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Politics and the place of doctors – Part 1

Posted by theonlinecitizen on January 1, 2008

By Jeffrey Leow

Not too long ago, the Sydney Morning Herald reported, amid the seemingly rising anti-Singapore sentiments in Australia, the following with regard to the Burma saga:

 

Singapore‘s hospitals also keep its leaders alive – the 74-year-old strongman Than Shwe has been receiving treatment for intestinal cancer in a government hospital in Singapore, in a ward heavily protected by Singapore security.”

 

A simplistic and idealistic view would perhaps be the following:

 

Now if I happen to be the attending physician, will I deny treatment, in the name of politics? “You should die for your evil doings on the 54,000 burmese people” (proceeds to inject “medication” which is actually merely 10cc saline into his dorsal IV cannula, prescribes 2 tablets of tic-tac-s thrice a day.)

 

I wish to bring up the point that in an ideal world, the health care profession is in no place to deny treatment because this is directly contradictory to the instincts and ethics of our age-old profession. However, that does not stop healthcare professionals from having political slants or viewpoints about matters.

 

Some express it via the Internet through blogs ( Dr Huang, AngryDoc, Dr Oz Bloke), some decide to serve in political parties and have their say. Intentions aside, there are avenues available and the ethics of the profession should all the more prompt a doctor into politics, as a doctor once said [something to the effect of]:

 

“It is akin to looking after my patients. Serving the general community is like serving the medical community which I used to and continue doing so, just on a public and community level, addressing a variety of issues, not just medical.”

 

Now this brings us to the question, “Do doctors really need to be actively involved in politics to make a substantial difference to the community?” The answer might be a resounding no.

 

“The medical profession is treated by politicians as a negligible quantity, but this is partly because it does not know, and partly because it does not care to use, its power. What doctors could do if they chose to use the legitimate influence which they have, is shown by an incident in a recent electoral campaign in America….” (See here for more.)

 

That was more than 100 years ago in 1901. We read that 38 years on, things have ALREADY changed so much. Here is an extract from a Time magazine article in 1939 :

 

“Fortnight ago every one of the members of the New York County Medical Society* received a ballot stating : “If under Proposition Four of [Senator Wagner’s] . . . National Health Program, money is made available to New York State to provide care for the low-income earning groups, do you favor the delivery of this medical care by means of compulsory health insurance?”

 

Many of the doctors invited found the advances of Publisher Gannett crude and stayed home. And the majority of Manhattan physicians, congenitally afraid of politics, and with little understanding [of] the practical meaning of planned medicine or the motives of those for and against it, went about their business, blissfully ignorant of the whole affair.

 

In the Singapore context, perhaps we could ponder on two questions:

 

Question 1: Is there inertia among the healthcare professionals in Singapore with regard to politics? Why do you think this is so?

 

Question 2: Do you think there is a great divide between what is being implemented by the Health Ministry and what the doctors actually want best for the patient? If so, why? What do you hope can be implemented?

 

These are the questions posed. Firstly, I direct them to the physician bloggers amongst you. Next, I would invite the other bloggers to give their 2 cents.

 

About the author: Jeffrey is an international medical student at Monash University, Australia. Visit Jeffrey’s personal blog here.

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12 Responses to “Politics and the place of doctors – Part 1”

  1. pissed said

    PM Lee speech today is awesoms. What pisses me off is that the class C wards will have means testing in 2008, to save the government money and ensure help goes to the most needy people. Meanwhile, the ministers who are coming up with this scheme, with their million dollar pay, will continue to enjoy pensions and free medical benefits. I am not sure why these privileges are not taken away from the ministers, but the middle class continue to be squeezed….

  2. JFK said

    If you were sick and needed urgent medical help , I dont think it is right to deny anyone.

    However if we weigh the outcome of having the ability to AFFORD urgent medical attention, then this is a red flag.

  3. George said

    From my observation, it takes a certain makeup to be a doctor. Doctors are by and large, apolitical, highly skilled ‘technicians’- for which a lot of us are indeed very thankful for.

    Because of the very nature of their profession and training, the difficulty for them is when they can/should make that take a back seat to another/a more fundamental issue.

    Is it right or moral to treat someone who is well known to be harming others? Is the doctor not an accomplice when his treatment directly enables that someone to continue to do harm to others?

    The right of a doctor NOT to treat such a person is a moral one. By ‘enabling’ the person, he (the doctor)is morally responsible for what that person can/will do to others.

