Pat Gunn (dachte) wrote,
Pat Gunn

Medical Exceptionalism

I'd love to be able to take more of a stance on this matter, but I can't (at least I can't based on anything other than issues) because the cultural/societal struggles involved are significantly more important than the rule-of-law issues that shape the battlefields, I think, and I've come to see law as neither something to automatically be hated (chaotics) nor always to be obeyed (lawfuls) in the ongoing struggle over the public good. The issue is this - various areas of expertise in society develop culture, and that culture tends to eventually develop its own ideas about the ethics of acts tied to the practice. Eventually, they grow used to being the only people talking about or regulating the ethics of practices tied their field, and grow very resentful of other people discussing or regulating the same. Sometimes these other people are society at large (possibly represented by the state), sometimes other groups in society. The argument goes that the outsiders should mind their own business and leave it to their subgroup to decide what's in the public interest (and when the struggle sits between subgroups, their claims are amusingly mirrored). Examples:

  • The New England Medical Journal recently made a play like this, suggesting that self-regulation in medical ethics is sufficient and that society at large should leave it to doctors. On one hand, there is a lot that has been done on this front by medical ethics groups. On the other hand, disqualifying society from ethical/moral regulation on matters close to the most important to society because the subsociety says "I'm already thinking about that" seems an odd delegation of power.
  • Some geeks have done it too, including those that sympathise with the Declaration of Independence of Cyberspace. The idea there is that they don't like legislators passing bills that affect them when the legislators don't really understand them -- this is again pretty analogous to the medical case.
  • Bar Associations and other remnants of the exclusive-guild systems Europe used to have have traditionally been the same way
  • Reporters and priests have a cultural history of following their own ethics, and often claim (not always receiving) the ability to live by their ethics rather than those of the population at large...

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