Does government-dictated “evidence-based medicine” violate the ethical obligations of physicians? Maria Martins says yes:
As doctors, we took the an oath. We created the profession of medicine and claimed our standard required us to use our own best judgment at all times for the greater benefit of our patient. We claim we base our treatments on “the evidence.”
It requires freedom and an independent mind to evaluate the evidence. The evaluation process is the art of medicine. You cannot legislate integrity and competence into doctors whose minds and judgment have been regimented to follow “best practice” guidelines.
It is a betrayal of our duty to our patient to use any consideration of some greater social good defined by the government to alter the best course of action for the patient. Our customer rightly expects us in the doctor-patient relationship to have his welfare as our absolute priority. It is immoral to use “average number of years of life a procedure would buy” — or any other government-inspired social utility — as a justification to limit the options we offer our patient. An attorney would be considered unethical if he used consideration of the greater good of society to influence his representation of an accused murderer.
Martin doesn’t spare her own profession, however, lambasting the AMA for restricting the number of physicians.
(Cross-posted from State House Call.)