]]]]]]]]]]]]]]]]]]]]]        ALLEGIANCE          [[[[[[[[[[[[[[[[[[[[[
                       From the newsletter of             (10/30/1989)
                         Thomas A. Dorman
                        (Freeman 93401DORM)

       The honor and progress of medicine stemmed from the 
Hippocratic ethic, which requires physicians to be accountable 
exclusively to their patients. The latter then upheld it voluntarily 
with their fees and gifts. Today, feigning to protect the public from 
corrupt or inept practitioners, political controls are superseding the 
Hippocratic ethic and private safeguards. Medical licensure is the 
model of such political RprotectionS.
       Imposed by law, political controls void the Hippocratic 
covenant, by making patient-centered ethics impossible. Grievously 
ordinary today, this condition was first advanced by Plato almost 2400 
years ago in The Republic  (c.387-370 B.C.). As posed by him, the 
physician's allegiance is to himself and the other holders of power, 
not to the patient: RThe business of the physician, in the strict 
sense, is not to make a profit but to exercise his power over the 
patient's bodyS. This makes the physician infallible (Rright' means 
the interest of the stronger party and... the ruler in so far as he is 
a ruler, makes no mistakeS) and entitles him to make vital decisions 
for the patient.
       Plato leaves no doubt about the scope of this power: This 
then is the kind of medical and judicial provision for which you will 
legislate in your state. It will provide treatment for those of your 
citizens whose physical and psychological constitution is good; as for 
the others, it will leave the unhealthy to die, and those whose 
psychological constitution is incurably corrupt it will put to death.
       Thus, the Platonic ethic necessarily dissolves the Hippocratic 
tradition. Thomas Szasz discussed several aspects of this process (The 
Theology of Medicine 1977). He notes ... "We witness here a collision 
between the Platonic and Hippocratic medical ethics Q the former 
easily triumphing over the latter....By making the physician the 
definer not only of his own but also of his patient's best interests, 
Plato actually supports a coercive-collectivistic medical ethic rather 
than an autonomous-individualistic one...clearly, the Platonic 
physician is an agent of the state Q and if need be, the adversary of 
his patient."
       Licensure is the physician's Platonic covenant. It makes him
answerable to the government, and ultimately its officers. It compels 
him to preside over the enslavement of his patients by the state, as 
soon as the latter so decides. Since medical care of people proceeds 
according to the demands of the masters, while the patients have 
virtually no say, its ethics now equal those of veterinary medicine.
Licensure and Freedom
       The broader picture of licensure consists of a politically 
generated arrangement by which certain classes of non-poor often 
called RprofessionsS  are subsidized directly by the public. The 
standards for licensure are always among the most technical and 
elaborate. Professional training becomes long, difficult and 
expensive. The number of schools and graduates drops, leading to a 
sharp rise in the professionals' fees and income. But licensure limits 
competition and mobility and causes errors in the allocation of 
professional services. Since it promotes norms and daunts change, 
licensure also must have a negative effect on quality. 
       Eventually  the early edge a group gains by licensure ebbs 
away, as other groups succeed in securing similar privileges. But all 
the drawbacks remain, and the government starts to use licensure for 
its own purposes.
       It is plain that if patients want freedom of choice and lower 
medical prices, they will have to accept the personal responsibility 
required by the market order. This cannot occur unless physicians also 
accept the discipline of the market.
       One of the signers of the Declaration of Independence, Dr. 
Benjamin Rush, clearly discerned the bent for ill of government 
medicine Q as well as its link to licensure Q when he wrote: "Unless 
we put medical freedom into the Constitution, the time will come when 
medicine will organize into an undercover dictatorship...To restrict 
the art of healing to one class of men and deny equal privileges to 
others will constitute the Bastille of medical science. All such laws 
are un-American and despotic... and have no place in a Republic.... 
The Constitution of this Republic should make special provision for 
medical freedom as well as religious freedom." 
       This article is an excerpt from one by George Yossif, M.D., 
Ph.D. printed in AAPS news, one of the few organizations your doctor 
could find which is in favor of free medicine.

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