Many physicians think that an ideal doctor should act like a philosophical zombie. They wouldn’t use those words, but popular descriptions of ideal physician behaviour sound less human, more zombie-like.
Philosophical zombies look and act like regular humans but do not have conscious experience or feeling; think more like I, Robot than World War Z. We understand them entirely in physical terms. Like zombies, doctors should be objective; empathetic but psychologically un-phased, infinitely malleable to their patients’ worldviews.
Zombie doctors follow guidelines faultlessly. They never veer from standards of practice for unscientific things like patient individuality. If planners or legislation call for action, zombies obey without question. If a patient requests a legal treatment, they twirl and mechanically deliver referrals like vending machines serve candy bars.
Patients never have to worry about zombie doctors acting unprofessionally. Zombies only do what zombies do, without any variability. Zombie doctors learn ethical guidelines and apply them with computerized regularity. They do not have opinions, debate nuance or wrestle with inconvenient social dilemmas. Zombie doctors do what they’re told and always act in patients’ best interests as defined by the social collective.
The zombie defence might explain why Canadian doctors supported the Sexual Sterilization Act between 1928 and 1970. Patients unfit to reproduce – for example, people with low IQ, no money, alcoholics – were sterilized against their wishes, sometimes without their knowledge during an unrelated procedure. Zombie doctors explains how the head of the Toronto Psychiatric Hospital served in the Eugenics Society of Canada during that period and received the Order of Canada.
But do patients really want zombie doctors? Or do we want doctors to act on strongly held personal morals?
Doctors denounce, and refuse requests for, female genital cutting even though most jurisdictions don’t prosecute parents who take their young girls out of country for the procedure. Most doctors denounce sex selection even though there are no laws against it in Canada (Globe and Mail, CTV News). If sex selection and female genital manipulation became legal, we hope most physicians would refuse to have anything to do with either of them.
As Dr. Margaret Somerville, the founding director of the Centre for Medicine, Ethics and Law at McGill University said recently, “Do you really want to be treated by a doctor who doesn’t care if he thinks that he’s doing something unconscionable or unethical or immoral?”
There will always be some tension between the moral convictions of an individual medical professional who adheres to his or her own worldview and the different procedures that are legally available in a pluralistic society. (National Post)
Clear laws can help. But Martin Luther King Jr. reminded us to, “Never forget that everything Hitler did in Germany was legal.” Just ‘following the law‘ is known as the Nuremberg defence.
Life is great when other people do what we want them to. But utopian dreams blur imperceptibly into nightmares. A civilized society should not force anyone, including doctors, to do what they find morally reprehensible, even if it is legal.