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Are Physicians to Serve as Moral Gatekeepers?
Are physicians to serve as moral gatekeepers? This question is nicely dissected, particularly in reference to the actions of cosmetic surgeons, in an article in the May 2010 issue of the Virtual Mentor by Jordan Amadio who by now has received his Doctor of Medicine degree from Harvard Medical School. Go to the link and read the article.
Beyond the individual patient for whom the patient’s physician has the fiduciary responsibility to attend and provide the patient the best and most beneficent advice and skills, there looms society. Society is the medium in which the physician must live and flourish along with his or her patient and which can have profound effects on both. And the question arises, when a physician attends the patient should the physician also consider the impact of what he or she is advising or doing upon society both in moral, practical and financial impacts? The latter two has recently been of concern because of the limits of resources and funding.
The moral aspect of what the physician decides and does has also important social implications. The matter of cosmetic surgery is considered in the article as, in many cases, a way the physician is reshaping societal views of what is considered normal, unpleasant, beautiful in personal appearance. And, perhaps, to make the ethical issue worse, physicians have become complicit (and being paid by the patient to be complicit) in resetting the societal views. Other areas of moral impact on society involves contraception, abortion, assisted reproduction, homosexuality, sexual identification as well as other non-reproductive or sexual areas such as gun control, death penalty, relations between physicians and suspected terrorists, end-of-life issues, physician-assisted suicide and organ transplantation, genetic screening and genetic mutation of plants, animals and perhaps humans. The question arises, as to how energetic or activistic should physicians become in their moral views and through their actions.
Moral and political views may merge. A recent example, written up in the national news, of a physician becoming almost a literal gatekeeper was that of a Florida urologist, Jack Cassell, who posted a sign on his office door allegedly reading, "If you voted for Obama ... seek urologic care elsewhere. Changes to your health care begin right now, not in four years."
What are your thoughts about personal gatekeeper roles of physicians in their position as professionals and by their voices and actions regarding moral issues and altering the way society looks at itself and behaves? Or should, ideally, physicians simply attend to the personal needs of their patients, suppressing moral concerns and dismiss worries regarding the effect on society in general? ..Maurice.