change the work of the attorney. Although all of the people working in the office are doing incredible work and are passionate and caring towards their patients, it is hard to ignore the idea that any potential bias that could arise from in-person meetings has been totally removed. One example of this could be whether or not a patient is in restraints or requires a guard while meeting with the attorney due to their violent or aggressive tendencies. This feeling of being threatened could add a bias to the attorney’s opinion of the client and subsequently their approach to the case. Additionally, an in-person interaction has more influence on the relationship between attorney and client in terms of likeability and relatability. With remote work, there are reduced interactions and each interaction is briefer with less chance for either party to get to know and experience one another. On a more pessimistic note, the attorney also does not see the patient’s physical state. It occurred to me that the patient’s race could cause an implicit bias either positive or negative for an attorney. It wasn’t until the third week of seeing the Skype hearing that I realized most of our clients were either Black or Latinx. This information should not necessarily be pertinent, but it is important to realize that during remote work, that information is not as readily accessible as it is during in- person pre-court meetings. The fact that it would have to be specifically searched for in the chart may make any potential bias less likely. Additionally, while speaking on a landline, you cannot determine a patient’s nutritional/physical well-being or the state of their hair or clothes. These types of attributes could also influence one’s opinion of them and an attorney’s preparation approach for the hearings. Although all attorneys are meant to stay impartial, when one perceives a patient is not taking care of themselves or may not have the means to do so, it adds to the attorney’s perception of what the patient’s life is like outside of the hospital and their potential stability for discharge. During the pandemic and while all pre-court interactions happen with the patient’s body being anonymous, there is no chance for implicit bias, not matter how rare it may be.
In my case, I remained anonymous in the same way, never meeting my supervisor or patients, and conducting all of my work over the phone or email and watching court without participating with video of myself. Sometimes this made patients mistrust me, but other times it made them trust me more. All the identifying facts a patient received about me were my name and the fact that I was an intern for “Defend”. This made many of them assign overqualifications to me (which is reasonable because every other intern for “Defend” was a 2nd or 3rd year law student). This made me tread a very thin line because I am not allowed to give legal advice, yet I was asked to constantly. This made me contemplate how client contact would have been different if they could see how young I am, or that I am a white female, or if they knew I was an undergrad student. This situational anonymity gave me more agency, potentially undeserved.
During the pandemic, many people are working in similar virtual manners. Although not all of this work is done over the phone as mine was, and instead involves video chat, there is still widespread anonymity in this form of work. A video can cut out one’s clothes and shoes, or can provide an alternate background, or can even change a viewer’s perception of someone due to lighting or a filter. These things mean that remote workers have limited available perspective of those they are working with. This means that potentially, an employee will not be judged by their quality or brand of clothes and shoes (i.e. perceived wealth), or maybe their race will become less pertinent. Whatever the case, the anonymity of the body could be an avenue for reducing bias in the workplace. All examples of supervisor and patient contact in this blog post are taken from experiences within my remote internship with the organization I termed “Defend” but are kept anonymous through the use of “they/them” pronouns.