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Uniform -- n. A distinctive outfit identifying those who wear it as part of a specific group, or, esp. for certain traditionally female jobs, as unskilled sex objects. See stereotypes.

November 4, 2006 -- Today the Manila Standard ran a short item by Jaime Pilapil reporting that Philippines Interior Secretary Ronaldo Puno had issued a directive barring the use of "the nurse's uniform by waitresses, sauna attendants and even entertainers," in an apparent effort to reduce the harm caused by widespread "naughty nurse" imagery. We agree that the constant flow of images associating nursing with sex inhibits nursing practice, and makes it harder for nurses to get the resources they need, as we noted in recent discussions about the Heart Attack Grill in Arizona. But we can't agree that making such conduct unlawful is the answer, except where it poses a more direct threat to public safety, as where the public would be likely to think that a non-nurse really was a nurse (the problem addressed by protected title statutes). We simply ask people like these business owners and their customers to consider the effects of their commercial actions on nursing. In any case, the Manila Standard item shows how influential the naughty nurse stereotype remains across the world.

"Puno restricts use of nurse's uniform" says Secretary Puno acted at the behest of the Philippine Nurses Association, which sought to protect "the image and integrity of the profession." The Association reportedly said that (in the piece's words) "[n]ot a few restaurants or bars have required their employees and attendants to wear skimpy nurses' uniform[s]." The Association also noted that some stores sold "figurines depicting nurses in sexually suggestive postures;" it's not clear if Puno's order applies to those, or other imagery that depicts "naughty nurses." In a statement, Puno reminded the governors and mayors charged with enforcing his order that (again in the piece's words) "only registered nurses can wear the uniform which, together with the cap and pin, is a symbol of purity, commitment and service to mankind." The piece did not explain what penalties were envisioned for those violating the directive.

Of course, we can't help but think of our friends at Tempe's Heart Attack Grill, and the recent suggestions of the state of Arizona and the Arizona Board of Nursing that the Grill's use of "naughty nurse" uniforms violates the state's protected title statute. The state ultimately ended those efforts. Although the Center has made its own problems with the Grill uniforms fairly well-known, we never suggested that many customers were likely to think the waitresses really were nurses, or that it should be unlawful to distribute naughty nurse imagery.

In the United States, some legal restrictions on speech are permitted if they serve important enough government interests, such as protecting the public from the harm unlicensed health practitioners might cause. Some speech really could wrongly suggest to many consumers that a particular person is a nurse, such as the marketing efforts of "baby nurses," who are generally not nurses at all. But where that kind of interest is not implicated, it seems to us that stereotypical imagery like that of the Grill and its Filipino counterparts is basically just hate speech, albeit by speakers who may be unaware of their own contempt for nursing. It may be a tired, profit-driven attack on a life-saving profession, but the best answer to such harmful stereotyping is generally more speech, and consistent advocacy efforts to persuade people to do better.

We commend Secretary Puno for taking disrespect for nurses so seriously. The "nurse-as-sex-worker" stereotype harms public health, discouraging practicing and potential nurses and undermining nurses' claims for the resources they need to save lives. (See our naughty nurse FAQ.) We wish people would stop making baseless attacks on nurses, just as we might wish people would refrain from other class-based attacks with no redeeming purpose, but it should not be illegal simply to make stereotypical, malignant public statements. (See our speech police FAQ.) An order as broad as the one described here could also sweep in a range of material making social or educational commentary about "naughty nurse" imagery, like the Center's web site, to take a random example. We might note that the unskilled angel image also causes harm to nursing, but we would not wish to see statements like those of Secretary Puno--who described the nurses' uniform as a "symbol of purity"--become subject to legal action.

The Manila Standard item also raises several issues apart from free speech. One is to confirm that the use of "naughty nurse" imagery to sell things, primarily to male consumers, remains a major global phenomenon. Another is that the Heart Attack Grill's use of such imagery in its waitress uniforms is far from original, but just another sad blip in a tradition of socially self-defeating marketing tactics that seems to have been established in the Philippines for some time.

Finally, we wonder about the practical effect of this directive. It's not clear how aggressive enforcement will be, or whether it might make "naughty nurse" imagery more enticing for being forbidden, at least in the short term. Or will the bars just switch to another image? The directive does send the message that this conduct is a problem, that many nurses would prefer not to have their profession constantly associated with sexual fantasies. It could make some people think, and make different choices over the long term. Of course it may not directly influence people's current sexual fantasies, but even they change over time, particularly when they are as dependent on specific cultural factors as "naughty nurse" fantasies are.

We thank the Manila Standard for this article.

See the article "Puno restricts use of nurse's uniform" from the November 4, 2006 edition of the Manila Standard Today.


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