The second privacy concern is the potential use of health-care facility records to incriminate an institution or its clinicians for providing abortion services. Relevant records could include electronic health records, employee emails or paging information and mandatory reports to state agencies. Clinicians may not realize that if they are using an institutional email address or server, their institution likely has direct access to information and communications stored there, which can be used to search for violations. State Freedom of Information Act (FOIA) laws also allow citizens to request public records from employees of government hospitals and clinics.

“Additionally, state mandatory reporting laws for child abuse might be interpreted to cover abortions — particularly if life is defined as beginning at fertilization,” the authors note.

The third scenario is that information generated from a woman’s online activity could be used to show she sought an abortion or helped someone to do so. Many women use websites and apps that are not HIPAA-regulated or protected by patient-physician privilege, such as period-tracking apps used by millions of women that collect information on the timing of menstruation and sexual activity.

“There are many instances of internet service providers sharing user data with law enforcement, and prosecutors obtaining and using cellphone data in criminal prosecutions,” write Mello and Spector-Bagdady, adding commercially collected data are also frequently sold to or shared with third parties.

“Thus, pregnant persons may unwittingly create incriminating documentation that has scant legal protection and is useful for enforcing abortion restrictions,” they said.

The immediate problem, Mello notes, is in the states that have already banned abortion or passed restrictive laws.

“There could be a problem with states trying to reach outside their borders to prosecute people, but that could well be unconstitutional,” Mello said.

Some states’ laws sweep abortion pills into the definition of illegal abortions, she said, and there are legal obstacles to supplying the pills across state lines.

“There is a lot of energy going into figuring out a workaround right now, but it’s too soon to call,” Mello said.

Recommended Protections

So how can clinicians and health-care facilities protect their patients and themselves?

When counseling patients of childbearing age about reproductive health issues, clinicians should caution their patients about putting too much medical data online and refer them to expert organizations that will help them minimize their digital footprint.

When documenting reproductive health encounters, the authors said, clinicians should ask themselves: “What information needs to be in the medical record to assure safe, good-quality care, buttress our claim for reimbursement, or comply with clear legal directives?” For example, does information about why a patient may have experienced a miscarriage need to be recorded?

Patients and clinicians should be aware that email and texting may be seen by others, so conversations among staff about reproductive health issues may best be conducted by phone or in person.

Finally, if abortion-related patient information is sought by state law enforcement officials, a facility’s attorney should be consulted about asserting physician-patient privilege and determining whether the disclosure is mandated by law.

This essay originally appeared in Korean on June 16 in Sindonga (New East Asia), Korea’s oldest monthly magazine (established 1931), as the third in a monthly column, "Shin’s Reflections on Korea." Translated by Raymond Ha. A PDF version of this essay is also available to download.

Interestingly enough, both sides interpret this as a question of representation. Those who emphasize meritocracy argue that allocating seats to account for the representation of minorities makes it difficult to achieve results. On the other side, those who criticize the lack of diversity support a balanced composition in terms of gender and regional background, among other considerations. Such focus on “balance” and “representation” limits the discussion. Let us return to Killoren’s explanation for the astonishing global success of the Korean Wave. The “female gaze” that propelled the Korean Wave was not the outcome of a strict meritocracy, and it did not arise from efforts to achieve balanced representation. It resulted from looking beyond the horizon of male-centered viewpoints to value female perspectives.

A diverse group of individuals brings a diversity of opinions to the table. The true strength of diversity, however, is that it encourages people to think outside the box. When people encounter and evaluate different viewpoints and alternatives, this fosters creative, original thinking that drives innovation. Organizations and institutions can thus enhance their overall performance by building a diverse workforce.

Ensuring the equitable representation of minorities and protecting their rights is, of course, a fundamental democratic value and a vital policy objective. Nevertheless, it is now time to approach the issue of diversity not only in terms of balanced representation, but also as a question of effectiveness and innovation. It is especially important to ensure diversity within entities like the Cabinet, which requires a high level of intellectual capacity and judgment.

South Korea is a patriarchal, “super-networked” society that emphasizes ethnic homogeneity and purity. High value is placed on common alma maters, shared regional backgrounds, and family ties. There is a dire need to enhance appreciation for the value of diversity. The era of industrialization called for a homogeneous workforce capable of producing uniform, standardized products. In this context, diversity could hamper efficiency. The new era of the Fourth Industrial Revolution, built on creativity and innovation, will increasingly require a rather heterogeneous workforce. Diversity should be recognized as an essential virtue that underlies innovation and success. The future belongs to societies and organizations that understand the true value of diversity.

