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A doctor has a right to his own life

By Jonathan Rosman M.D.
web posted February 25, 2002

When I came to the United States from South Africa as a young doctor 17 years ago, I was excited. I was leaving behind an oppressive, racist regime, and I was entering a country founded on the inviolable rights of an individual to life, liberty and the pursuit of happiness. I did not expect to find a political system trying to enslave me.

Doctors in this country do not seem to have the same rights as other Americans. We are regarded as public servants who are expected to selflessly sacrifice our time and resources to satisfy the needs of our patients--that is, we are expected to be altruists. For example, emergency room specialists and anesthesiologists are already required to do pro bono work, and managed care and Medicare continually try to squeeze more effort out of us under increasingly oppressive bureaucratic oversight, for less and less reward.

Every doctor, like individuals in other jobs, has a right to work for himself and for his own enjoyment, and to make a ton of money at it if he can. As individuals, doctors have a right to offer their patients treatment according to their best judgment, and to charge such fees as they judge their expertise to be worth. Conversely, patients have the right to accept or reject our advice and services, and to shop around for the best deals they can get. Having the right to your life does not guarantee health or medical treatment at the doctors' expense, but it does guarantee that every individual has the freedom to seek whatever treatment he wishes, according to his own judgment and his own means. Individual rights means the freedom to act within one's means; it does not mean an entitlement to the goods and services provided by others.

However, not only have American doctors been stripped of their professional freedom by all the various oversight agencies (which include licensing boards, the Health Care Financing Administration, managed care companies, peer review committees and more), but--more importantly--they have also been morally disarmed. Our intellectuals have taught doctors that need comes before ability, and that healthy and rich doctors have a duty to support sick and poor patients. They have taught doctors that the consumers of medical services (patients) are morally superior to the providers of medical services (doctors), just because the consumers are in need.

Bureaucrats have eagerly latched on to this altruistic idea, and have erected a maze of welfare laws and regulations to satisfy the needs of the poor and the sick, and to "protect" them from "greedy" doctors. Thanks to these controls, it has become very difficult for doctors to think or to act freely on their own judgment. And it is the best doctors, the most dedicated and those least ready to relinquish their independent judgment, who have been the first to leave the practice of medicine when doctors' rights were trampled on. Who will ultimately be left if this trend continues? To quote Dr. Hendricks in Ayn Rand's novel Atlas Shrugged, "Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it--and still less safe, if he is the sort who doesn't."

To save American medicine, American doctors need to be saved from altruism. To accomplish this, doctors must vigorously challenge the invalid notion of a "right" to health care. Nobody has a right to an antibiotic made by someone else, just as he does not have a right to someone else's car. Nobody has a right to have his gallbladder removed, just as he does not have a right to have his toilet fixed by a plumber. No one has a right to demand that a doctor treat him, but doctors do have rights, just as do auto workers and plumbers, to practice their profession (or trade) free from coercion.

To save themselves, doctors must proclaim openly that they refuse to regard themselves as anyone's servants. They should be left free to enjoy their careers as they see fit. It is important that as doctors we assert our moral right to be free. On the issue of their rights, doctors need to be inflexible and intransigent. They need to declare openly and loudly, "It's my life--hands off!"

Freedom is the dream that as a young doctor I was looking for 17 years ago. It is still possible to realize it today if we doctors defend our moral right to our lives.

Dr. Rosman, a psychiatrist in private practice in Pasadena, is a senior writer for the Ayn Rand Institute in Marina del Rey, California. The Institute promotes the philosophy of Ayn Rand, author of Atlas Shrugged and The Fountainhead. Send comments to reaction@aynrand.org.

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