17 October 2018

Freedom means progress – so why do we stifle dissent?

AHPRA Medicolegal

In 1847, Ignaz Semmelweis, a Hungarian physician, first discovered that the incidence puerperal fever could be significantly reduced if doctors washed their hands before attending to mothers.

Despite publication of results showing that hand-washing reduced mortality to below 1%, this was not the “generally accepted view” of the medical profession at the time. His views and suggestion to wash hands were deemed “offensive” by the medical establishment. Ultimately Semmelweis died of pyaemia in an asylum. He had been beaten by guards 14 days after admission.

Homosexuality was considered a psychiatric disorder and listed in the DSM one and two. In 1973, the Board of the American Psychiatric Association voted to remove the diagnosis. There was uproar, leading to a vote, where the board’s decision was narrowly upheld.

Yet the DSM three contained a new diagnosis of ego-dystonic homosexuality. This was only removed in 1986!

At some point, bloodletting went out of style.

Every one of the beliefs we no longer hold had to be challenged at some point. Every time, the establishment rejected change and it took the “rebels” time and effort to eventually succeed. Often at significant personal cost.

All change starts with an idea. In turn, to advance this idea it must be communicated to others.

In 2018, apparently, we know all there is to know. According to a draft code of conduct by AHPRA, doctors need to censor what they say in public and should only express the “profession’s generally accepted views”. Just to round it out, one needs to explain when your personal opinion differs.

When last I checked, if you got three doctors together there was a fair chance of five opinions.

The rationale for this attack on the basic human right of doctors to freedom of thought and expression is that the “boundary between a doctors personal and public profile can be blurred”.

Being a doctor is what we do, it not who we are. Each human being has many facets. Training in medicine, as against law or architecture, does not negate all other aspects of our existence.

Furthermore, as doctors we apparently need to “consider the effect of comments outside of work” as “trust in the profession could be undermined”.  Since when are we a collective rather than individual human beings?

If a doctor or lawyer or anyone else behaves in an unacceptable manner it is not a reflection on all those who happen to do the same job.

The other underpinning assumption in this, as highlighted superbly by Dr Maxine Szramka, (TMR, 30 August) is that the public hangs on every word uttered by a doctor. Clearly, as she noted, if this were the case then nobody would smoke or be overweight.

Memo to AHPRA, doctors are not the governors of societal thinking.

Even ignoring this, what exactly is the medical profession’s opinion on a host of medical and non-medical matters? What is the best antidepressant? When exactly is arthroscopic knee surgery indicated?

Outside of medicine there are doctors in every major political party. Which one speaks for the profession?

The AMA counts roughly 25% of doctors as member. Do they speak for all?

When was the last time they polled members before making a statement? Which is the official religion of the medical profession? Which football code do we all endorse?

Doctors, as members of society, have different opinions on all matters of state. The selection process for medicine gives weight to academic performance. Doctors are among the more intelligent members of society. This does not make their opinions right, but it certainly means they have every right to express them.

All this needs to be viewed in the context of the elevation of “offence” to being the highest crime. We must never say anything that anyone might choose to take “offence to”.

Truth is not of interest to the “right on” brigade. For example, violence and child sexual abuse in indigenous communities are a concern, but there is outrage if it is mentioned.

Woe betide a doctor with a politically incorrect view, or who dares speak an unpopular truth.

The elephant in the room is AHPRA as a tool of state control of doctors. Silencing of dissent is not a new tool of state control. When this silencing is meekly accepted, society is weakened.

This attack on doctors is an attack on society. It must be stopped before it starts.

Dr Joe Kosterich is a General Practitioner based in Perth. To read more www.drjoetoday.com

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7 Comments on "Freedom means progress – so why do we stifle dissent?"

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1 year 3 months ago

Well said Joe – Dark Ages, Inquistion, burning of witches – its still very much alive in 2018

Anne Malatt
1 year 3 months ago

Wonderful article Joe and I wholeheartedly agree. As Arthur Schopenhauer said: “All truth passes through three stages: First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident.” When are we going to learn from history and open our hearts and minds to the next stage of our evolution? We can only learn and grow and expand if we allow those at the forefront of change to freely express themselves…

Maxine Szramka
1 year 4 months ago

Hear hear Joe. ‘This attack on doctors is an attack on society. It must be stopped before it starts’

Chris Hazzard
1 year 4 months ago
We still have problems with dissent. In the early 7’s I responded to patients requests for home births. Although higher risk I always made sure that I had the backup of a senior obstetrician. Then I realized that a driving force for this demand was the paternalistic attitudes of the profession towards the mother’s wishes. With the help of a midwife driven organization called The Childbirth Education Association we compiled women’s experiences and formulated a list of sympathetic practitioners. The AMA and the Medical Board moved to have me deregistered. Fortunately I had enlisted Prof Carl Wood as a co-adviser… Read more »
1 year 3 months ago

Hi Chris, is this Chris of Chris and Veronica H? Hello from a far.

1 year 4 months ago

Well said Joe.
I tire of the Virtue Signalling, Politically Correct, Cultural Appropriation detecting militant Social Justice Warriors who are tolerant of everything except criticism.