From Representation to Innovation

In the United States, diversity is one of the most important considerations not only in companies’ hiring decisions, but also when colleges and universities hire professors or admit students. Pursuing diversity was once regarded as a means of empowering minority groups by ensuring that they had access and representation. However, it is now commonly understood that an organization’s capabilities and achievements cannot be maximized without diversity. There are many ways to achieve diversity. A range of factors is considered, including race and ethnicity, age, gender, personal background, and past experiences. It is believed that an organization can overcome groupthink and dismantle a rigid internal culture only if it is composed of diverse individuals. Put differently, innovation and success depend on diversity. Schools, companies, and government entities all have a department that is responsible for improving diversity, and there are many organizations that now have a chief diversity officer (CDO) in addition to a CEO and CFO.

This is a relatively recent phenomenon in American history. As a nation of immigrants, the United States initially pursued assimilation. It only recognized English as the official language. This began to change in the 1960s with the civil rights movement and the emergence of feminism. There were calls to protect and empower minorities and vulnerable groups, and these efforts were also institutionalized. Affirmative action is perhaps the most prominent legacy of this era.

In 1961, President John F. Kennedy signed Executive Order 10925, introducing affirmative action for federal contractors. Affirmative action sought to proactively counter discrimination by providing preferential treatment to minorities that were disadvantaged on the basis of “race, creed, color or national origin.”[4] There was an initial emphasis on addressing racial discrimination, but this later expanded to countering discrimination on the basis of sex or disability. In essence, this is similar to practices that are well known in Korea: creating quotas for individuals of particular backgrounds and giving extra points in hiring evaluations or admissions decisions. These practices were most commonly used by companies and universities.

Affirmative action has always been controversial in the United States, with opponents calling for its repeal. Some argue that it fails to solve the problem by creating reverse discrimination, while others claim that it generates new forms of discrimination. The former is raised primarily among white men, while the latter is voiced by Asian Americans. It was charged that high school students who worked hard to achieve high scores were disadvantaged in university admissions because schools applied racial quotas. Although the Supreme Court ruled the use of racial quotas in university admissions to be unconstitutional in the Bakke decision (1978), critics allege that prominent universities still maintain tacit quotas for African and Hispanic American applicants. This fall, the Supreme Court is expected to hear arguments in a case brought mainly by Asian American individuals against Harvard University and the University of North Carolina for the use of “race-conscious” admissions programs.[5]

California, where I have lived for many years, is among the most progressive states in the United States. In 1996, however, it became the first state to vote against affirmative action in a statewide referendum when it passed Proposition 209. I was an assistant professor at UCLA at the time, and I vividly remember many heated discussions and debates about this topic among professors, students, local residents, and civil society organizations.

The controversy surrounding affirmative action in California has persisted. Proposition 16, which sought to repeal Proposition 209, was defeated by a wide margin in November 2020. Even in the United States, there is a fraught conversation about pursuing diversity as a means of achieving equitable minority representation. On the other hand, there is a growing recognition that diversity is essential for organizations to innovate and succeed.

Diversity = Innovation

When I write a course syllabus, I include two components in addition to lecture topics, assignments, and grading policies. First, I pledge to observe the Honor Code, which has a long tradition at Stanford. Under the Honor Code, faculty members do not proctor exams. Second, I vow to “respect diversity.” As a professor, I pledge “my intent that students from all diverse backgrounds, perspectives, and situations be well served by this course,” and I affirm that “the diversity that students bring to this class be viewed as a resource, strength and benefit.” I emphasize diversity as an essential element that enhances students’ learning experience. Accordingly, I “present materials and activities that are respectful of diversity,” which includes “gender, sexuality, disability, age, socioeconomic status, ethnicity, race, religion, political affiliation, culture, and so on.” Faculty members are encouraged to include such language on diversity in their syllabi, although it is not a requirement. Nevertheless, this practice is becoming increasingly widespread among faculty members.

Major U.S. companies such as Google and Microsoft have appointed chief diversity officers (CDOs) and strive to attract employees of diverse races, socioeconomic backgrounds, and gender identities. Diversity tends to be based on inherent components (e.g., sex and race), but it can also be expanded through acquired components, such as studying abroad and gaining other life experiences. These companies seek various ways to improve diversity. They believe that diversity enhances productivity and allows the company to better respond to changes in the external environment. Melonie Parker, Google’s CDO, describes her mission as making “Google more reflective of the world around us.”[6] There is a firm conviction that creativity and innovation arise when individuals with diverse backgrounds and experiences exchange new ideas and perspectives.

