Friday, September 21, 2007

Government Intrusion on Medicine, Part 1

In 2006 New York began checking the blood sugar levels of residents with diabetes by requiring medical labs to report test results to the city -- the first time any American government has monitored individuals with a non-contagious disease. The program is justified by its supporters on grounds that money and lives could be saved through intervention in the care of those whose diabetes is poorly controlled. There have been surprisingly few opponents. On the other hand, that's not really surprising; it's strong evidence for the assumption in Stewards of the Flame that most people will voluntarily give up freedom and privacy, and willingly deprive others of it, if told that government action will "save lives" or even simply have "health benefits." I fear this premise of the story is not an exaggeration.

As the New York Sun observed, "Given the complete lack of protest in response to the new mandated diabetes reporting and tracking scheme ... it is highly likely that we will see proposals to mandate reporting of serum cholesterol levels, high blood pressure, and body mass indices, followed by city interventions to prod us into changing our behavior to reduce the risks of heart attack, stroke, and the spectrum of maladies associated with obesity. This new diabetes regulation is, in short, a harbinger of more intrusive legislation to come -- all in the name of 'public health.'"

But surely Americans cannot be forced to submit to unwanted medical care; doesn't the law require informed consent? Yes, and the Supreme Court has ruled that competent adults cannot be treated against their will. But not everyone is aware of this fact. (It was, for instance, ignored in the Academy-Award winning movie Million Dollar Baby, the ending of which depended on the assumed inability of a conscious heroine to reject treatment.) Arrested criminals must be read their rights, but in medical situations people are often simply handed a consent form and told to sign it. Except for surgery, they generally must sign a blanket consent before even being permitted to see a doctor.

Moreover, the law is unclear when it comes to screening, as opposed to treatment; screening programs don't always provide for opting out. In any case, the vast amount of government indoctrination on health matters goes unchallenged and indeed, meets with widespread approval. One of the reasons I make a point of Stewards of the Flame not being suitable for the same readership as my YA novels is that I don't want parents and librarians to think I'm using my position as a well-lnown YA author to undermine this indoctrination among kids. To adults, however, I am quite open about the fact that I disapprove of most of it. What's best for the health of individuals is not a matter for the goverment to decide. It wouldn't be even if it weren't controversial -- and it is; medical experts don't always agree (more on this later under the heading "Heresy in Medicine.") Such decisions depend on personal factors and should not be made by anyone merely on the basis of statistics.

For many more links to articles about government compulsion in medical treatment, go to and click through to the background information pages.


Paula said...

Sylvia, I totally agree with your comments. One area of government intrusion that particularly concerns me is their attempt to regulate alternative medicine. Why can Americans not choose which form of care is right for them? Is the government more intelligent and capable than its individual citizens? I don't think so. And why are alternative practitioners restricted and harassed when they attempt to promote their opinions and products? Because the government fears losing control of the very lucrative medical and pharmaceutical industries. This strikes me as a total contradiction of the freedoms our constitution provides its citizens. Keep speaking out, Slyvia. I hope you have planned more books with these themes.

Sylvia said...

I certainly agree with you Paula. And it's not just that the government doesn't want to lose control for economic reasons -- there is a huge bureaucracy that would have no reason for existence if the public at large hadn't been indoctrinated with the idea that it knows what's "best" for people. The Medical Establishment has always had a lot of lobbying power, too, and thus maintains its monopoly though influence over elected officials. The one area in which few people seem to recognize threats to freedom is medical care - they will rebel against any other imposed restrictions, but will tolerate and even demand government regulation of whatever is said to promote health.