Collective action, unions and even strikes are morally OK for doctors, but only if goals help patients too, UMHS medical ethicist says.
ANN ARBOR---Before they strike, negotiate with insurance companies or lobby Congress, physicians should make sure they are acting with their patients---not just themselves---in mind.
So writes a medical ethicist from the University of Michigan Health System in a new paper that coincidentally parallels the current debate over collective bargaining for doctors and the American Medical Association's June 23 vote to form a union.
"Doctors already act collectively and can do so morally. But the goal of collective action must be completely consistent with their commitment to the patient and respectful of the trust patients place in them," says Susan D. Goold, M.D., M.S.H.A., M.A., assistant professor in the UMHS Department of Internal Medicine.
"Even a strike could be morally justified if circumstances were bad enough," Goold continues, "but there are many other collective action options available short of striking. And doctors must also remember that morality and legality are not always in line with one another."
Goold presents her views in a commissioned paper to be published in a special issue of the Cambridge Quarterly of Healthcare Ethics, from Cambridge University Press in England.
In the paper, she disputes some of the most common arguments against physician collective action, unionization and strikes, but puts forth other reasons why such actions might not stand on solid moral ground.
For example, Goold writes, some argue that physicians should not strike because
they are professionals. Airline pilots and teachers, she replies, are
professionals, too, yet they are organized and routinely strike. Others say
striking doctors would deprive the public of essential services and cause
hardship or even death. But, she answers, most health-care services are
non-essential, and physicians could
Contact: Kara Gavin
University of Michigan