“Diversity = Innovation” is not just an article of faith. In the United States, researchers have accumulated a considerable amount of empirical evidence in support of this maxim across a variety of disciplines. Scott E. Page, a professor of complex systems at the University of Michigan, describes in great detail in The Difference (2007) how diversity leads to innovation. According to Page, having a diverse team enables cognitive diversity, which is critical to problem solving. When faced with difficult tasks, cognitive diversity allows the team to perform more capably than the sum of its parts.

In “How Diversity Makes Us Smarter,” Katherine Phillips, the late professor of business management at Columbia University, stresses that diversity makes teams more effective at completing tasks. In diverse teams, individuals are able to consider and evaluate alternatives and novel points of view.[7] If an organization consists only of people with similar educational backgrounds who think in similar ways, it is unlikely that innovative or unique ideas will ever emerge.

At Stanford’s Hasso Plattner Institute of Design, or “the d.school,” which is well known in Korea, diversity is understood as “radical collaboration.” Individuals with different perspectives and experiences collaborate in the classroom and when completing assignments. For instance, a computer science major will work together with a student majoring in the humanities. A prominent example of this way of thought is on display at Stanford’s Institute of Human-Centered Artificial Intelligence, where one co-director has a background in computer science, and the other in philosophy.

According to a 2007 survey by the Society for Human Resource Management, 91% of companies responded that “enhancing the ability of people from different backgrounds to work effectively together” was an “extremely important” outcome of effective diversity management.[8] Catalyst, widely known for its research on the role of women in the workplace, also reported that companies with more women in high-level management positions tend to have transparent management practices and become more profitable through the pursuit of creative business strategies. A 2018 analysis of 1,700 companies by the Boston Consulting Group found that companies with “above-average diversity on their management teams. . . reported innovation revenue that was 19 percentage points higher than that of companies with below-average leadership diversity.”[9]

It is none other than Silicon Valley, the global leader in technological innovation, that best illustrates the relationship between diversity and innovation.

Technology as “a Manifestation of a Culture”

“An iPhone is not a product. It’s a manifestation of a culture.”[10] This statement about the iPhone also perfectly encapsulates the ethos of Silicon Valley as a whole. In April 2015, Prime Minister Shinzo Abe of Japan visited Stanford and hosted a discussion on technological innovation with the CEOs of major U.S. tech companies, including Apple, Google, Yahoo, Twitter, and Microsoft. I was also there and I noticed something fascinating about the discussion. While Prime Minister Abe focused on the technological aspects of innovation, the leaders of Silicon Valley all emphasized its cultural aspects. Without exception, they began from the premise that innovation was rooted in culture, not technology. At the core of that culture is cultural diversity.

It has already been over 20 years since I joined Stanford and became a resident of the Bay Area. Having grown up in Korea, where I was taught to be proud of the homogeneity and unity of the Korean people, what struck me most about living here is a way of thinking that places great value on cultural diversity. Simply put, Silicon Valley was not built only by white men. Talented individuals of diverse backgrounds came together, competing and cooperating in their endeavors as they created today’s technological landscape. Immigrants laid the foundations for many of the companies that were launched in Silicon Valley, including Intel, Yahoo, Tesla, Google, and Twitter. The cultural diversity that permeates this region can be felt not only through these companies, but also in its schools, shops, and restaurants.

When people of diverse backgrounds and experiences come together, they create original ideas and put forth new perspectives. In turn, this catalyzes technological innovation. This ethos is deeply ingrained in Silicon Valley’s business culture. One often hears that “Silicon Valley is 90% culture and 10% technology.” This is in exactly the same vein as the above quote about the iPhone as “a manifestation of a culture.”

Some in Korea may respond that the United States is unique in its status as a nation of immigrants. Israel offers an illustrative counterexample. Although it has a strong national identity like Korea, it has relied on a diverse talent pool to build a “creative economy.” It created an ecosystem to support entrepreneurship in the technology sector, thereby overcoming tremendous economic difficulties to become a “startup nation” that has attracted global attention. In this process, 850,000 immigrants who arrived after the collapse of the Soviet Union played an important role. Over 40% of these immigrants were professors, scientists, and engineers with ample research experience. Israel proactively incorporated these individuals into its economy and society. It is common to hear multiple languages spoken on the streets of Tel Aviv. The startup nation did not arise out of coincidence.

