Signature Significance: With Its Orwellian”Guide To To Language, Narrative, And Concepts,” The American Medical Association Has Joined The Ranks Of Leftist Propaganda And Indoctrination Organs. NOW WHAT?

I’m sorry about the rambling headline, but I couldn’t find a short way to summarize just how bad this is.

It is fair to say that we can confidently add the AMA to the ABA and the ACLU as organizations that have decided to abandon their organizational missions to join the ideological assault on the United States, its values, and what our society once agreed upon as democratic and pluralistic priorities. “Advancing Health Equity: A Guide to Language, Narrative and Concepts,” recently approved and released and reading like a high school Junior Marxist Club manifesto, officially injects far Left cant into medical practice, where it does not belong and never has. Doctors are professionals, and as such have a duty to serve the public good using their special skills and knowledge. Being a doctor of medicine, we have learned, imbues one with no special policy expertise, historical perspective of political acumen whatsoever. Consider, just as a sampling, former Senator Bill Frist, Howard Dean, Ben Carson, Rand Paul (most of the time , fortunately retired Virginia Governor Ralph Northam , and, of course, Dr. Fauci.

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Now Featured In The Left’s Attack On Freedom Of Speech: Doctors Censoring Doctors

Gee, why would officious authoritarian egomaniacs who think they are God try to do something like that?

The New York Times reports that medical groups are agitating for state boards to discipline physicians spreading “misinformation.” The Federation of State Medical Boards, which represents the groups that license and discipline doctors, recommended last month that states consider suspending or revoking medical licenses of doctors who share false medical claims.

The American Medical Association says spreading misinformation violates the code of ethics that licensed doctors agree to follow. “”Misinformation” is defined by Ethics Alarms as opinions that do not comport with the majority opinion in the profession, with the added qualification that such non-conforming opinions are considered especially worthy of censorship if they offend the political Left, which is where the AMA hangs its metaphorical hat.

The medical association, like its allies, are increasingly unashamed aspiring totalitarians. In this post from April, I wrote about how the AMA issued a statement that it was “deeply disturbed” and “angered” by a recent Journal of the American Medical Association podcast that “questioned the existence of structural racism.” Though JAMA supposedly has editorial independence from the AMA, the association forced JAMA Editor-in-Chief Howard Bauchner to ask for the resignation of podcast host and deputy editor Dr. Edward Livingston because his statements and tweets were “inconsistent with the policies and views of AMA” and “structural racism in health care and our society exists and it is incumbent on all of us to fix it.”

“Structural racism in health care and our society exists and it is incumbent on all of us to fix it” is what the medical profession now calls a “fact.” What the medical profession’s censors are really after is lockstep ideological conformity, using the power to take away the means of contrarians to earn a living as a bludgeon. The Times article would be amusing it it wasn’t so ominous. How can a doctor or a journalist call anything said about the Wuhan virus and its friends “mis-” or “dis-” information, when so many “facts” have been promoted to the public by health experts and then been retracted, reversed, qualified or otherwise contradicted? Dr. Fauci admitted that he deliberately lied to the public about whether masks protected the public from infection. Do you think any state broad will try to take his license away? No, because he’s one of the good doctors, and his misinformation is a means to a just end.

I am pretty certain that any effort to silence medical professionals who espouse controversial opinions will be struck down even by liberal judges, and that the medical groups advocating censorship know it. What they are really trying to accomplish is prior restraint, intimidating non-conforming doctors into keeping quiet by raising the specter of discipline. It’s the ethical equivalent of extortion.

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The New Fascists Among Us, Part II: The American Medical Association

The tweet above is the smoking gun that proves the attitude toward freedom of thought, opinion and expression in the American Medical Association, a group that most Americans believe is dedicated to the area of expertise of its members: health and medicine. The tell-tale words of the fascist are right there: “harmful podcast and tweet,” because words that challenge the required orthodoxy must not be allowed, and “We are taking steps to ensure this doesn’t happen again,” meaning intimidation, punishment, indoctrination, and censorship. These are the tools of those who fear free speech, and who demand compliance with mandated beliefs.

Once the damning tweet was exposed by, among others, Campus Reform, the American Medical Association took it down. There is no reason to do this unless the group realizes that it reveals too much. This tweet, however remains:

That tweet exposes the AMA for what it is: a political ally of an ambitious rights-repressive regime, and an organization that is abusing its perceived authority and the public trust. As with a similar recent proclamation by the CDC, firearms and the Second Amendment are not the proper concern of the AMA. Using the power of a collective professional organization to lobby publicly or privately for restrictions on American rights unrelated to medicine is an abuse of power and a misrepresentation. (The American Bar Association, and many, many others, engage in the same insidious mission creep. It is why I refuse to belong to the ABA.)

