Confronting the Cost of Silence in Healthcare: Wits Internal Medicine hosts Ethics Session
- FHS Communications
The Department of Internal Medicine at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) hosted an ethics-focused academic meeting on the 28th November 2025. The title was “Silence Kills: The Missing Link Between Ethics and Safety in Medicine.”
The session, hosted in the weekly departmental meeting, explored why clinicians often remain silent in situations of perceived risk, discomfort, or deviation from best practice. This silence can often contribute to ethical distress, compromised patient safety, and strained team dynamics.
“In contrast to the department’s usual academic meetings, which focus on diagnosis and management, this session centred on the human and psychological dimensions of clinical practice,” explained Dr Jarrod Zamparini, a Wits Lecturer and the Academic Meeting Coordinator in the Department of Internal Medicine at CMJAH. He says the discussion proved emotionally charged, as it reflected on the daily realities faced by healthcare workers in the state sector. At the centre of these challenges are resource constraints, high workload and burnout.
This platform created a needed space for open dialogue, especially as “entrenched hierarchies” can make speaking up feel too risky or unsafe.
Drawing on behavioural science, organisational psychology, and the South African healthcare context, the session was presented by Dr Khosi Jiyane, a Clinical Psychologist, and Jeshika Gopal-Bassett, an Industrial and Organisational Psychologist, both from The Human Edge.
The speakers examined the psychological and structural factors that discourage open communication in high-pressure clinical environments, highlighting how fear of judgment, hierarchical power imbalances, and the emotional toll of clinical work can all contribute to a culture of silence.
The session also emphasised practical, evidence-based strategies to help empower clinicians to raise concerns early and constructively. These included techniques to navigate complex power dynamics, frameworks for initiating difficult conversations in ways that support both ethical practice and team wellbeing.
L-R: Jeshika Gopal-Bassett, Prof. Adam Mahomed (Clinical HOD: Internal Medicine, CMJAH), Dr Khosi Jiyane, Dr Jarrod Zamparini
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