A new oath for doctors: the customer is always right
A storm erupted not long ago when a Columbia University psychiatrist wrote that "My profession has been hijacked. I cannot do my job, my patients are suffering, and I am fed up." She was upset with the stringent political correctness in her profession, which dictated that she avoid being judgmental of her patients’ sexual practices. When they experienced problems due to their promiscuous behavior, she could only repeat, "Make sure you’re protected." Today, medical professions on both sides of the Atlantic are hardening this political correctness into an official code of conduct.
Canadian doctors are starting to feel the heat in the nation’s largest province, where the College of Physicians and Surgeons of Ontario (CPSO) has introduced a draft policy advising doctors that "there will be times when it may be necessary for physicians to set aside their personal beliefs" in providing services, and that decisions to restrict their practice "based on moral or religious belief may… constitute professional misconduct". In other words, there may be times when doctors are called upon to violate their conscience for the good of the patient.
What's happening here is a wholesale overhaul of the physician's role in society. |
A strange concept, but it gets stranger still: the CPSO policy also states that doctors "should not express personal judgments about the beliefs, lifestyle, identity, or characteristics" of their patients. Not express "personal judgments" even about a patient’s lifestyle?
It may have always been part of the doctor’s role, but now it’s no longer acceptable for doctors to make us uncomfortable about our actions. We don’t want to hear about the dangers of promiscuous sexual behavior or the benefits of teen abstinence; still less do we want doctors to "preach" about the negative effects women often experience from abortion (or, gasp, about the humanity of the fetus). And least of all do we want doctors discouraging lesbians from artificial insemination, or young people from sex change operations.
Ontario is not alone. The General Medical Council in Britain introduced a similar policy in March. The GMC also says it expects doctors "to be prepared to set aside their personal beliefs where this is necessary in order to provide care".
And while British doctors are not being silenced altogether, they had better speak very carefully: "You must not express to your patients your personal beliefs, including political, religious or moral beliefs, in ways that exploit their vulnerability or that are likely to cause them distress", and "You should not normally discuss your beliefs with patients unless those beliefs are directly relevant to the patient’s care. You must not impose your beliefs on patients, or cause distress by the inappropriate or insensitive expression of religious, political or other beliefs or views."
The GMC’s possible interpretation of terminology like "inappropriate" and "insensitive" should be enough to place any doctor in fear of losing his license if he doesn’t leave his tongue at the door.
What’s happening here is a wholesale overhaul of the physician’s role in society, for familiar reasons: to eliminate any possible criticism of the ideological agenda that has cloaked sexual relationships and settled over the central institutions of marriage and the family.
In the United States, doctors may not be afforded even the dubious "protection" of official codes of conduct like those in Ontario and Britain; they may simply be required to close their eyes and do the deed. This is what the California Supreme Court unanimously ruled this month in a shocking decision, where it found that a California doctor couldn’t refuse to artificially inseminate a lesbian on the basis of religious objections, even though other doctors were available to perform the procedure. The Court said: "Do the rights of religious freedom and free speech, as guaranteed in both the federal and the California Constitutions, exempt a medical clinic’s physicians from complying with the California Unruh Civil Rights Act’s prohibition against discrimination based on a person’s sexual orientation? Our answer is no."
The California Court repeatedly relied in its decision on a 2004 case where it had ordered Catholic Charities to provide their employees with insurance coverage for prescription contraceptives, although this violated their religious beliefs. Catholics are often in the firing line in these debates, because their hierarchy has tenaciously held to its disapproval of artificial contraception and abortion. Although many Catholic doctors and pharmacists do not agree with their Church and many others are willing to compromise Catholic teaching, a growing number in the United States have been "conscientious objectors".
Is this just dogmatic obstinacy? No, it is that the Catholic Church has developed, over the centuries, a coherent view of professional morals and a humane understanding of a physician's role, much like the ancient Hippocratic tradition.
Pope John Paul II viewed medicine "more as a mission than as ordinary work," and even called it "a commitment which, in its nobility, usefulness and ideality, is very close to the priest's vocation". He compared the doctor to a priest!
The Catholic understanding of the physician’s role is a holistic one. Since the body and soul are not viewed as independent but as joined, the doctor is not healing only the body, but also has a certain responsibility to help in the spiritual healing of the patient. Moreover, it is also recognised that actions done by individuals don’t occur in a vacuum but affect society; as a result, the doctor has a responsibility beyond the individual patient, to society and its common good – and beyond that still, like every Christian, to the ultimate Truth that is God himself. It would thus be inconceivable for a doctor to divorce his ethics from his practice of medicine. Here’s how the Pope described the doctor’s calling in 2000:
"You have firsthand experience that in your profession medical care and technical services are not enough, even if provided with exemplary professionalism… The sick must be helped to regain not only their physical health, but also psychological and moral well being. This presupposes that the doctor, in addition to his professional skill, also has an attitude of loving concern inspired by the Gospel image of the Good Samaritan. With every suffering person, the Catholic doctor is called to bear witness to those higher values which have their firmest foundation in faith."
It’s no surprise that the revamped face of the medical profession will be challenging for doctors who want to be consistent with pro-life convictions. But it should ring alarm bells for all doctors whose faith and morals inform their daily working lives. Physicians are now expected to carry out their patients’ wishes without being handicapped by moral hand-wringing. Medical associations seem to believe the time has come to toss the Hippocratic Oath and its "never do harm" into the dustbin of history. In an era of tolerance and individual autonomy, the emerging creed is "the customer is always right."
Lea Singh graduated from Harvard Law School in 2003. She works for a nonprofit organization in Ottawa, Canada.
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