BY MIKE MAGEE
Stable, social societies are built on human trust. If you were forced to rebuild a society ravaged by war and destruction, where would you start? This is the question faced by the US military at the end of World War II, especially when it came to rebuilding Germany and Japan, hopefully into stable democracies. The Marshall Plan answered the above question, and its success in choosing health services as a starting point was well documented by many over the next few years, including the RAND Corporation. Their 2007 summary said in part:Nation-building efforts can only be successful if sufficient attention is paid to the health of the population.”
They started with women’s and children’s services, the very site that has been targeted by a splinter of politicians and Supreme Court judges, replacing entrusted doctors with partisan bureaucrats in an approach so obviously flawed that it was half a century ago. forced a course correction in the form of Roe to Wade.
The practice of medicine is complex. Ideally, it requires knowledge, skills, supporting infrastructure, proximity and presence. But above all, it requires trust, especially in moments of urgency, with lives at stake, when an individual, family and community are all on high alert. When time is of the essence, and especially when one or more people are trying to make the right decision for two lives instead of one, decisions are impossibly personal and complex.
This was widely acknowledged by most physicians, including the most devout and conservative across the country in the troubling years leading up to Roe v. Wade† As late as 1968, membership in the Christian Medical Society refused to approve a proclamation declaring abortion sinful. In 1971 it was announced that America’s leading conservative religious organization, the Southern Baptist Convention, was encouraging its members”to work on legislation that would allow the possibility of abortion under conditions such as rape, incest, clear evidence of severe fetal malformation, and carefully assessed evidence of the likelihood of harm to the mother’s emotional, mental and physical health.” In 1973, both the Southern Baptist Convention and the Christian Medical Society chose not to actively oppose the Supreme Court ruling against a Texas law banning abortion known as Roe v. Wadeand reaffirmed that position in 1974 and 1976.
What they recognized was that the nation’s social capital, political stability and security, depended heavily on the compassion, understanding and partnership that grew out of the patient-doctor relationship. As most doctors saw it, what good could come of politicians being made in the midst of such complicated, emotion-ridden and highly personal decisions?
The American Medical Association’s prepared response to the June 24, 2022 reversal of Roe v. Wade was immediate and immediate. They called the decision “a blatant allowance of government interference in the medical examination room, a direct attack on the practice of medicine and the patient-doctor relationship…” Their president, Jack Resneck Jr. MD went on to say: “…the AMA condemns the Supreme Court†s interpretation in this case. We will always have doctors† supports and defends the practice of medicine, we will fight to protect the patient-doctor relationship.” But what exactly does that mean?
I am nearly 75 and a lifelong member of the American Medical Association and I expect to know the AMA, its history and its strengths and weaknesses, as well as everyone else. Aside from having had deep personal relationships over the years with many members of the Board of Trustees (some of whom quietly continue to contact me for advice), I have seen the evolution of the patient-physician relationship in six countries over a 40-year period.
Those who know me well and who have resisted my criticism of the organization know that my intentions are honorable and that the alarm signals I hear reflect my belief that in order for our profession to survive as noble, self-directed and committed especially to the patients who enable us to care for them, we must have a national organization with reach in every US town and city, and official representation in every state and specialty.
My concern today, despite strong messages from Chicago, is that the AMA and its members have not fully understood that this is a “mission critical” moment in the organization’s history. It’s also an opportunity to purposefully flex its muscles, expand its membership and strengthen its priorities. The strong words, without actions to back them up, I believe, will permanently seal the fate of the AMA and challenge the status of medicine as a “profession.”
Here are five actions I think the AMA should take immediately to make it clear that doctors are united with our patients, working with nurses and other health professionals, and that last week’s actions cannot and will not last.
- The AMA should withdraw all funding for all Republican candidates until the 2022 election.
- The AMA should actively encourage “civil disobedience” by physicians as appropriate to protect the health and well-being of all women, regardless of age, race, sexual identity, religion or economic status.
- The AMA, under the auspices of its General Counsel, Andra K. Heller, should convene a formal strategy meeting with the legal counsels of all state and specialty medical associations to formulate an aggressive legal approach to mitigate the damages of the recent action of the Supreme Court to a minimum. †
- The AMA should actively promote AMA volunteers to help provide a full range of women’s health care at federal institutions and on federal land, and establish information sites that coordinate travel and expenses when interstate travel is required for access to care.
- The AMA must make it clear immediately that any restriction on the prescription of drugs to support women’s health care, including contraceptive medications and devices, and Plan B treatments will result in a coordinated nationwide disruption to health services.
Mike Magee MD is a medical historian and the author of “CODE BLUE: Inside the Medical-Industrial Complex.”