In his reply to my article, Dr. Miguel Faria, a very fine neurosurgeon and writer, states that it is unethical for physicians “to intrusively ask patients about the presence of guns in the home” and that by so doing, physicians become “snitches” against their own patients.

I agree that if the purpose of asking about guns is solely to report the possession of guns, and that if the physician asks “intrusively” and reports without the patient’s permission and in the absence of an imminent threat, it would be wrong.

It is the free mind and individual responsibility, the principles of the Renaissance that have brought us the wonders of modern health care through the free-market capitalist system and through the inventiveness of the free minds it has raised. It seems we are now going to harness the capitalist engine for rationing....

Medical efforts to prolong the lives of individuals afflicted with serious disease or injury began with primitive medicine, perhaps in the Neolithic Period (8000-3000 B.C.), when we discerned from paleontologic evidence a tendency for primitive men and women to care for the sick and wounded in the shelters provided by the deep caves of Europe.

Physicians classify diseases in a variety of ways. Clinical classifications are often made according to either the suddenness of onset or the expected prognosis. Diseases are considered acute if they develop suddenly and have a short clinical course. Chronic diseases, on the other hand, have a slow onset, indolent course, and long duration. They heal slowly if they improve at all.

Since the time of Hippocrates (460-370 B.C.), the Father of Medicine, physicians have traditionally subscribed to doing no harm and prescribed what is in the best interest of their individual patients; in other words, putting their patients first. This concept is known as individual-based ethics.

The new bioethics movement, on the other hand, subscribes to population-based ethics, in which physicians become obligated to make decisions for their patients in concert with what is in the best interest of society or the state.

In this modern era of moral relativism, where one can justify doing nearly anything to anyone, where does one turn for advice on ethics in medicine? Well, right here in the Medical Sentinel, of course, but what about those who have not yet discovered the AAPS?

Dear Editor,

For 30 years, I have fought for the maintenance and restoration of medicine based on the Oath and ethics of Hippocrates.

The justification for the independent practice of medicine is so the physician remains beholden to his patients rather than the government or third-party payer.

Dear Dr. Faria,

Your review of Dr. Leo Alexander’s article, “Medical Science Under Dictatorship,” (“Euthanasia, Medical Science, and the Road to Genocide,” Medical Sentinel 1998;3(3):79-83) which [initially] appeared in The New England Journal of Medicine in 1949 was both stimulating and timely.

The October 2, 1996 issue of the Journal of the American Medical Association (JAMA) was devoted to the theme of managed care. I wonder how many people noticed the title of the painting on the front cover? The painting is by Max Beckmann and is titled “The Sinking of The Titanic.” How fitting!

Rapid transition characterizes the ethical revolution
that appears to be at the doorstep of the 21st century.
Dramatic shifts in technology and
communication potential are anticipated.
Increasingly diverse beliefs and value systems,
which make defining a moral framework difficult,
are the order of the day...
Moral Responsibility in the 21st century:
The Status of Ethics in the Professions,
Alumni course (Philosophy A-122),
Summer Session, 1995, Emory University.

The American Medical Association (AMA) has become a chameleon in its medical ethics. Examples abound. Long after the cancer- and other disease-causing effects of cigarettes were known, the AMA continued to accept money from tobacco, even promoting particular brands.(1) Not until 1981 did the AMA finally sell investments in tobacco stocks under heavy pressure from the news media and anti-tobacco groups of young physicians.

In matters of style, swim with the current;
in matters of principle, stand firm like a rock.
Thomas Jefferson

The Corporate Practice of Medicine

The physician should be contemptuous of money, interested in his work,
self-controlled, and just. Once he is possessed of these basic virtues,
he will have all others at his command as well.
Galen

Can the Medical Profession Survive Flexible Ethics?*

The crisis of American medicine is not tobacco, AIDS, silicone implants, the Gulf War Syndrome, breast or other forms of cancer, physician-assisted suicide, euthanasia, licensure, medical care for the poor, or any other specific medical or ethical issue. The crisis of American medicine is far greater than any one of these problems, indeed it is far greater than all of them combined, because the answers to these problems do not come from within them but from medical ethics.

