A post by Bob Doherty in the ACP Advocate Blog supports an increasingly popular narrative: the idea that the interests of the medical profession are necessarily opposed to those of patients and that some entity must advocate for patients against the profession. The ACP, as I read the post, would like to appoint itself as that entity by being the "conscience of medicine."
Can the conscience of medicine be collective? Conscience is naturally collective for certain general virtues such as being honest and being good to people. It's based on precepts that are innate and form what philosophers call the natural law. But as the collective conscience moves from general to specific, as defined by a community, government or an organization trouble may ensue as examples from history have shown. When it is defined by a particular side in political debate bad consequences can be taken for granted. But based on Doherty's remarks that's exactly how the ACP seems to be defining it.
In his post he traces the evolution of the ACP from an apolitical society that existed to represent the professional and educational interests of physicians to an activist organization involved in many facets of politics. Despite Doherty's empty disclaimer that it's only about the well being of patients the ACP has come down squarely in a partisan manner on a variety of issues. In order to support such a disclaimer you would have to stretch to absurdity the idea that the political process exists to serve people.
There's nothing new or shocking about a professional medical organization being involved in politics. It takes on a new dimension, though, when you articulate a partisan stand on multiple issues and imply in the same breath to physicians at large “we are your conscience.” It smacks of intolerance because it says in effect “if you disagree you're in the wrong and not putting patients first.”
But as long as we have this new conscience of medicine we should note that it is strangely selective given its silence on the ethical questions now swirling around the American Board of Internal Medicine. That's something the conscience should be screaming about.
HT to Retired Doc's Thoughts.