In his article, The Medical Profession as a Moral Community, Edmund Pellegrino adds a slight twist to the health as a commodity vs. right debate by placing responsibility in the hands of the medical community. Previously in class we have discussed the role of the public and private sector in health care distribution; however, we have not yet delved into the moral weight it holds over physicians. Pellegrino argues that the medical community is likewise a moral community and as such must unite on ethical issues and serve as a voice for the patient, putting the primary responsibility of caring for the sick above all self-interests. I agree with Pellegrino’s argument and believe that in order to achieve better health among Americans, collective action by medical professionals is needed.
Physicians comprise a moral community: they have made a promise among themselves and society to do no harm, exist within a body that stands on its own regardless of specific membership, and are part of an entity that holds great power (Pellegrino). The oath of a physician promises beneficence and non-maleficence. This is a tall order. No physician alone is capable of protecting all of society, this “spectrum of obligations [belongs] to the whole moral community” (Pellegrino). Doctors have power over vulnerable patients, make decisions that have life-altering consequences, hold knowledge that is available to a privileged few, and are often the final say in a patient’s health (Pellegrino). Every decision made by a doctor is reflected upon the medical community, which is why, aside from the Hippocratic Oath, there are currently in place several regulations and standards upheld by physicians.
Concepts of health and illness have taken a dramatic shift over the last several decades and with them the responsibilities if the modern doctor. Not only is he/she to protect the ill, they are also to do their best to prevent illness and help to maintain health and wellness. Why is it then that much of patients’ money goes to administrative fees? Unnecessary tests? Most importantly, why are doctors refusing to see patients based on insurance type? Though doctors are professionals and provide a valuable service, net profit should not be at the front of their minds when vetting a patient. Instead of thinking about how much money they can make off of an individual, doctors should be primarily concerned with what they can do to help them.
The American Medical Association (AMA) has often taken collective action on important issues. For years they had a huge hand in preventing universal health care reform, when really, it should have been the other way around. Instead of allowing self-interests, namely profits, influence their response to potential reform, physicians should have rallied along the idea of providing more care to individuals who can’t afford it. Patients do not exist under a large, resource-wealthy interest organization like doctors do within the AMA. Thus, regardless of socioeconomic status, patients are not as effective in making their opinions heard and enacted at the policy level. Only the medical community is capable of this.
Although I believe the medical community is responsible for raising expectations in access to health care, I also understand that they are people that work hard with bills and material desires just like the rest of us. Medical school is incredibly timely and expensive. If the U.S. government were to adopt a system that paid for medical school, I think it would be more reasonable to force all practices to accept Medicare and Medicaid insurance schemes.
Individually, physicians may not have a lot of clout and influence over the government and areas of the private sector; however, if they use their collective power, medical doctors have a chance to truly fulfill the promises they made to protect the people.
Pellegrino, E. D. “The Medical Profession as a Moral Community.” Bulletin of the New York Academy of Medicine 66.3 (1990): 221-32. NCBI. Web. 20 Apr. 2014.