{"id":805,"date":"2010-12-24T17:57:44","date_gmt":"2010-12-24T16:57:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=805"},"modified":"2010-12-24T17:57:44","modified_gmt":"2010-12-24T16:57:44","slug":"hate-the-sin-operate-on-the-sinner","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/12\/24\/hate-the-sin-operate-on-the-sinner\/","title":{"rendered":"Hate the Sin, Operate on the Sinner"},"content":{"rendered":"

There’s a story in the BMJ<\/em><\/a> about a German surgeon who refused to operate on an anaesthetised patient because he – the patient – had a swastika tattoo. \u00a0The surgeon, it’s reported, was a Jew who couldn’t find it in his conscience to operate on anyone with Nazi sympathies. \u00a0The head of the German Medical association has said that the surgeon should not be reprimanded.<\/p>\n

While I have a fairly visceral dislike of the far right, which extends to anyone with far-right sympathies, I think that this opinion is flawed. \u00a0There’s several reasons for this, and they refer to all the players in the scenario.<\/p>\n

First, and weakest, is that we don’t know that the guy was a Nazi. \u00a0He could have been an ex-Nazi who doesn’t have the cash for a tattoo removal; or maybe he was satisfied that it’d never be seen publicly. \u00a0It may be that the probability of this being the case is low; but the surgeon can’t have known it not to be. \u00a0But this reason is, as I said, very weak.<\/p>\n

There are stronger reasons, though. \u00a0Let’s allow that the patient actually does currently have neo-Nazi beliefs. \u00a0Learning that his operation was interrupted for no medical reason, but because his surgeon was a Jew, is – I’d have thought – not likely to weaken his adherence to Nazism. \u00a0He could just as well take it as evidence that Jews really don’t like gentiles, and Germanic gentiles in particular. \u00a0Yes, the reasoning is fallacious – but a Nazi who doesn’t fall prey to fallacious reasoning at least once in a while is unlikely to stay a Nazi for very long.<\/p>\n

Along similar lines, one could mount a kind of Arendtian argument along the lines that central to Nazism was the idea that you could draw a bright line – moral, political, social – between Jew and non-Jew; from this reasoning, to say that one has the right not to operate because one is Jewish is unwittingly to play into that false antagonism. \u00a0This kind of point is picked up in the BMJ<\/em> article by\u00a0Claudia Wiesemann, who notes that<\/p>\n

World Medical Association\u2019s 1948 Declaration of Geneva states: \u201cI will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient.\u201d<\/p><\/blockquote>\n

But, the article continues:<\/p>\n

She believes that the \u201cdoctor in Paderborn should have operated on the patient. He should have been prepared for situations of this kind,\u201d she said. \u201cHowever, I think the doctor should not be reprimanded for refusing to do the operation. Firstly, he took care to arrange for somebody else to step in and did not endanger the patient.\u201d<\/p><\/blockquote>\n

The second reason, she added, is that the Declaration of Geneva was originally drafted \u201cto preclude the horrible racial politics of medicine during German national socialism. It is a sadly ironic twist of history that exactly this paragraph now should serve to judge as morally unethical what the Paderborn physician has done\u2014or not done\u2014to a neo-Nazi. I feel it would be morally dubious for a German law court to pursue him for that.\u201d<\/p><\/blockquote>\n

Well, except that he could have endangered the patient. \u00a0It’s not clear whether another surgeon was available at that time; if not, the patient would have been exposed to anaesthetic risk one more time than necessary. \u00a0But endangerment aside, I think that there’s also something a bit twisty about the way that a clear violation of the Geneva Declaration is being defended on the grounds that the Declaration was made in the wake of Nazism. \u00a0So what? \u00a0The Declaration says that race, religion, politics and all the rest of it have nothing to do with medical practice. \u00a0That means that Nazi medical practice would be condemned. \u00a0It doesn’t mean that Nazis would be excluded from treatment, even temporarily; there’s an ocean of difference (and not just moral: it’s ontological, too) between Nazi practices and Nazis. \u00a0The Geneva Declaration’s moral power comes from the fact that it extends moral protection even to the repugnant, while still condemning what they do.<\/p>\n

I think, too, that there’s something morally dodgy about medics taking on a quasi-judicial – or simply judgmental – role. \u00a0 At least as far as the surgeon qua<\/em> surgeon is concerned, the moral or legal status of the patient is neither here nor there. \u00a0(I’ve written on a related theme<\/a> in the American Journal of Bioethics<\/em> in response to a paper by Gesundheit <\/a>et al<\/a><\/em>; the focus is slightly different, but there’re clear points of contact.) \u00a0A medic’s job is – at least plausibly – primarily to cure, and thereafter to give comfort. \u00a0To refuse this is to misunderstand what being a medic is about. \u00a0Nor can appeals to conscientious objection carry much weight here – even if you think that there should be scope for such objections, it’s one thing to refuse to participate in a procedure you think wrong (as in the abortion conscience clause), and quite another to refuse to carry out a procedure you admit to be permissible on a person you don’t like.<\/p>\n

So, somewhat against my instincts, I think that a reprimand would be in order. \u00a0Just because someone is an arse, it doesn’t mean that they can’t be wronged. \u00a0And it looks like the patient here, arse though he may have been, has been wronged.<\/p>\n","protected":false},"excerpt":{"rendered":"

There’s a story in the BMJ about a German surgeon who refused to operate on an anaesthetised patient because he – the patient – had a swastika tattoo. \u00a0The surgeon, it’s reported, was a Jew who couldn’t find it in his conscience to operate on anyone with Nazi sympathies. \u00a0The head of the German Medical […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[575,328,475],"tags":[],"class_list":["post-805","post","type-post","status-publish","format-standard","hentry","category-bmj","category-philosophy","category-politics"],"yoast_head":"\nHate the Sin, Operate on the Sinner - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/12\/24\/hate-the-sin-operate-on-the-sinner\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hate the Sin, Operate on the Sinner - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"There’s a story in the BMJ about a German surgeon who refused to operate on an anaesthetised patient because he – the patient – had a swastika tattoo. \u00a0The surgeon, it’s reported, was a Jew who couldn’t find it in his conscience to operate on anyone with Nazi sympathies. \u00a0The head of the German Medical [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/12\/24\/hate-the-sin-operate-on-the-sinner\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2010-12-24T16:57:44+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Hate the Sin, Operate on the Sinner\",\"datePublished\":\"2010-12-24T16:57:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/\"},\"wordCount\":937,\"commentCount\":13,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"BMJ\",\"Philosophy\",\"Politics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/12\\\/24\\\/hate-the-sin-operate-on-the-sinner\\\/\",\"name\":\"Hate the Sin, Operate on the Sinner - 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