A group of doctors discussed gambling.
“You’d never believe the pain some of my patients experience with problem gambling,” one said.
“We should lobby government to stop using revenues from gambling!” said another.
Some listeners nodded.
“Don’t we finance hospitals with lotteries?”
Silence.
“Should physicians dictate morality?” someone asked.
Doctors Limit Freedom?
Regardless of the morality of gambling and casinos, should physicians advocate for laws that limit patient freedom? What is the role of freedom in health and human flourishing?
A physician leader frowned at my defence of patient freedom.
“When do we stop making laws and start supporting individual freedom?” I asked.
“Don’t you agree with seat belts?” he asked. “How about stop signs?”
“Of course I agree with seat belts and stop signs,” I said.
“Well, then you agree with government limiting free choice!”
Now there’s the rub: how much freedom do we give up to live together in a ‘free’ society?
People who conflate stop signs with prohibition confuse mutual limits on individual freedom with imposing personal preference on others.
It’s one thing for us to obey stop signs for the safety of all. It’s something else entirely for intelligentsia to impose restrictions on other people’s behaviour that have little to do with their own freedom.
What do you think? Where do we draw the line between promoting healthy ideas and limiting individual freedom? Who should decide? Do we need more health related laws or do we have too many already?
As long as healthcare is tax funded, and universal, we should limit freedoms of people to keep costs down. If health care is private, then you can advocate for individual freedoms. Take helmets for cyclists. That cyclist can drive through the cars and not wear a helmet as long as they pay for the consequences. If they sustain a head injury in a public system of health care, the trauma care will cost hundreds of thousands of dollars funded by the rest of us. By wearing a simple helmet, the govt creating bikelanes , and police enforcing safe cycling, we can collectively safe thousands of dollars in accidents and the consequences of accidents from the rest of us. To those who say, it is my business to wear a helmet or not, sign a document saying you will bear the costs of treating your injury, not the rest of us, and go ahead and weave in and out of traffic with no helmet
Brilliant comment, Scott!
I wonder how far we can push this logic of expecting people to follow the rules or pay for the consequences? Could we use the same logic to enforce behaviours at home? Could we advocate for padlocking fridges because poor diet choices cost society so much?
Of course, I agree with helmets. I struggle with where to draw the line and who should draw it.
Thanks again. Looking forward to seeing you soon…maybe at the AGM in October?
Cheers
Shawn
When the state commits its taxpayers to easing the consequences of its people’s actions, then the state has a responsibility to try to prevent those consequences. When socialized health care pays for not only the unavoidable frailties of our biology, but also for easing the negative outcomes of our lifestyles, then it is drawn into attempts to alter those lifestyles, even if only for fiscal reasons. -philw-
Well said, indeed!
We struggle to find limits of what not to pay for in healthcare; people cry foul at every item delisted. Accepting unlimited state support seems to demand unlimited state involvement in our choices.
Thanks so much for commenting!
Shawn
Good question.
The welfare system inevitably invites these kinds of dilemmas. Since there is a behavioral component to most illnesses and injuries, as budget deficits get increasingly more difficult to manage, one naturally turns against the welfare beneficiary as one of the culprit for runaway costs, whether its the smoker, the drinker, the obese, or the elderly.
The only moral solution is to do away with all health insurance (public and private–private health insurance would not exist without public subsidy anyways) and all govt. intervention in health care. Health care costs would plummet and quality and availability would soar.
Great comment, Michel.
We see patients berated every day in emergency departments across Canada.
“Did you call your doctor’s office?”
“Why not?!”
“Did you take a tylenol for the fever?”
“Why not?” (eyes roll)
“Next time, you really should try not to use the emergency department for anything but true emergencies.”
We expect patients to self-triage to the ‘correct’ access point. But guess where doctors and nurses turn when they want quick access for themselves or their loved ones?
I think we need the government involved in healthcare in the same way that we have referees involved in a hockey game. Interventionalist refs are uniformly despised. We do not need the referees determining the flow and outcome of the game.
Thanks again for taking time to read and comment!
Best,
Shawn