President Trump’s first weeks in office have left many, both here and abroad, slack-jawed. Americans are scared, angry, and divided; so are doctors. As pediatricians, we watch politics unfold in our exam rooms on a daily basis. We meet families seeking prenatal consultation from pediatricians about how diagnosed fetal anomalies may affect their child’s life, we care for those infants in the neonatal intensive care unit, in the emergency department, in outpatient offices, and we see the tremendous joys and the unimaginable sorrows these families experience.
We counsel adolescent girls seeking contraception, and work with them to go to a clinic such as Planned Parenthood that provides appropriate medical services in an affordable and confidential manner.
{mosads}We care for children who have come from abroad through charitable programs to receive state-of-the-art treatments for otherwise fatal conditions. We evaluate children for “failure to thrive” who turn out to be in fact malnourished because their parents’ lives are so stressed from erratic employment, mental health issues, and economic hardship, without sufficient safety net programs in place to help these families thrive.
It is simply impossible to separate the practice and ethics of medicine from politics.
A recent study evaluating the trends in political leanings among doctors in different specialties received some media attention, particularly given the provocative conclusion that a physician’s political ideology may actually affect the type of patient care they provide.
Do patients thus have the right to be informed of a
physician’s political party affiliation? We, as a society, spout the
belief that
healthcare ought to be
apolitical, and that
political opinions detract from good patient care.
National medical organizations, and
physician groups across the country, are torn at the seams over the appropriate role of doctors in this
“alternative fact” era, and what our obligations are with respect to healing our ailing patients and this ailing nation. We face both internal and external pressure to keep quiet under the guise of “avoiding partisan politics.”
Historically, a deliberate separation between personal political beliefs and bedside practice may have been justified. But times have changed. The past weeks have shown that we remain stuck in crude debates about male politicians’ rights to control women’s health and supersede physician and patient decision-making.
We ration healthcare on a daily basis, in ways both visible and invisible, both justified and deeply biased, and yet the national dialogue remains mired in sensational and inane terms like “death panels,” and we have been unable to adjust to a reality in which the historical dependence on stable employer-based health insurance is no longer. It’s true that with recent events,
doctors have been
speaking out. And yet, while we are encouraged to engage in sanitized advocacy, major medical societies such as the American Academy of Pediatrics – to which we both belong- continue to release
tepid statements about “all children being important,” and explicit political advocacy at work is, as a rule, strongly discouraged.
Now is not the time for dispassionate, politically-correct debate about the respective strengths of conservative and liberal approaches to healthcare and medicine; we have to return to a fundamental discussion about the most basic rights of individuals in a country with enormous resources. Political engagement by physicians is mandatory; a refusal to engage is in fact a partisan position, in which false equivalency is granted to actions that directly oppose the fundamental humanistic values that lie at the core of medicine.
The infighting among physicians is a smokescreen, a fallacy, a distraction from those values. Physicians may be Republicans, Democrats, Libertarians, independents, but we must all be progressives with a lower case “p.” As doctors, we have all taken an oath to use our training and empirical knowledge to help people to the best of our abilities, to promote health and well-being, thereby advancing the human condition.
If this does not invoke the original definition of progressiveness, we don’t know what does. If we as physicians – as the guardians of humanism we ought to aspire to be, rather than the sanitized providers of consumer medicine we are at risk of becoming — refuse to take a stronger stand against actions that hurt people, our silence will be deafening.
Dr. Rebekah Diamond is a resident physician training in pediatrics. She lives in Ann Arbor, Michigan. Dr. Phoebe Danziger is a resident physician training in pediatrics. She lives in Ann Arbor, Michigan.
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