In the era of industrialization, it was vital to have a workforce capable of making standardized products. Diversity could reduce efficiency. Ernest Gellner, a prominent scholar of nationalism, traced the origins of modern nationalism to the economic needs of industrialization. The mass production of standardized goods necessitated a homogeneous workforce, and the most effective way of creating such a workforce was to cultivate citizens who shared a common national identity. From this perspective, South Korea and Japan were able to achieve rapid economic development through industrialization because they were able to easily form a homogeneous workforce. A strong sense of ethnic homogeneity played a critical role in this process.

In the era of the Fourth Industrial Revolution, however, a country cannot become a leader if it has a homogeneous workforce. To be a “first mover” and not just a “fast follower,” having a heterogeneous workforce could prove to be consequential. Korea is the exact opposite. Everyone seeks to receive the same education and build the same résumé in a race to the same finish line. A social and corporate culture that values and enforces conformity surely cannot be a wellspring of creativity and innovation. Given such a culture, companies, organizations, and institutions will inevitably settle for drifting along, simply going through the motions. Korean society must find a new source of vitality. Enhancing diversity to stimulate innovation and change could be the answer.

Beyond Homogeneity and Assimilation

The most conspicuous examples in Korea of a lack of diversity, and the harmful consequences resulting from it, are the culture of Korean academia and the country’s policy toward immigrants.

According to a 2014 analysis, 84.1% of faculty at Seoul National University (SNU) consist of the school’s own alumni. The figures for Yonsei University and Korea University are 73.9% and 58.6%, respectively.[11] A report on hiring practices for full-time faculty members at SNU between 2012 and 2019 reveals that of 93 departments, 28 departments consist entirely of faculty who are SNU alumni. For another 40 departments, the proportion of SNU alumni exceeds 80%. Many Koreans assume that I received my PhD from Stanford, and they are genuinely surprised when I tell them otherwise. This applies to faculty at Stanford as a whole. There are only a handful of professors who have received their degrees on “The Farm.” When I applied for faculty positions, I followed prevailing norms in the United States by excluding the university that I had graduated from.

In this sense, the United States is the complete opposite of Korea. There is strong opposition to so-called academic inbreeding, and schools strictly limit the hiring of alumni. Unless there are special reasons to do so, alumni are typically not appointed as faculty members. If they are considered as candidates, alumni are subject to a more rigorous review during the hiring process. In most universities, the proportion of alumni among faculty does not exceed 20%. It is uncommon to see professors return to their alma mater. Those who do typically return after many years, having gained broad recognition in their field while teaching and researching at other schools. The kind of homogeneity and academic inbreeding that is common in Korea is unthinkable in the United States.

It is widely accepted in the United States that the harms of academic inbreeding far outweigh any potential benefits. There is even a study that finds that alumni have 15% lower research output than other faculty and are 40% less effective at communicating with their colleagues at other institutions.[12] There is now a critical discussion in Korea about the hiring of alumni as faculty, but it is unclear how much has changed in practice. It should be noted that many Korean academics obtain their PhD overseas before returning to their alma mater. Nevertheless, it is questionable just how much creative intellectual activity can take place in a department filled with fellow alumni. A friend who is not an alum of the school at which he teaches once told me that “if I attend, it’s a faculty meeting, and if I don’t, it’s an alumni gathering.”

Another example is the government’s policy of assimilation, which is carried out under the banner of “multiculturalism.” Starting in the 2000s, a significant number of migrant workers and female “marriage migrants” began to arrive from China, Southeast Asia, and South Asia as South Korea was faced with a plummeting birth rate, an aging population, and a shrinking labor force.[13] In response, the Roh Moo-Hyun administration (2003–08) adopted “multiculturalism” as a major policy initiative. It is remarkable that a country such as South Korea, which built its national identity on ethnic homogeneity, accepted the idea of multiculturalism. Unfortunately, however, the policy has been implemented in a way that departs from the true meaning of multiculturalism. Most government programs and policies are geared toward the assimilation of foreigners into Korean culture.

There are few, if any, efforts to improve the understanding of foreign cultures among Koreans. For instance, there are programs to teach the Korean language and Korean history to a marriage migrant from Vietnam. There are even classes that teach her how to make kimchi. On the contrary, insufficient attention is given to enabling her Korean husband and in-laws to understand and respect Vietnam’s history and culture.