  4. Charles said

    Question 1: Is there inertia among the healthcare professionals in Singapore with regard to politics? Why do you think this is so?

    My ans: Yes, there is inertia among the healthcare professionals in Singapore with regards to politics. This is not surprising since the government has managed to depoliticized the various sectors within the Singapore society. If it can and has managed to muzzle the voice of the law society, surely, it has instilled the same discipline to the medical professionals.

    Question 2: Do you think there is a great divide between what is being implemented by the Health Ministry and what the doctors actually want best for the patient? If so, why? What do you hope can be implemented?

    Ans: Not so much about doctores but healthcare in Singapore should be made more affordable to the public, perhaps even free, at least to those who cannot afford it. This is in light of the obscene salaries our ministers are getting.

  5. Anonymous said

    Wow This Sure is Against Doctor’s opinion and Australia.I wonder Why? Hmmm some of our MP are doctors. What is the real intention of this blog post? And you are purposely putting moral issues that of Burma and expanding it.What motivates you? Well This will be that perfect example of Biased reporting as put fro by a certain editor of someplace:P. OR I’m just spouting nonsense,must be the latter.

  6. Jeff said

    Charles, i certainly agree with what you say. Sometimes i really wonder if what we think really matter. When it comes down to the crunch, will we even get to vote? (i live in clementi and my parents never vote; i think its a walkover all the time). And, if we vote, will we, amid all these issues, still vote someone else?

    Anon (Jan 4, 1.57am), actually i put up the Burma thing is just to kick off what i was about to say: “the point that in an ideal world, the health care profession is in no place to deny treatment because this is directly contradictory to the instincts and ethics of our age-old profession. However, that does not stop healthcare professionals from having political slants or viewpoints about matters.” i hope it wasn’t too abrupt. this should be contended for/agsinst, but it was done on purpose to spark some lively comment-exchange.

    And this brings me to answer George’s comments:

    great questions. however i doubt i can answer them, maybe we should leave it to the lawyers. but the 4 main tenets of biomedical ethics are clear: beneficence (do good), non-maleficence (first do no harm), equity/justice, and autonomy. these are ideals. i guess what i’m saying is that its not always easy (at least to me) to fulfill all of them. and this was told to me by a tutor who’s a medical lawyer. we were advised that as long as we can justify our actions, no one can actually sue you.

    there’s still much to learn..

  7. MJ said

    Pissed, I believe that the means testing for class C wards was implemented to prevent the abuse of the healthcare system. This measure is also to free up the space in class C for those who truly need them. Ideally, this system would ensure that every citizen would have affordable healthcare (which would be scaled according to what their income is) and yet provide welfare to the needy, which is a good balance to have in society.

  8. George said

    Jeff,
    The 4 tenets are right, noble principles – when considered without a real world context.

    They are first principles of decent, moral people (doctors?)But they cannot apply in a context when abiding by/upholding them would result in deprivation of/in clear cruel violation of these same ideals for others, in the context of Burma, millions of other people.

    Are doctors, by going by the letter without considering the spirit of their oaths, dishonouring their own code and themselves?

    In the real world, taking refuge behind the H.O. in the context of helping a dictator perpetuate his misdeeds is an unconscionable cop-out.

  9. Jeff said

    George, point taken. However i think perhaps you misunderstand that i am trying to justify for the actions of Singapore or whichever doctor has rendered treatment. That is NOT the intention of the introduction (using Burma) as i have mentioned in the same comment (no.6).

    But i take it to you if it were so easy, you should try being a doctor someday.

  10. George said

    Yes Jeff, I can imagine the difficulties you allude to. But unless individual doctors take a stand, and like-minded ones come together to foster/promote a cause they truly believe in, the status quo will remain.The path of least resistance is usually the more comfortable one to take. But, I do appreciate why doctors here not among those taking such initiatives. The heavy workload is one I can think off. I have doctor friends and I really appreciate their work dedication.

    But at the end someone must do something. Perhaps, a majority of doctors are in inertia because they are very comfortable, very work oriented, very indiffernt to what’s happening outside their professional job scope to change.

    That’s my lament.

  11. […] i have also written an article named “Politics and the place of doctors”, and part 1 is published at a Singaporean current affairs blog, The Online Citizen. I joined it a while back […]

  12. […] and the place of doctors (part 1) 10 03 2008 A while ago, i wrote this article for The Online Citizen, a socio-political blog focusing on Singapore current affairs and politics. They did not publish my […]

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