Politics and the place of doctors – Part 1

By Jeffrey Leow

Not too long ago, the Sydney Morning Herald reported, amid the seemingly rising anti-Singapore sentiments in Australia, the following with regard to the Burma saga:

"Singapore's hospitals also keep its leaders alive - the 74-year-old strongman Than Shwe has been receiving treatment for intestinal cancer in a government hospital in Singapore, in a ward heavily protected by Singapore security."

A simplistic and idealistic view would perhaps be the following:

Now if I happen to be the attending physician, will I deny treatment, in the name of politics? "You should die for your evil doings on the 54,000 burmese people" (proceeds to inject "medication" which is actually merely 10cc saline into his dorsal IV cannula, prescribes 2 tablets of tic-tac-s thrice a day.)

I wish to bring up the point that in an ideal world, the health care profession is in no place to deny treatment because this is directly contradictory to the instincts and ethics of our age-old profession. However, that does not stop healthcare professionals from having political slants or viewpoints about matters.

Some express it via the Internet through blogs ( Dr Huang, AngryDoc, Dr Oz Bloke), some decide to serve in political parties and have their say. Intentions aside, there are avenues available and the ethics of the profession should all the more prompt a doctor into politics, as a doctor once said [something to the effect of]:

"It is akin to looking after my patients. Serving the general community is like serving the medical community which I used to and continue doing so, just on a public and community level, addressing a variety of issues, not just medical.”

Now this brings us to the question, "Do doctors really need to be actively involved in politics to make a substantial difference to the community?" The answer might be a resounding no.

"The medical profession is treated by politicians as a negligible quantity, but this is partly because it does not know, and partly because it does not care to use, its power. What doctors could do if they chose to use the legitimate influence which they have, is shown by an incident in a recent electoral campaign in America...." (See here for more.)

That was more than 100 years ago in 1901. We read that 38 years on, things have ALREADY changed so much. Here is an extract from a Time magazine article in 1939 :

“Fortnight ago every one of the members of the New York County Medical Society* received a ballot stating : "If under Proposition Four of [Senator Wagner's] . . . National Health Program, money is made available to New York State to provide care for the low-income earning groups, do you favor the delivery of this medical care by means of compulsory health insurance?"

Many of the doctors invited found the advances of Publisher Gannett crude and stayed home. And the majority of Manhattan physicians, congenitally afraid of politics, and with little understanding [of] the practical meaning of planned medicine or the motives of those for and against it, went about their business, blissfully ignorant of the whole affair.

In the Singapore context, perhaps we could ponder on two questions:

Question 1: Is there inertia among the healthcare professionals in Singapore with regard to politics? Why do you think this is so?

Question 2: Do you think there is a great divide between what is being implemented by the Health Ministry and what the doctors actually want best for the patient? If so, why? What do you hope can be implemented?

These are the questions posed. Firstly, I direct them to the physician bloggers amongst you. Next, I would invite the other bloggers to give their 2 cents.

About the author: Jeffrey is an international medical student at Monash University, Australia. Visit Jeffrey's personal blog here.

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