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Dr. O’s Lesson 2 Notes: Health as an Ethical Issue and the Right to Health
Care
1. Democracy is not identical to capitalism. One is a political ideal (self
government, majority rule, minority rights, equality of opportunity, and so on) and
capitalism is an economic arrangement.
2. Physicians do not really pay the full amount that their education costs. You
and I pay for most of it. That is, the public in Canada does. From birth to final
graduation, medical students are nurtured and educated, largely at the public’s
expense. Compare the tuition at an American medical school with what one
pays in Quebec. At many good American universities, tuition can reach well over
$50,000 per year in American currency. It is much cheaper here in Canada,
even if one attends the best medical schools.
3. This third point is crucial. The particular function of medicine—its raison
d’être—is to heal people, to treat people and to try to prevent illnesses and pain,
to save lives where possible and to respect patients and their preferences. It is
not the function of any profession per se (in itself) to make money. All of us do
that if we have a job.
There is a public interest to be served by having the art and science of
medicine—it has a social function. Medicine is basically a social or societal
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service, not a private business. We all have a stake in maintaining at least a
certain minimum level of good health in our society, and indeed in the world.
People and their health are the essence of medicine—not profit.
4. There are some conditions and diseases which are both lethal and
contagious. Should we simply let them spread throughout the population if those
who have the condition cannot pay for health service?
Now, I have not claimed that most or all doctors are out for profit alone.
Perhaps most or even all doctors are genuinely concerned about their patients,
just as all other health professionals are. They are entitled to fair compensation
for their services, just as all other professionals are. But I wanted to look at the
argument and its criticisms to show that the special function or purpose of
medicine is not to make money but rather to heal the sick, prevent illness and so
on.
Doctors are not our slaves, but they are not to be worshipped and feared
as gods. They are women and men who have certain specific functions, rights
and responsibilities. People who go into health professions do so with for as
many reasons and with as many mixed motives as the rest of when we enter our
students who ostensibly hate or distrust all doctors because they have had one
or two bad personal experiences. There are many of us, conversely, who have
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been lucky enough to be well served by doctors and nurses in Quebec and
Canada.
So, while it is fair to be skeptical and critical, it is unfair to condemn all
doctors and/or other health professionals just on the basis of a few personal
experiences. On the other hand, if all of your experiences have been unpleasant,
and all your friends' experiences have been too, then either you may have a
legitimate complaint or you and your friends have been unaccountably unlucky.
(I had some bad teachers in university, but I didn't conclude that all professors
are deficient.)
To sum up: medicine is not just a business. It has been called a "sacred
calling", but even though it is not, it certainly is intended to care for us and/or to
try to cure us, not merely to make a profit off of us.