Furthermore, Korea’s policy of multiculturalism predominantly focuses on marriage migrants and low-skilled migrant workers. There is a prevailing tendency to address migrants as a socially vulnerable group that needs to be protected. Migrants who receive “protection” and “benefits” from the government become part of an invisible hierarchy that places them below Korean citizens. This has become ingrained to an extent such that “multiculturalism” has become synonymous with “helping the poor” in the minds of many Koreans. Because such policies give rise to an implicit hierarchy between natives and migrants, they are often not well received by the migrant population. These policies can also instigate anti-migrant sentiment among the Korean public, which creates a conflict between Koreans and those belonging to multicultural families.

In a 2018 analysis, the Software Policy and Research Institute projected that Korea would face a deficit of 31,833 workers by 2022 in core sectors of the Fourth Industrial Revolution, including artificial intelligence, big data, cloud computing, and virtual/augmented reality.[14] This is why major Korean conglomerates, including Samsung Electronics and Hyundai Motors, are making a concerted effort to attract foreign talent. From the perspective of foreign workers, however, Korea is not necessarily an appealing destination, given a socioeconomic environment that is still not receptive to diversity. INSEAD ranked Korea 27th out of 134 countries in its 2021 Global Talent Competitiveness Index. In terms of “tolerance of immigrants,” Korea ranked 65th.[15] This is deeply disappointing for a country that now has the 10th largest economy in the world.

Without changes to the socioeconomic environment that immigrants face, it will be nearly impossible for Korea to attract foreign talent. The Ministry of Justice recently announced that it will create a new government agency to oversee immigration issues.[16] However, these institutional measures will not bear fruit until there are efforts to improve public awareness about the importance of ethnic and cultural diversity and how this diversity can spur innovation.

Demolishing Korea’s “Super-Network”

As I noted in Superficial Korea (2017), Korea is a “super-networked” society. According to one analysis, there are at most 3.6 degrees of separation among Koreans. In a country of over 50 million people, it is possible to connect any two individuals by crossing three or four mutual acquaintances. This is precisely what it means to be super-networked. It is no surprise that Koreans rely so heavily on shared regional backgrounds, alumni connections, and family ties. The denser the connections, the more exclusive and insular each of these groups becomes. Put differently, the barrier to entry becomes insurmountable. As the bonds in the in-group become ever stronger based on shared experiences, hostility toward the out-group intensifies. It is difficult to expect these groups to change. A form of exclusive, group-based behavior has thus emerged in an extremely competitive, super-networked society.

For Korea to take a leap forward, it must demolish the walls of its exclusionary super-networks. In its place, Korea must build a new home that opens its doors to talented individuals with diverse backgrounds, perspectives, and experiences. This requires Korea to look at diversity in a new way. Diversity should be understood not just as a means to achieve balanced representation, but even more so as an essential ingredient of innovation and success.

During the election campaign, President Yoon Suk-Yeol’s pledge to abolish the Ministry of Gender Equality and Family became a political football. Ongoing discussions about the role of this ministry should now move beyond the previous question of how to protect women. By enhancing gender diversity, the government could help transform Korean society by unleashing creativity and innovation. Debates and discussions about specific policies should focus on how to achieve this larger goal.

The Moon Jae-In administration failed to innovate because it relied on a super-network of former pro-democracy activists. President Yoon’s Cabinet appointments, which draw heavily from lawyers and former prosecutors, are raising concerns that this administration could repeat its predecessor’s mistakes by relying on a super-network of prosecutors. The Ministry of Justice; Ministry of Unification; Ministry of Land, Infrastructure, and Transport; and Ministry of the Interior and Safety are all led by lawyers who studied in the same university (Seoul National University) and department (Law) as the president. Moreover, the prime minister, presidential chief of staff, and minister of economy and finance (who also serves as the deputy prime minister for the economy) are all civil servants who built their careers in the Ministry of Finance.[17]

In response to criticisms about the lack of diversity among high-level appointments, the Presidential Office insisted that it chose the most qualified and experienced individuals. It may be that these individuals are indeed able to work effectively as a team and draw on their skills to quickly achieve significant results in government policy. However, will this be enough for Korea to innovate and forge a path to success in the rapidly changing environment of the Fourth Industrial Revolution? It would be wise to remember that embracing the female gaze enabled the success of the Korean Wave.