Skip to main content

Personal Is Political in Professional Practice

"Should a doctor treat an alcoholic who is injured due to drunk driving? Would your opinion change if it were just a solo accident v/s injuring/killing other people on the road?" asked @arshiet. The regular controversy. Should doctors judge their patients? Is it ethical to even ask the question of whether it is ethical for doctors to withhold treatment to anyone? What are the social determinants of alcohol use?

The issue is straightforward in the emergency room. You save life first and worry about alcohol and justice later.

But what about elective issues? If you are an obstetrician and you are pro-life, do you avoid elective abortions? If you are a pediatric surgeon and you consider circumcision as genital mutilation, do you avoid ritual circumcisions? Conscientious Objection - apparently that's what it is called.

One of the solutions offered is that the healthcare provider can be upfront about the moral position and arrange a different provider. This helps the patient to retain autonomy and the provider to retain moral clarity.

Basically, doctors can't simply cancel patients.

If we refuse to see the doctor-patient relationship as special, we can see that what's at play here is the tension between "personal is political", cancel culture, etc on one side and the practical realities of the world on the other side. I've personally gone through the self-isolation of ideological purism and come out with the ideology that it is okay to be altruistically pragmatic.

The world is full of people with incompatible ideas, values, and norms. If we start cancelling, we end up cancelling almost everyone. If we don't cancel, we become an apolitical mess. The point is then about finding alternatives to canceling everyone. You cancel some, you strategically avoid some, you engage sincerely with some others.

That intelligent, "nuanced", intersectional approach to politics is called life.

Comments

Follow me

@asdofindia on Twitter
@learnlearnin on Telegram

About Me

My photo
Akshay S Dinesh
I am a general practitioner rooted in the principles of primary healthcare. I am also a deep generalist and hold many other interests. If you want a medical consultation, please book an appointment When I'm not seeing patients, I code software, advise health-tech startups, and write blogs. Follow me by subscribing to my writings

Popular posts from this blog

Meftal-Spas vs Meftal-Forte for Menstrual Pain

I was recently asked by someone whether Meftal-Forte is a better drug than Meftal-Spas for menstrual pain. I hadn't heard about Meftal-Forte till then. So I looked up. 1mg told me both the drugs are manufactured by Blue Cross. The page about Meftal-Spas gives us what I knew already - it is a combination of Mefenamic Acid 250mg and Dicyclomine 10mg. The page about Meftal-Forte told me that it is a combination of Mefenamic Acid 500mg and Paracetamol 325 mg. Based on this, the quick answer is "No. Meftal-Spas seems to be better suited for menstrual pain in people who find relief by using it. But self-medication may not be the best way to manage menstrual pain." The longer answer is that dicyclomine is an anti-spasmodic that is widely used with anecdotal evidence supporting its use in primary dysmenorrhea. Mefenamic acid is an anti-inflammatory drug that is indicated for use in primary dysmenorrhea. Paracetamol is not really indicated for primary dysmenorrhea. Th

Does Medicine Need a Paradigm Shift?

Let's start with physics As my brother's T-shirt says "The Pulse of the Earth is in Physics". Physics is a fundamental science. Also called "pure" science. That is a fancy way of saying it is reductionist. When you think of an apple falling to Earth in physics, all you think about is its mass and the forces acting on it. Everything else is immaterial to physics, including the questions like "Is the apple rotten/ripe?", "What is the probability of the apple falling on a rabbit and killing it?", "Are there hungry people waiting for the apple who won't get to eat it?", and "Is the apple cursed?" The question whether apple is rotten can be answered by another branch of science called biology. Physics and biology are called natural sciences. These are branches of science which rely on observation of the universe to reach at inferences on how the universe works. The question on probability would fall under mathematics.

What Can An MBBS Doctor Do?

In the protest surrounding suspension of Dr Saibal Jana and Dr Dipankar Sengupta, a debate has emerged around what an MBBS doctor can and cannot do, especially in rural settings. This is a very complex question that requires a complex legal answer. There are several relevant case laws and even acts like Clinical Establishments Act which talk about some aspects of this debate. But let us look at it from a more fundamental and fresh perspective. Law is not static. It is subject to continuous change. Law is not blind either. It is acutely aware of context. Therefore, there is no need to frame a universal, absolute, strict law regarding a nuanced question like this. What are some of the considerations that must be kept in mind when framing a law on this question? - How to bring equitable healthcare to the people of our country? - How to protect people from harm? - What is the situation with respect to human resource availability in rural healthcare? - How do referral pathways work in our