Flat White

Doctors are doctors, not philosopher kings

15 February 2019

7:47 AM

15 February 2019

7:47 AM

Doctors swear on the Hippocratic Oath that they will “first do no harm”, yet they pay little attention to the side effects they are causing with their activism.

The passing of the Medivac bill and the associated debate on asylum seeker health is an example of doctors becoming monolithic in their views.

When the Australian Medical Association’s spokesman Dr Paul Bauert compares Nauru and Manus to Auschwitz, it’s clear many doctors have lost all perspective in debates that extend beyond clinical medicine.

There is a growing divide among medicos with public sector doctors inevitably playing the activist roles. Doctors with alternative views are wary of speaking out.

Such fears are well founded. Last year Sydney GP and practising Christian Pansy Lai was subject to a GetUp! campaign demanding her deregistration. Her crime was to oppose gay marriage. The sinister move attracted sympathy among some doctors.

This week after I expressed my support for the government’s border security arrangements, a junior colleague suggested I had broken my medical College’s Code of Ethics. He argued my view on public policy was discriminatory towards asylum seekers. This is despite the fact I treat refugees and asylum seekers in my work at Bankstown.

Medical professionals are increasingly mimicking the worst of campus politics, where alternative political views deemed conservative are seen as corrupting a moral purity. There are moves to ostracise colleagues who are seen as traitors.

Another doctor who had worked at Christmas Island said he knew many health professionals who had a more nuanced experience of asylum seekers’ health but were fearful to speak out. My colleague, not wanting to be identified, spoke of asylum seekers faking appendicitis symptoms to facilitate transfer to the mainland as well as the contagion effects if any detainee was successful in gaining release via self-harm. There was a big spike in others doing the same.

These are uncomfortable trends to consider but when permanent residency is the prize, people will go to extraordinary lengths, and understandably so. It doesn’t make them bad people, just humans responding to incentives.

We know there has not been a single asylum seeker who has been sent back after gaining transfer, as they lawyer up in parallel with any necessary medical treatment.

The passing of the Medivac bill magnifies these incentives and will spur future arrivals to try their luck, knowing doctor’s groups and their supporters are unlikely to cease their activism.

The Hippocratic Oath is unworkable in practice, because doctors must do some harm in the form of side effects to do good. Doctors seem less interested in the side effects at a community level after focusing exclusively on harm reduction at all costs.

This then locks them in alliance with the politics of compassion fundamentalists.

It was emergency physicians who led the move towards lock out laws killing Sydney’s nightlife. Public health physicians demand taxes on sugar. And support for everything from climate change to gay marriage has been promoted by doctor’s groups on the spurious grounds of health.

And now doctors are helping to dismantle our successful border protection regime.

At a time of declining institutional trust, doctors retain a strong moral authority. They are like secular priests. But medicos’ are hitching their wagon to powerful, alternative currents and confusing them with science.

Tanveer Ahmed is a psychiatrist, author and commentator.

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