Physicians frustrate governments. Doctors think too little about how much care costs and too much about patients who need help.
The Government of Ontario and the Ontario Medical Association arrived at a mediated Proposed Physicians Services Agreement (PPSA) this month. Doctors vote on it on March 22 – 27.
On March 28, we find out whether doctors will accept the agreement or send it to arbitration.
Labour negotiations give government its best chance to manage the $14 billion spent in Ontario on medical services (2020-21). Contracts offer a way to control doctors’ behaviour. Medical services agreements are the heart of central planning in Canada.
A Mediated PPSA
Government does not care about doctors’ incomes, nor should it.
Public health doctors created vaccination mandates and vaccine passports. Doctors tabled the ideas. Politicians followed doctors’ advice and turned it into policy.
Ideas shaped the policy, and policy formed a protest. Public policy made the Truckers’ Freedom Convoy a reality. Prime Minister Trudeau’s response to the protest turned the protest into a global movement.
The historic events of the last four weeks required more than just public health or politics alone. They needed public health plus politics, doctors plus politicians, authoritarian thinking plus authoritarian political response.
Doctors in Authority or Authoritarian Doctors?
Public health doctors follow their own ethic, which other doctors find unethical. Public health seeks to do the greatest good for the greatest number of people. Other doctors try to do the greatest good for the individual patient in front of them.
Doctors who treat individual patients focus on patient autonomy and informed consent above all other goals. Autonomy and consent define what morality means in medicine. It is immoral to treat patients for any other reason than their own good and with their full consent.
Public health doctors, who “treat” populations, ignore autonomy and consent by design – these ideas mean nothing if a vaccine mandate might help the majority. According to public health, we must always do what benefits the majority, even if it causes some harm to a few. Not taking action is itself immoral, if action might benefit the whole population.
Friction between public and personal health is not new. Evidence and open debate have resolved the tension in the past. Well-known riots about Smallpox vaccination stand out as a rare failure, not the norm we should expect.
The Truckers’ Freedom Convoy 2022 has forced a clash of law and morality.
At the start of the pandemic, it seemed reasonable to suspend citizens’ constitutional rights of movement and association. We were willing to try anything.
After two years, it is now the norm to override The Constitution. The slightest possible benefit to health legitimizes the most illogical mandates.
For example, Ontario announced this week that students can play basketball, without masks, but they must wear masks on the bench. Panting, yelling, and close contact on the court is okay. But resting on the sidelines requires a mask.
Constitutional Conundrum
When, where, and how to suspend citizens’ constitutional rights remains an open question. If the courts and parliament get around to debate, pandemic mandates might even turn out to be constitutional in retrospect.
Will The Constitution require amendment? Maybe it is not clear enough where final authority lays.
If The Constitution is not clear, maybe we need a new, separate process — something to guide politicians, when they take the law into their own hands for public safety.
Laws aside, politicians still have to convince voters. Does current research support current mandates?
Researchers have debated the value of non-pharmacologic pandemic interventions (masks, mandates, stay-at-home orders, etc.) for over a year now. One thing is clear, we have much less control than we think. The new Johns Hopkins’ study settles one point: lockdowns reduced Covid deaths by only 0.2 per cent.
Is It Nonsense?
Most people do not debate The Constitution or current research. They just need to know if something makes sense.
Prime Minister Justin Trudeau softened his tone and showed more compassion this week. But he did not soften his message. He said, “Mandates are the way to avoid further restrictions…” (see video below).
Trudeau is triple-vaccinated. He tested positive for covid last week. Canada is one of the most vaccinated populations in the world. Almost 100% of the most vulnerable citizens are vaccinated.
Citizens can see through this.
Unanswered Questions
• Is it right to continue suspension of The Constitution in light of current evidence?
• Are the mandates good laws? Is it immoral to oppose them?
• Should political leaders denounce protesters?
• Should police arrest protesters or just steal their gas and firewood?
• Do bridge blockades change our opinion of the protest?
State of Emergency or Incompetence
Premier Ford declared a State of Emergency this week. He implied he had no other choice.
The Toronto protest came one evening and was gone before morning. Leaders met with protest organizers before it arrived in the city. Negotiation worked.
Most Canadians support the right to protest, and a large portion supports the Freedom Convoy. At least they did last weekend.
On one hand, a blockade is a blockade, and it is unlawful. By this measure, blocking railways, pipelines, a community in Caledonia for 16 years, or the Ambassador Bridge is unlawful.
But law is not so simple. Intent matters.
People are breaking the law because they want the government to leave them alone. That is wrong. But is it immoral?
The Constitution of Canada
When truckers blockaded the Ambassador Bridge, I doubted my support for the protest. I support law and order. It rests on The Constitution and the Rule of Law. Government must uphold both.
For those who lost jobs due to unconstitutional mandates, citizens have a duty to fight back. They should use all peaceful means at their disposal.
What more should citizens do when governments ignore the supreme law of the land?
Politicians could have ended this weeks ago. As we discussed last week, there is Only One Rational Response to the Truckers’ Freedom Convoy 2022. Let’s hope it is over soon.
