The Occasional Perspective - 5/19/22

Opinions and Reflections

An Informal Survey – In the last two weeks, I’ve had the opportunity to re-engage with air travel for the first time since prior to the pandemic. I was immediately struck by the change in “sartorial standards” by the traveling public. So, I decided to do a personal survey on the use of ties – yes, those old, sometimes very colorful, accoutrements that hang around the necks of people attempting to convey a sense of authority. At Chicago O’Hara, I saw two men with ties – one was a pilot and the other a young man who was obviously out-of-place amidst the swarm of people. At the Salt Lake City airport, the number of “tied” people increased dramatically to 7 including 2 young Mormon missionaries wearing badges denoting their status, two pilots, 1 out-of-place young man (not the same guy) and two random travelers. Clearly, sartorial standards have changed. Now…what should I do with those 100+ ties I have hanging the basement closet?

Insidious Insincerity of Invectives – I am not a particular rigid person (I don’t think ??). If you’re going to serve in an entrepreneurial or innovation capacity – rigidity is one of the last capabilities you would want to add to your team. At the same time “consistency” is important. If you want to engage in an out-of-the-box approach toward solving a problem, the ideas a member of the team puts forward need to hang together. There needs to be a degree of consistency. At the outset, I must decry the ongoing discussion on the abortion question. I’m sure that my fundamentalist friends and colleagues will be upset with me although they likely know my position already. The 1973 Roe v. Wade decision ushered in a new era not only related to reproductive rights but also for personal rights, in general. Over the last half century, we have been engaged in an ongoing discussion on the balance between personal and public rights or, the rights of individuals versus the many and the balance between these two ends of the spectrum.

What is particularly galling is the call by those on the extreme right such as Representative Paul Gosar (R-AZ) who support revocation of Roe v. Wade. Yet, those same individuals when they exhale will wax poetic about the fact that everyone should be able to make their own decisions on masking during the pandemic – putting aside the notion on the balance of individual health relative to community health. Another example of the inconsistency of thinking is Governor Greg Abbott (R-TX) who has vociferously argued against vaccine mandates because "…whether or not somebody is going to have something put into their body that they do not want put into their body. That’s more than freedom, that’s the right to control and secure your own body. And that’s exactly why we’re winning on this issue." [NOTE: As reported in Rolling Stone]. 

A thorough review of the individual, public, community and societal health questions are totally ignored. Rather, these arguments shout out for “what I want”. Legislation is even being introduced to make it illegal to care for an ectopic pregnancy. So, now we (the health care professionals) will be forced to maintain an ectopic pregnancy to it’s fullest development so we can then care for the hemorrhagic death of the woman! How absurd!!! Actually, such proposals are more than absurd. They reveal a total lack of understanding and nuance related to the issues at hand. These are simplified, expedient arguments that seemingly are thrown out as click bait for that portion of the public inclined towards positions of opposition to reproductive rights. If there were real thought and consistency that tied ideas together we would most likely have a path toward resolution.

The polemics by the politicians is more than disheartening. They are disgusting. The reversal of over 50 years of policy which was deeply debated for a long period of time is disheartening. The concept of personal control over one’s medical choices is a cornerstone not simply for abortion rights but also for many other areas. This is forgotten in the insidious insincerity of invectives thrown about in the debate over Roe v. Wade. Let’s hope the premature release of a “draft” statement was a “draft” by one group and that there are other “drafts” still under consideration by the U.S. Supreme Court so that they can stand as a court rather a small group of politicians – which we all increasingly have less respect for their role in society.

Righting The Wrongs – On May 7th, the American Medical Association celebrated its 175th anniversary. In an article on the “voice of medicine”, James Madara, MD, CEO and Executive Vice President of the association highlighted the many contributions the AMA has made over the years toward fostering a better health care system. In particular, Dr. Madara points to the Code of Ethics promulgated by the AMA as a source for facilitating the improvement of the profession and medicine, in general over the many decades. In fact, given the current anticipation related to the U.S. Supreme Court decision on abortion rights, you may want to consider a review of reproductive rights set by the AMA. But, just as importantly, Madara points to the wrongs which were promulgated by the AMA including the banning of women and Blacks from membership. He offered up the following in his article:

As we celebrate the AMA’s many contributions to science and public health, we also recognize that there are periods in our long history that we are not proud of. At the point of our founding, AMA leaders made decisions to exclude women and Black physicians from our ranks, contributing to a health care system today that is plagued by inequities and injustices for patients and physicians alike.

In 2008, the AMA concluded a three-year study on the racial divide in organized medicine and publicly apologized for our organization’s past discriminatory practices against Black physicians, an effort we called “a modest first step toward healing and reconciliation.” This is a journey of reflection that continues today with an enterprise wide commitment to rectify past wrongs.

None of us are perfect and associations are merely groups of individuals that collectively make bad or incorrect decisions through the lens of time. It is good; however, to fess up when the wrongs are noted. So, I applaud Dr. Madara’s notation of those wrongs which have affected not only the profession but society in general. Actually, the AMA went a couple of steps further in recent weeks with its clear rejection of the “draft” opinion leaked to the public. Gerald Harmon, MD, President of the American Medical Association – in a statement released by the Board of Trustees stated:

"With deliberations underway, we strongly urge the court to reject the premise of the draft opinion and affirm precedent that allows patients to receive the critical reproductive health care that they need," Harmon said. "Allowing the lawmakers of Mississippi or any other state to substitute their own views for a physician's expert medical judgment puts patients at risk and is antithetical to public health and sound medical practice."

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