MEDICAL ETHICS UNDER CAPITALISM

Grey River Argus, 15 January 1941, Page 8

MEDICAL ETHICS UNDER CAPITALISM

By

G. Bushnell,

B.S.

WE PRINT BELOW an article from the September issue of the quarterly journal, “Medicine To-clay and To-morrow, a PY which has been forwarded to us by a medical The matters which the writer discusses are of special terest a in New Zealand, in view of the imminent change-over from a Capitalist to a Socialist system of medical service. Ed.

WHAT IS THE POSITION of medical ethics to-day? What have the handbooks on medical ethics for the hist ten to twenty years to tell us? Their introduction is generally philosophical and their advice is sometimes good and sometimes not. so good.

One lolls us that “a medical practitioner’s Hrst thoughts as he undertakes his new duties will be tor his familv. for his parish and his country and for all our people ... to this end he should enrol himself at once as a member of the 8.M.A.” Anol her recommends “the necessity ol joining one of the Defence Unions”; several include remarks on starting practice, choice of n house, calling on colleagues, success in practice, increasing one's practice, medical secrecy and etiquette, implied contractual relations of doctor and patient, fee sharing, canvassing, covering, advertising, salaries, embalming, statutory medico-legal obligations, granting of certificates, etc., which are to be our guide to our (commercial) code of conduct, to our patients.

Again, we see that our present medical ethics permit the victimisation of a doctor who accepts a contract practice at a too low salary according to arbitrary professional scales, and in recent years a mem-

her of the public medical service could be, and has been, dismissed for putting into practice or endeavouring to carry out what his medical school has taught him to be his duty. Must Doctors be Quacks ? We leanr that a recent President of the B.M.A. invited a former colleague to send him some observations for ihis address dealing with the relationship of the medical profession and the public, but such observations were discreetly omitted, being based on socialist ethics and drawn up in conjunction with a Director of a Medical Research Institute and other workers. They conflicted, of course, with capitlised commercial ethics and morality.

Indeed it has been often said that a doctor MUST be in part a quack in order to maintain his status; that is, he must imply that he can do MORE than he can do and knows MORE than he does know, and in fact is NOT an honest exponent of what

medical science CAN OR CANNOT do in the patients’ interests.

Medical ethics is only a branch ° f the science of ethics and provides the moral obligations which apply to tne conduct of medical practice. Ethical science defines man’s moral duty to the community as the “greatest possible good to the greatest number ot persons,” including oneself. “Soviet Communism,” by S. and B. Webb, contains 104 pages on ethics ana, when discussing the cult of science in the U.S.S.R., says that the discovery of truth by ITSELF is not enough for the salvation of man, but that a “conception of right and wrong must bo embodied in man s lite, in other words a “conscience” which recognises universal individual indebtedness. This is in contrast with the morality of capitalist competitive society in which our code of medical ethics has evolved.

Our capitalist society’s main political feature is the private ownership of the means of production (including that of health and frequently of life and death), and this is used by the owners who are in part the medical and allied professions, certain, commercial interests and certain vested interests, under the incentive of making profit. A second feature is man’s increasing knowledge of. and command over, nature, which if medical science were fully applied would revolutionise and raise the general standard of health. A third feature is the political system and a fourth the religion or faith of society.

Socialist philosophy involves the principle of universal indebtedness, of the individual to the community, of nation to nation, of race to race, and vice versa. Socialism must be sincere and honest and always hold to its ideals, or its fundamental ethical principle is endangered and its name may become a smokescreen for immorality. This is also the spirit of the true Christian religion.

Exponent of Truth In a socialist society the eth'cs of doctors are merged in those of alt good citizens. He ‘s a medical worker for the benefit of society (and himself thereby) and has no special ethics. He is equal to all others once the economic barrier is removed. He is the trusted exponent of medical science and truth; he is not a quack; he speaks the truth openly in the best interests of his patients. Thus he can explain openly and honestly whether his treatment is a specific and certain cure or only remedial and helpful to natural recovery. Such honesty would raise the medical and ethical status of his profession generally as being the trustworthy leader of his technical sphere.

And what, a field is open in the socialist, conception of health, perhaps the greatest one in community ethics! It demands (a) the fullest measures for the creation of positive health and the prevention and treatment of diseases; (b) the fullest cooperation of the individual and of the community, and vice versa, and each must vigilantly guard its interests; and (c) these mutual obligations to be met by universal and' constant positive instruction in health, and propaganda as to how to get it. The surest way to fight disease successfully is for the creed of socialism to win through.

Professor Limonosov in his quiet unobtrusive way was proud of the progress being made in his country. He did his part, working in a clinic and spending long hours with medical students so that the Soviet Union might have more and better doctors. for physicians the revolution was a boon, he said. “Now medicine is a science. We treat those who need care and the government pays us. Before, it was a business. If the patient had the money to buy, we sold him our services. If he had no money, he went without —just like shoes or theatre tickets. Disgusting!!” (Comrades and Citizens, by Seema Ryniin Allan.