In past posts on this topic, I have noted that if my doctor started questioning me about whether there is a firearm in my home (there is), I would a) end the discussion, b) leave the office and c) find a new doctor, just as I would if he quizzed me about how fast I drove or what kind of dog I owned. Physicians are authoritarian by nature, and I suppose it is to be expected that they would gravitate toward totalitarian government and its methods. Expected, I say, but not tolerated or excused, at least by me.

Nobody else should tolerate or excuse it either.

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Morning Ethics Warm-Up, 1/22/2018: The Returns Of A Terrible Idea, A Times Mania, And Lord Acton’s Observation

Morning!

1. Bad Ideas Never Die Dept. The Obama Administration  killed an unethical Bush Administration rule that permitted a wide variety of health care workers to refuse to administer treatments and procedures they found morally repugnant, what the Bush administration termed workers’ “right of conscience.” It was, and is, a terrible idea; The American Medical Association  explained why, in the context of opposing conscience outs for pharmacists, when it declared..

“RESOLVED, That our American Medical Association reaffirm our policies supporting responsibility to the patient as paramount in all situations and the principle of access to medical care for all people (Reaffirm HOD Policy)…

Now that bad idea and the same ethically warped principles are embodied in a new Trump administration policy that provides “religious freedom protections” for doctors, nurses and other health care workers who object to performing procedures like abortions and gender reassignment surgery. This is a sop to the Republican evangelical base. As I wrote here (actually partially quoting myself from an earlier article),

“Conscience clauses” came into being in the wake of the Supreme Court’s Roe v. Wade opinion legalizing abortion. Obviously that right to privacy ruling put Catholic hospitals in a difficult position, so the U.S. Congress passed the Church amendment (named after Sen. Frank Church of Idaho) in 1973. This provision allowed individual health care providers and institutions such as hospitals to refuse to provide abortion and sterilization services, based on moral or religious convictions. Most states adopted their own “conscience clause” laws by 1978. Conscience clauses are a terrible idea that encourage arbitrary professional misconduct. It is an example of how morally-based action can lead to unethical conduct….People who voluntarily undertake the duties of a job should either be prepared to fulfill those duties, take the consequences of not doing so, or not take the job in the first place.That is the ethical duty that one accepts when one agrees to do a job. “

President Trump doesn’t do ethics, and not being a deep thinker,  inconsistencies of principle don’t resister on him. The reason for requiring health care workers to perform their jobs regardless of whether some portion of it clashes with their religious beliefs, moral conviction, political passions or gag reflex is the same whether a doctor objects to abortions, a baker doesn’t approve of gay marriage , a restaurant owner doesn’t want to serve blacks, Hispanics, or Republicans, or an NFL football player is offended by the National Anthem. Society doesn’t work any other way. The religious freedom dodge easily turns into a cover for bigotry, harassment and oppression.

Nothing in the Constitution says that citizens have the right to hurt people when they practice their religion, or defy our laws, or refuse to perform the duties of their professions or employment while still getting paid because they cite religious conscience.

2. I Told You Not To Look Under That Rock! Dept. For some reason, I broke my own rule and skimmed a Paul Krugman column. What was I thinking? What is so digsuting about Krugman is his intellectual dishonesty, as he writes down to his readers using rhetorical tricks, rationalizations and lazy arguments that are 90% political bias and 10% substance at best. Here was the sentence that exploded my head,  stopped me from reading, as Krugman twisted reality to hold Republicans responsible for the government shutdown that was 100% caused by Senate Democrats blocking the continuing resolution to keep the government open:

“Protecting the Dreamers is, by the way, enormously popular, even among Republicans, who oppose deporting them by a huge margin. So it’s not as if the G.O.P. would be giving up a lot.”

So, as long as a provision is popular with its base, a party isn’t “giving up a lot” by supporting it—regardless of whether it is responsible, fair, smart, principled, or in the best interest of the country. Got it, Paul. This is the lowest common denominator theory of democracy being peddled to New York Times reader by its Nobel Prize-winning columnist: legislation by poll. Continue reading

Comment Of The Day: “Comment Of The Day: ‘Comment Of The Day: No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination.’”

I agree, this is getting ridiculous: our colloquy on the ethical and policy complexities of health care policy has created the first Ethics Alarms Comment of the Day on a Comment of the Day on a Comment of the Day. Nonetheless, John Billingsley’s COTD is deserving, as well as interesting and informative. Here it is, his comment on Comment Of The Day: “Comment Of The Day: ‘No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination’”—which in this case you really should read Charlie Green’s post that prompted it.

I have a few comments on specific points.

