Medical Politics Goes to School

Many physicians argue that medicine and politics are, and should remain, separate disciplines. But others maintain that whether the topic is health care reform or medical marijuana, medicine and politics are often so intertwined that they are impossible to separate.

That’s the perspective of Nathan Emmerich, the author of a recent article in the Journal of Medical Ethics arguing that “medical politics” should be covered in the curricula of medical schools.

“The author suggests that ‘the political’ is implicitly recognizable in the historical roots of medical ethics education … and also that the medical profession, or indeed any profession, cannot be understood as an apolitical form of social organization either in its institutional or scientific … forms,” Emmerich wrote in the article.

“There is a very definite political dimension to the debate in the medical profession as to whether it wants to involve itself in things like euthanasia and assisted suicide,” Emmerich, a doctoral student writing his dissertation at Queens University, Belfast, Ireland, on the teaching of medical ethics, told MD Magazine: Peers & Perspectives.

“Over and above the ethics of the question, do we want the medical profession to provide that service, is that what the medical profession wants to see itself as doing? There’s a dynamic of that question that belongs to politics,” he said.

Emmerich said although politics should be an important part of the medical school curriculum, he does not believe there should be a shift from a focus on ethics to a focus on politics. “What I do think is that ideas about politics can be added to a variety of areas in medical education,” such as medical sociology and epidemiology, which have “obvious political dimensions.” In addition, the structure and arrangement of the medical profession and its relation with government and other professions are important areas that medical students may not be aware of.

But Emmerich hastened to add that the medical profession should maintain its independence from either government or political parties. “However, independence is not the same as being apolitical,” he said. “The medical professions can and should contribute to debates about health, the funding of health care, and what constitutes individual and social responsibility, for example. Maintaining absolute apolitical neutrality in such debates … would remove an important perspective from the public debate.”

He added that medical institutions and physicians, as both public or private citizens, should, as appropriate, engage in debate and put forward their perspectives as part of the ongoing democratic process.

Emmerich cited the debate about health care reform in the US as a prime example of appropriate political involvement by a professional group.

“That’s very much the responsibility of the profession. If you take that a profession holds a body of knowledge in trust, such as the medical sciences and the various things that doctors do and know about, that it holds that interest for the good of society, well, how that’s administered and the institutional arrangements for providing the goods that is that knowledge to a wider society and individuals, it has to have an interest in that,” Emmerich told MD P&P.

“It’s very much their responsibility to take part in that debate and have a position, because otherwise it really doesn’t serve their democratic good and the public good, because the public is just left with people from outside of medicine who don’t have the insider’s view of what it is like to work in a hospital day in and day out or be a family physician day in and day out,” he added. “It leaves a large gap if the medical profession doesn’t engage and doesn’t take part in the debate.”

Although they are sure to eventually learn the ins and outs of politics on their own, medical students would likely benefit at a much earlier period in their career from having it worked into the curriculum. The idea of medical politics “[does not] necessarily open a new front in the battle for curricula time,” Emmerich wrote in his article, “but might simply provide a new perspective from which medical educators can refresh and re-engage with their subjects and students.”