A Physician’s Concern for Patients Can’t be for Sale

Commentary, Healthcare, Marco Navarro-Genie, Uncategorized

Human beings can be corrupt whether they wear blue suits, lab coats, or academic robes.

When a member of Alberta’s Legislative Assembly alleged last spring that patients in Alberta were dying in the thousands as they waited for care, he understandably caused a stir. Raj Sherman, himself a physician, claimed that none of these things had come to light before because doctors were being forced to leave and were paid off to keep silent.

That Sherman’s claims lacked evidence has already been identified.  But a stench of impropriety has remained around the question all this time.  The Alberta government heeded the calls for an investigation (though it resisted the idea at first), even if it will not be an independent inquiry. The fact that there is an investigation lends some credibility to Sherman’s claims.

 Witnesses are being asked to step into a highly politicized field.  Interested in keeping the foul smell in the air, an opposition party launched a dedicated phone line to solicit testimony, intimating that that without their help, doctors, nurses, and government workers would not easily step forward.  Yet, without their pressure there may not have been an investigation.

But a warning light needs to go on, if truth is really what Albertans are after.  Searching for truth in the field of politics is as arduous as looking for truth in a battlefield.

The dedicated telephone line seems to assume that callers will be blameless victims or disinterested parties.  But the line between the interested and the disinterested in this whole affair has not been examined, and it may be quite blurred.  Given that the majority of Albertans place high importance on healthcare, all are interested of course, but some may be more interested than others.

The calls for full immunity to be granted to those who come forward sets off a chain of perverse incentives that is only likely to politicise the matter further –and the question does not need more politicization.

At issue here is the prevalent perception that the doctors who were allegedly pushed out are in the right and by extension that the administrators involved are in the wrong.  There is need to consider that while this version of things may be on the whole true, it may not be true in all cases.  Things are rarely that black and white.  It would be wise to wait for the investigation to conclude before passing judgement on what may or may not be. Prejudging the witnesses one way or the other may result in prejudging the outcome.

Sherman’s allegations that doctors have been “forced” to leave set up those doctors as victims.  But while doctors can be dismissed from their employment, no one can force them to take money they don’t want.  No one should doubt the possibility that there may be corrupt bosses waiving public money at employees to have them leave.  But it is much harder to believe that doctors are being forced to take the money. Doctors have choices: it is unlikely that bureaucrats are stuffing money in the pockets of doctors or depositing hundreds of thousands of dollars in their bank accounts against their wills. 

The claim of public concern and care for patients that supposedly propels rebelling doctors implies a principled position.  But if silence has been exchanged for money, principles have ultimately been undermined. 

The heart of the contradiction in the allegations should be disturbing upon reflection. Healthcare personnel have been fired for defending patients and the public good.  Then, they are encouraged to leave the jurisdiction, effectively turning a blind eye, while they receive large sums of money that comes from the same people they claim to be defending.

It is not imposing a terrible moral burden to expect that a physician’s concern for her patients should not be for sale.  If someone takes money to walk away in silence because she witnessed corruption, she becomes an instrument of the same corruption.  Physicians are no exception.  If Sherman’s allegations are true, those who have taken money in exchange for silence are not blameless victims, and they can hardly claim to have the public interest at heart. A blanket assumption of their innocence would be naïve, and will serve no truth. Similarly, immunity might result in no justice.

There is ample room to guard against the assumption that all people in the front lines giving testimony in this affair are blameless.  With this in mind, we should challenge the notion that witnesses need to receive immunity at any point, especially those whose silence may have been bought.