“New diseases like RLS”

RLS was first described in 1685 and the first detailed clinical description was in 1944 and it was shown in test recordings in 1962. Not really a new disease but a newly publicized disease. Once a medication was developed that was effective at relieving the symptoms, it became profitable for a pharmaceutical company to target it and raise awareness. The company was not being altruistic, but is it wrong to make money by informing someone that there is a way to relieve the distress they are experiencing? If you have ever talked to someone who really has this disorder, you know how much it disrupts their lives. Is it over diagnosed? Possibly, but polysomnography to make a firm diagnosis is expensive and it is a condition where the clinical symptoms are pretty reliable. Probably cheaper to just treat it.

“Because who’s still going to argue with your doc? Especially when he or she gets side benefits from giving in to the latest DTC ads on network news programs?”

I hate DTC ads. I would be good with a spot that just said, do you experience these symptoms (of RLS perhaps)? If you do, tell your doctor. I actually spent quite a bit of time telling patients why they did not need the newest, expensive drug they heard about on TV or in a magazine either because they didn’t meet the criteria for it or because I felt that the cheaper alternatives were just as effective and needed to be tried first. It was a hard sell, particularly when the patient would say, “but my insurance will cover it.” I, and I think most doctors, take being a good steward of the healthcare dollar seriously. In the past there were sometimes substantial “side benefits” from drug companies especially if you used really expensive things like artificial joints or pacemakers. The most I ever received was dinner in a restaurant and things like cheap pens and sticky note pads. These days there are no more cheap ballpoint pens and meals typically are take out from Newks or equivalent in the office during a presentation. Not something I am likely to sell my soul for although I understand the implications. Continue reading

Good-bye and Good Riddance to Bush’s Unethical “Conscience Clause”

The Obama Administration has deep-sixed a controversial Bush Administration rule that permitted a wide variety of health care workers to  refuse to administer treatments they found morally repugnant, what the Bush administration termed workers’ “right of conscience.”

Hospitals and clinics faced a loss of federal funds if they failed to uphold the rule, which itself was ethically repugnant. Kudos, thanks and hosannas to President Obama for getting rid of the Federal variety; some states, regrettably, still have them.

The American Medical Association’s position on the matter, embodied in a resolution passed by its membership, is clear and well-reasoned. Its reasoning applies to health care workers though the specific subject of the resolution was pharmacist conscience clauses.

The AMA’s resolution, “Preserving Patients’ Ability To Have Legally Valid Prescriptions Filled,” states: Continue reading

Doctors and the Deadly Anti-Snitch Reflex

Everybody, or almost everybody, hates to report friends and colleagues for misconduct. This is the anti-snitch reflex, a strongly programmed response from childhood. Telling authorities about the misconduct of others sets off internal alarms that have been installed by parents and peer groups, ensuring that we feel terrible if we “tattletale.” This is betrayal, a violation of loyalty, and most of all, a breach of the Golden Rule: we’d never want anyone to snitch on us.

For professionals, however, this reflex is false, mistaken and even deadly. The duty to report dishonest public employees, crooked cops, unethical lawyers, conflicted accountants, self-dealing business executives, fraudulent researchers and others in the workplace—even if they are colleagues and friends—trumps childhood codes, personal loyalty and general discomfort. There is nothing noble or admirable about allowing innocent people to entrust their life and livelihood with untrustworthy professionals. Nevertheless, a disturbing large proportion of all professionals can’t bring themselves to do the right thing when it comes to the core ethical duty of stopping workplace dishonesty, incompetence or corruption when it involves a colleague.

A recent survey of doctors is not comforting, but it confirms the problem. Continue reading

Credential Deceit From Rand Paul

Rand Paul’s resume dishonesty is not in the same league with Richard Blumenthal claiming Vietnam service that wasn’t. It is closer in unethical heft to Illinois Republican Senate candidate Mark Kirk’s representation of a group military award as in individual one on his resume. Still, if candidates for national office show a penchant for dishonesty and deceit before they are elected, what can we expect later, when they have the keys to the candy store and genuine power? Continue reading

Provocative Links for Ethical Weekend Reading

Here is a diverse selection of five ethics-related posts from cyberspace for your weekend reading pleasure:

  • Christopher Hitchens analyzes, critiques and updates the Ten Commandments—and does an excellent job of all three, here.
  • Finally, a former Bush Justice Department official takes aim at the Republican attacks on the so-called “Al Qaeda Seven,” a despicable moniker apparently invented by Mary Cheney. There really is no debate here: the suggestion that attorneys who previously represented accused terrorists cannot be trusted to work in Justice is legally, ethically and logically ignorant. Still, it is good to have a Republican lawyer say so.