French physicians need to be careful what they say

Cultural differences in the balancing of ethical principles can help us see things about how our own culture sets our ethical priorities. Recently the French College of Physicians has decided to hold a hearing on whether Dr. Pierre Dukan, the proponent of a controversial weight loss diet, has violated the country’s medical ethics code by proposing that an anti-obesity option be added to the national baccalaureate exam taken at the end of high school. The option he proposed would be passed by students staying within a recommended weight range (see article in Time).

While there are a number of good arguments for why such a proposal could be harmful by promoting eating disorders and would be unfair to those who were overweight for reasons that they were unable to control and because weight is unrelated to academic performance which the exam is intended to measure, I find it interesting that the French medical community would see this as an ethical violation. Their code of ethics states that “a doctor must be aware of the repercussions his views can have on the public.” This represents a high view of the responsibility a physician has for the welfare of the public in general and not just the physician’s own patients. It suggests a strong sense of what it means for medicine to be a profession that is practiced for the common good. It appears that there are other reasons for the desire to sanction this controversial physician as he is also being accused of practicing medicine like a business in the sales of his diet books.

It is hard for me to imagine the AMA sanctioning a physician in the US for making a proposal that could have harmful effects that were not in the best interest of the public. The principle of personal liberty with its attendant freedom of speech has such a high place in our ethical priorities that it overshadows concern for the common good and professional responsibility. It is also nearly impossible to imagine practicing medicine as a business being seen as a violation of ethics. The business model of medicine as a contract between providers and recipients has so replaced the concept of medicine as a covenant-based profession that is hard to find physicians in the US who do not practice medicine as a business whether they want it to be that way or not.

While the motives of those seeking action against Dr. Dukan may not be entirely pure (few of us have entirely pure motives), the ethical standards being used in this situation make me wonder about the things that have displaced those standards in the medical profession in the US.

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Cody Chambers
Cody Chambers

It’s good to learn a few things from the French. It may be time to come to grips with the fact that we may never have health care reform until we abandon the business model of medicine. In my view, medicine is more akin to Christian ministry; and building charity hospitals, as we have in much of our country’s history, is a better option.

Korey Krings

Thanks for the suggestions shared on your blog. One more thing I would like to talk about is that weight-loss is not all about going on a celebrity diet and trying to get rid of as much weight that you can in a couple of weeks. The most effective way to lose weight naturally is by getting it gradually and obeying some basic points which can assist you to make the most from a attempt to lose weight. You may understand and be following a few of these tips, nevertheless reinforcing awareness never does any damage.