Thursday, August 12, 2010

Haynes on Social Justice and Medical Ethics

Dr. Beth Haynes of the Black Ribbon Project makes some insightful observations about the recent push to teach "social justice" to medical students.

Here's an excerpt from her essay, "Social Justice and Medical Ethics":
Since 2005, the "Initiative to Transform Medical Education" has been working to correct what it views as deficiencies in the current training of phsicians. These include an over-emphasis on the ability to acquire knowledge and problem solve-- to the detriment of "caring." Traditionally, physicians have expected to be autonomous decision-makers -- but that clashes with "increasing be more accountable to various constituencies, including...the public, payers and government." Although physicians are recognized as "prepared to do what they believe is best for individual patients... [t]hey are not...prepared to participate in ethical and political discussions about the allocation of health care resources, which are not limitless."

"Social justice" is a euphemism for economic egalitarianism--and since people do not naturally come by equal wealth, "social justice" requires taking from some to give to others. "Social justice" is in direct conflict with the principles of equality before the law and the right to private property. "Social justice" also requires that a physician NOT advise his patients solely based on what is in the patients own best interest. He must instead somehow "balance" the patient's interests with those of the rest of society.
This collectivist view of "social justice" places doctors at odds with their Hippocratic Oath to do their best for the individual patient. Yet this is what our government attempting to force doctors to do.

Dr. Haynes goes on to explain the proper way to approach medicine -- as a business in which physicians and patients exchange value for value as traders in a free market. In other words, capitalism:
Capitalism is nothing more than individual rights applied to trade. Profits, in medicine as in any economic transaction, are not gained by exploiting patients or customers. Profits are simply the proper reward for successfully offering a value to others which is worth more to them than it costs to produce. In a system of free trade, self-interests are not in conflict -- not even between a physician and a patient. In a direct-pay, fee-for-service relationship, it is in the best long term interest of the physician to offer advice and treatment based on the patient's best interest. And, it is in the best long term interest of the patient to only deal with a physician who does!

We can not defend patients' freedom without also defending the freedom of physicians. We can not protect the doctor-patient relationship without protecting the autonomy of both. Freedom of association and freedom to contract are interrelated principles fundamental to a free republic, to capitalism and to the ethical practice of medicine. "Social justice" requires that the individual be sacrificed to the collective. Such an act is as immoral in medicine as it is anywhere else.
Read the whole thing.

And if you like her work, feel free to contribute to the Black Ribbon Project!