Featured Post

Is the new professionalism and ACP's new ethics really just about following guidelines?

The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Friday, June 03, 2016

Politicalization of medical ethics-you have to ask why and by whom

The politicization of medicine is cogently  discussed  by Dr. Thomas Huddle. See here for an abstract of his article.

First, with the publication of the Charter, Professionalism in the New Millennium in 2002 the notion of social justice was injected into the listing of attributes and behaviors that physicians should exhibit to act professionally.Rather than a well reasoned and documented  argument for such action being presented by the authors, we saw a series of gratuitous assertions.

Subsequently a commitment to social justice was declared to be an ethical imperative in the American College of Physicians'  (ACP) ethics manual. Other professional organizations followed suit pledging at least rhetorical support of the inclusion of social justice into their ethical propositions.

 Dr Huddle, who teaches at University of Alabama Medical School at Birmingham, says in part:

1) civic virtues are outside the professional realm, (2) even if civic virtues were professionally obligatory, it is unclear that civic participation is necessary for such virtue, and (3) the profession of medicine ought not to require any particular political stance of its members.

"Advocacy on behalf of societal goals... is inevitably political".

" civil virtues are outside of the professional realm" and " the profession of medicine ought not to require any political stance".

Requiring a commitment to social justice is clearly  political and requires physicians to take a particular political stance and a particular philosophical position..Advocacy for social justice is one feature of the modern liberal or progressive political stance.Such advocacy is not typically part of the conservative political viewpoint or the libertarian ( aka classical liberal) position.

The notion of justice upon which which the country was founded  was that of the justice embodied in the rule of law,i.e. treating everyone equally under the law. The foundational notion of the social justice line of thinking is essentially that treating folks who are unequal equally is unfair and unjust and therefor there must be societal ( i.e governmental)  effort to mitigate inequality by redistributional  and other coercive  efforts of the state.

The physicians who authored the Charter and the ACP's new ethics would appear to be of the progressive persuasion while there are many physicians in the country who are not. A small group of what I have labeled as the "medical progressive elite" have seemingly captured the conversation and are attempting to  profoundly alter traditional medical ethics.To the extent that they and similar minded individuals set the agenda of major medical professional organizations and medical students education they may have succeed. but I wonder how many practicing physicians are even aware of the views that they pretend to be a settled issue.

Why would such an effort be launched and well funded ? Who gains from efforts  to bring about a sea change in traditional medical ethics? The answer to that may be found in the plan that the elite medical progressives later introduced to enable practicing physicians to on  a day by day basis practice social justice.Simple they just had  to follow guidelines .In that way there would be an alleged greater benefit to the collective -although sometimes as the expense of the individual patient-and presto we have a utilitarian form of social justice with the collective and of course third party payers benefiting.Is this the "why"?


Note: An shorter version of this essay had been published previously. I redo it now because sadly a version of social justice seems to be firmly appended to medical ethics,on paper if not in practice and few voices are heard in opposition.I find physicians believing that they should work for the good of the group or the collective or society a very frightening notion one with a slippery slope  as evidenced by what went on in collectivist societies in the last century.

1 comment:

Lisa said...

In the name of social justice, while I paid for the best insurance to make sure I could receive medical treatment, I was back-burnered because of race-based need. Since I am white I have 'too much privilege'. This entitles me to continuous discrimination in the workplace, and now also in healthcare. Since it is simultaneously 'not happening' while I also 'totally deserve it' it logically doesn't even make sense. Mandatory wealth redistribution under our new regime means I had to pay so that non-whites could receive. It used to mostly be church that would take everything from whites to give to blacks, but it was so successful it was rolled-out widescale.

I was urgently in need of medical attention more than two years ago. I lost my money paying premiums and got to watch people airlifted in for treatment of ebola. I decided to compare the listed mortality rates, and I was actually at DOUBLE the risk of death. I have been unable to work, denied SSD so we can give it to foreigners, and am racking up debt while refused healthcare. Unable to travel to safety--if there is any--because I am left weak and untreated for a serious condition which may possibly have caused irreparable damage.

I still am supportive of doctors in general because I think many of them are good doctors who are being harassed by the ABIM--though the way the House of Medicine is messed up--you kind of caused this problem yourselves. Meanwhile I am still alive through what can loosely be labeled crack-house medicine, and of course heardy robust genes. That got me lashed out against as a White Supremacist by one of the doctors helping to do her part to exterminate me, because I have had the audacity NOT to drop dead when there is a really determined effort to snuff me out.

For this reason, I refuse to die. I will live and I will remember names. Jesus can do the forgiving, that's not my job. Some of you doctors have a special place in hell, and it is my hope and prayer that I can at the very least help you to that prison bitch status that is your just deserts.

Social Justice = exterminating white people: cannot even count how many times I have watched Jews howl with laughter at the intentional infliction of bodily harm on white people, that knee-slapping good time, while screeching, "This is stand-up comedy" I don't find it very amusing, and the white doctors who join in are twice as disgraceful. Your day is coming, and it will not be pretty.