1. I will give no deadly medicine to anyone if asked, nor suggest any such counsel.
– Hippocrates, approx. 400 B.C.
2. Why I hope to die at 75.
– Ezekiel Emanuel, 2014
Choose one of the above. But if you don’t choose, number two will be chosen for you – in both senses of that term. Number two will become the default option.
Perhaps you didn’t notice. But on August 18, 2008, medicine ceased to be a profession, and became merely a business to be regulated by the state. The California Supreme Court ruled that physicians have no right to refuse to perform a procedure they consider unethical.
The case involved two Christian physicians, one a woman, who practiced obstetrics and gynecology at a women’s clinic. A lesbian couple asked for artificial insemination using donor sperm. The couple already had three children by this means, with the help of doctors elsewhere.
The doctors told the women that they were uncomfortable with this procedure. The women claim that the refusal was based on their being lesbians. But the doctors state that they would decline to do the procedure on any unmarried woman.
The women could have gone back to the doctors who performed the prior inseminations. But the clinic now had the contract with the women’s insurance plan. Thus in addition to the alleged anti-lesbian discrimination, the women also complained of increased cost.
In the end, the women did have the procedure performed by another doctor. The case reached the California Supreme Court, which ruled that physicians have no right to refuse service, because they are “running a business.”
Silly me! I thought medicine was a profession, even a calling. That’s what I was taught in medical school, decades ago. That’s what my classmates and I believed as we took the Hippocratic Oath when we graduated.
But now, only one of the 141 American medical schools still administers the Hippocratic Oath. Oddly, that one is the State University of New York Upstate Medical School in Syracuse, and not a medical school at a religious-based university like Brandeis, Loma Linda, or Saint Louis (where my father went to medical school).
All the other schools use a variety of oaths, of which only one rejects abortion, only four forbid having sex with patients, and only 25 reject euthanasia – all of which are forbidden by the Hippocratic Oath. I cannot find words to express my sadness at the decline of my profession – my calling.
At one medical school, the Hippocratic Oath was replaced when students laughed during the ceremony. They found the “archaic” language amusing. Apparently they had never read Shakespeare, whose language is much older, not to mention the King James Bible. Ignorant high-school graduates are depressing. Ignorant medical-school graduates are frightening.
The classic translation of the Oath that I took was made by Dr. Francis Adams, who died in 1861. The “archaic” language that the students laughed at is more modern than our Declaration of Independence, our Constitution, and our Bill of Rights. Will they too become a source of laughter? Oh wait, they already have. Recall that then-Speaker Pelosi was asked where the Constitution empowers the federal government to control everyone’s health care, and she replied, “Are you serious?” – while giggling.
If you ever doubt that we are in deep trouble, recall the medical students’ laughter and Speaker Pelosi’s giggle.
Some of the oaths are made up by the students themselves. In effect, they are swearing to follow their own ideas – how hard is that? But when I graduated, we swore to uphold the 2400-year-old principles of a great profession – which I found difficult to follow, though I tried. Indeed things have changed.
I believe the chief cause of the Hippocratic Oath’s demise is its ban on abortion. But in the Oath, euthanasia and abortion are next to each other. Discarding one prohibition weakened the other. If all human life isn’t sacred, none is. Intermediate positions are weak and are being overrun one by one. Who is worthy to live becomes just a matter of opinion – and the only opinion that matters is the government’s.
Once we throw away the rulebook, the referee becomes a dictator.
If you doubt this, note that the Japanese finance minister recently declared that old people should “hurry up and die.” An advisor to the British government stated that elderly patients in mental decline have a “duty to die.” And Ezekiel Emanuel, MD, PhD, formerly advisor to President Obama, declares that we should all die at age 75.
Exactly how does this differ from the Nazis declaring the disabled to be “life unworthy of life” and “useless eaters” who were a “drain on the Fatherland”? I see no difference – except that the Nazis were more efficient in carrying out their program. But with practice, we too will become more efficient.
So the Hippocratic Oath is out the window. Yes, that Oath, the Oath that I and most medical graduates took a generation ago. It required me to follow that form of treatment which in my judgment was in the best interest of the patient. It required me to keep secret whatever I heard in the course of my practice, or even outside of it.
But as young people would say, that’s so yesterday.
Now, doctors will have to do as they are told, even if they believe it to be unethical. At least for now, they can still complain. But how long before complaining will be ruled “hate speech,” and their servitude will be complete?
The two physicians did not refuse to accept the lesbian couple as patients. They did not refuse to give emergency care. They did not refuse to give treatment to relieve pain or alleviate a disease. The doctors refused to perform a specific elective procedure they believed was morally objectionable.
The women could have gone to other doctors willing to perform the insemination − and did so. The case was not about their “right” to be inseminated. The case was about the doctors’ right to be independent professionals, exercising their best judgment, rather than servants, subject to punishment if they didn’t follow orders.
The Bill of Rights lists rights of the individual to be free from government coercion. Freedom of speech guarantees my right to post columns on my website, but it does not force anyone to read them. The “right” of the couple to be inseminated, on the contrary, means that the government has the power to force the physicians to perform the procedure.
“Right” now has been twisted to mean that the individual can be coerced by the government. When “right” comes to mean coercion, rather than freedom from coercion, it is not a hopeful sign for the survival of liberty. If we don’t even know the meaning of “rights,” how can we keep them?
And now what? Observant Catholic, Evangelical, and Jewish medical students may have to participate in abortions. Religious doctors of all denominations may have to participate in assisted suicide, euthanasia, selective destruction of female fetuses, cloning, infanticide of “defective” babies, slow starvation and dehydration of the disabled and the elderly − or whatever.
What happens when Social Security, Medicare, and Medicaid costs rise even higher, as they are sure to do with massive immigration? There will be severe pressure to deny expensive care to the elderly, or the severely disabled of any age.
We used to look down on physicians who acted like business people. Now the California Supreme Court has ruled that physicians are merely “running a business,” and they will be regulated as such by the government. If you can’t see that our civilization is in decline, perhaps you should have you eyes checked. That is, if you can afford it – Medicare doesn’t cover refraction or eyeglasses.
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