The Duty to Care

Look down and see
The beggars at your feet.
Look down and show
Some mercy if you can.
Look down and see
The sweepings of the street.
Look down, look down
Upon your fellow man.
–A song from the show Les Miserables

Earlier this week, the inestimable junior senator from Kentucky, a Libertarian and Tea Party darling, and a self-certified ophthalmologist, equated the notion of a right to health care with that of enslavement of medical professionals.

“With regard to the idea of whether you have a right to health care, you have realize what that implies. It’s not an abstraction. I’m a physician. That means you have a right to come to my house and conscript me. It means you believe in slavery. It means that you’re going to enslave not only me, but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses. … You have a right to beat down my door with the police, escort me away and force me to take care of you? That’s ultimately what the right to free health care would be,” – Senator Rand Paul.

(emphasis mine) Quote source: Andrew Sullivan

Here’s a video: Rand Paul Expresses an Opinion

I am shocked, nay—appalled that a physician trained at a reputable medical school (Duke University) would so cavalierly suggest that the Hippocratic Oath is mere fluff, that it is permissible for a medical person to pick and choose whom he (or she) will so deign to “take care of.”  Appalled that a physician would claim the right to deny care to anyone he deems unworthy of his vaunted expertise, for whatever reason he may contrive.  Appalled that he would suggest that being required to do his job is enslavement.

No, Rand Paul.  It is not enslavement to expect you to do the job to which you voluntarily signed up for when you became a physician.   It is not enslaving doctors when we expect them to take care of people that need to be taken care of.  It is not enslavement when we expect them to do their jobs, to be doctors.  It is certainly not enslavement to try and create a system that will increase access to doctors and nurses and medicines for everyone who needs it.

For you see, Rand Paul, every person in this society has a role to play—such as parent, teacher, plumber, homeowner, soldier, student, banker, factory worker, senator, and physician.  All these roles come with privileges and obligations.  Let’s call these privileges ‘rewards,’ and these obligations ‘duties.’  When you adopt a role, you assume the duties as well as the rewards of that role. Taking up duties, by definition, means you relinquish certain liberties you may once have enjoyed. This is true no matter what role you take, whether as parent, plumber, soldier, doctor, or as senator.  When you become a parent, you exchange the liberties of “me time” for the duties of raising a child.  When you become a homeowner, you exchange the liberties of financial freedom for the duty to pay down your mortgage. When you become a physician, you exchange the liberty of seeing only those you want to see for the duty to give care to all who come to you as patients.  When you became a senator you exchanged the liberty to speak for yourself for the duty to speak on behalf of all those people you represent—including those who disagree with you.

To say that you should not be forced to meet the obligations expected of your role because that infringes on your personal freedoms–that is tantamount to me telling my boss that I’m not going to do my paperwork because being required to so do so infringes on my liberty, my right to choose how I wish to do my job. Guess what, Rand Paul, if I ever dared say that I would rightly be fired, because we do not get to reap the rewards of duties not performed.

Perhaps you forgot the Hippocratic Oath?

  1. I swear to fulfill, to the best of my ability and judgment, this covenant
  2. I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
  3. I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
  4. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
  5. I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
  6. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
  7. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
  8. I will prevent disease whenever I can, for prevention is preferable to cure.
  9. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
  10. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

I wish to repeat #9 again, because it bears repeating, Mr. Rand Paul:

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

To be a doctor is to take on the duty to care, Rand Paul.  It is not enslavement. Do you even know what slavery is, Rand Paul?

Slavery is not just the absence of liberty.  Slavery is the commodification of a person’s body, of all his or her abilities as well as life.  Slavery is denying a person his or her personhood; denying a person the right to speak or vote; to literally sell a person’s body for money. Slavery is taking away all power a person has over his or her life.

When bodies are treated as commodities—that is slavery. When a body’s health becomes a source of revenue for others—that is when liberty is at risk; for it is when bodies become infirm that choices become restricted. When you deny a person access to health care, you deny them agency over their bodies and their health, and thus over their lives. You deny them the ability to make choices. That is more like slavery than requiring or even just expecting doctors to perform their Hippocratic duties ever will be.

Having a duty to others is not slavery, Rand Paul. When you conflate the two, you render the term and history of “Slavery” meaningless. You invalidate the entire notion of a social contract.Which I hasten to point out is the intellectual basis of our entire political society.  Our Founding Fathers—the very men you Tea Party ideologues so revere—built our Constitution on the concept of a social contract.  Which you now, with careless hyperbole and disregard for history, mock.

For shame, Rand Paul. Shame.

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10 thoughts on “The Duty to Care

  1. Well said.

    Does the senator have an email address? Send it to him. If not, you should print and mail it to him.

  2. I still don’t get this slavery analogy. The NHS has been in existence for something like 60 years and this strange post-apocalyptic scenario (where doctors are literally dragged into the streets and forced to care for the sick) hasn’t yet come to pass. ALSO, this hasn’t happened figuratively either. People actually still CHOOSE to become doctors and work for the NSH. I mean, honestly. And I know I said it before, but I’ll say it again. Slavery analogies are the new Nazi analogies.

    FURTHERMORE, Bob is right. You should email your post to Senator Paul and make sure you point out that you put it on your blog.

  3. Wow! My first visit to your blog and I’m mightily impressed. I agree with Bob, that you should send this to the charming man in question.

  4. What a freaking goombah. Seriously. I’m a health care provider and I am eager to see us make the switch to a national health care system. And I will happily participate in it if we ever see our way clear to doing that.

    1. Yeah, I dont understand how anyone could not want universal single payer health care. Nothings ever perfect or without problems, but its sure as heck better than what we’ve got!

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