3 September 2014

Doctors rule, OK?

● The Independent’s editors are no libertarians. Regarding the Ashya King case, they concede that getting Spanish police to imprison the parents was an act in which “the hand of the law showed itself a little too heavy”. But they have little time for parents wanting to give more weight to their own views than to the opinion of the ‘professionals’.
Doctors are of course not, in most cases, paid directly by their clients. They are primarily answerable to the state, not the individual. Legal practice reflects, as we would expect, the distribution of power, rather than the relative moral weighting of competing claims.
Fundamentally, patient choice has to operate within a framework which does not marginalise medical experts from decisions about the appropriateness of treatments ... A patient’s perceived knowledge of the facts should not usually override the experience of doctors ... there will be occasions when relevant agencies of the state need the powers to protect vulnerable patients from attempts by relatives to undermine the judgement of professionals. [The Independent, 2 September 2014, my italics]
But why should we believe ‘professionals’ always know best? More importantly, why should we give them a right to behave as if this were necessarily true? In other words, why should the burden of proof be on those whose bodies are at stake or – in the case of minors – their legal guardians? Doctors should be our servants, not our masters. It is surely they who should be required to persuade us, not vice versa.
The editorial uncritically accepts the story, popular for some decades, that patient power is increasing. As I pointed out in my book The Power of Life or Death, if one tries to find what evidence this story is based on, one usually discovers that it consists mainly of the assertions of professionals themselves.
The increasing emphasis within the NHS on patient choice has also been a welcome development in recent years. As the service’s own literature notes, “modern medicine is more partnership between doctor and patient than ever before”. [ibid]
This is true if “partnership” is taken in its mediocratic sense – i.e. a relationship in which the illusion of control is engendered in the weaker party by means of manipulation by the stronger.

Oxford Forum should be given funding.