October 7, 1997

Dear Dr. Annis:

[Regarding "The Transformation of Medical Ethics Through Time" (Medical Sentinel, Vol. 3, # 1-2, 1997) which I gave in part as a speech to the American Society of Dermatology (ASD) last year in San Antonio, Texas]... I admit I was highly critical of the AMA and organized medicine. Unfortunately, it is all true and I wish I did not have to say it. Sadly, I have it all well documented. In fact, most of it is quite detailed in my new book, Medical Warrior: Fighting Corporate Socialized Medicine.

The year is 2025. In an attempt to understand the tragic demise of American medicine in the tradition of Hippocrates, we look back on the course of events around the turn of the century.

Imagine this scenario: you visit your doctor for back pain. Your doctor asks if you have firearms in your home. Then he announces that your family would be better off (especially your children) if you had no guns at all in your house. You leave the doctor's office feeling uneasy, wondering what guns have to do with your backache. Does your doctor care about your family's safety? Or instead, did he use your trust and his authority to advance a political agenda?

In the public debate over legalized euthanasia and physician-assisted suicide, opponents of such measures often invoke the history of medicine in Nazi Germany as an example of the danger in these practices. Those who invoke the "Nazi analogy" suggest that the sanctioning of euthanasia could lead to the wholesale destruction of those whose lives are deemed valueless or burdensome to society.

"When I use a word," Humpty Dumpty said in rather a scornful tone,
"it means just what I choose it to mean --- neither more nor less."
"The question is," said Alice, "whether you can make words
mean so many different things."
Lewis Carroll
Through The Looking Glass

It is no coincidence that the debate over physician-assisted suicide and euthanasia has arisen at a time when managed care has been forced on employees and socialized medicine is being surreptitiously implemented in a piecemeal fashion in our country. There has been increasing talk of a "right to die" and of "death with dignity." Marching close behind those who insist on the "right to die" are those who feel it would be in society's best interest to create a duty to die.

Dear Editor,
One of the basic tenets of American jurisprudence is that an individual is innocent until proven guilty. Lately I have come to realize this no longer applies to physicians.

Recently, I was asked to see a patient in neurologic consultation because he had reportedly displayed "irrational behavior." He had been admitted to the locked psych ward with a diagnosis of psychosis not otherwise specified which translates to "haven't the foggiest idea what's wrong, but I think he's crazy." He was a very pleasant, soft spoken elderly man and after I introduced myself, he sat down and calmly related the following story.

The "shared ethics" espoused by the Tavistock Group reflect a growing collectivist attitude toward medical ethics that is destroying our profession piecemeal (" 'Shared Ethics' for all providers a Quixotic quest," Internal Medicine News, March 1, 1999, p. 5).

The medical ethics of Hippocrates are based on the individual, but groups such as Tavistock embrace a collectivist morality in which individual rights take a back seat to the rights of society, government, and insurers.

March 20, 2002
Dear Mr. Smith,

Changes in health care delivery threaten the values of professionalism and are tempting physicians to reject their commitment to the "primacy of patient welfare." So claims a new group, the Medical Professionalism Project, which is comprised of delegates from three medical organizations --- the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) Foundation, the American Board of Internal Medicine (ABIM) Foundation, and the European Federation of Internal Medicine.

I was struck one particular morning when I heard on the radio on January 15, 1999, that the editor of the Journal of the American Medical Association (JAMA), George D. Lundberg, M.D., had been fired by the AMA for using JAMA for his own political purposes. The chickens had come home to roost, I thought.

JAMA and Medical Journalism

The AMA is joining the gun prohibitionist movement in full force. Led by the long-time speaker of the AMA's House of Delegates, now president-elect of the AMA, organized medicine has joined the gun control movement full steam ahead. This new leader, Richard F. Corlin, M.D., will call for the AMA to increase funding to "study data on firearms injuries" at its June 20 annual meeting.(1)