The contact for trust in the doctor-patient relationship and the damage to it that ensues when antisemitic comments professed from said physicians and medical students spews forth. Antisemitism today, another group tomorrow. Physicians must be held to a higher standard.
Are physicians held to a different ethical standard? Is there a distinction between our professional and private lives, the opinions that we share, and the impact it may have on patient care?
Before answering, let’s discuss the central tenet of the doctor-patient relationship: the contract for trust. When the patient comes to see a physician in any environs, the expectation is that the physician will provide the best care humanly possible. Granted, human beings make mistakes and indeed when these mistakes happen, I can tell you that physicians experience tremendous guilt, regret, and emotional stress that can last weeks if not months knowing that they may have been responsible for any inadvertent harm.
When something terrible befalls the patient that was outside of the control of the physician, they will usually ruminate and ask themselves “What could I have done differently so this would not of happened?” There is a period of anguish including situations where the physician was not responsible for the harm that befell the patient. They could have had a stroke, heart attack, or an incidental finding of cancer that really could not be determined or found beforehand. Nevertheless, tremendous guilt and regret ensues.
The basis of this relationship contributes to the patient’s confidence that their physician will be doing their best to address their concerns; that they receive good care whilst mitigating harm.
Relationships are built up over many years. I for one have patients that I have known for more than 30 years. Therefore, anything that can damage this relationship will by extension damage the ability to provide care to the patient. Indeed, if there is no trust, there is absolutely no way that the physician can be effective in providing care. This can happen either by the physician’s own actions or that of the patient.
However, I would like to focus on the physician side of things. This is especially relevant today as emotions are running very high as it pertains to the explosion of opinions regarding the latest Israeli- Hamas conflict. Commenting on the conflict is beyond the scope of this show. However, what is relevant is how it impacts the level of trust between patient and physician. How so?
I would like to raise awareness of what is going on at the University of Ottawa that are seemingly not taking the lead in addressing an issue that is having a deleterious effect on its medical student body. It has also galvanized many physicians that are aghast by what they have read and seen.
Letters have been written to the Dean of Medicine yet the response has been less than transparent as it could be. The network between physicians is relatively tight and news travels quickly. Physicians in charge of training programs are aware of the statements made and have reacted by saying that they will not be welcome in their training programs should they apply.
A medical student at the University of Ottawa was elected to lead their medical school class and as such represents all and not a specific portion of the class. In this situation the student was posting/reposting antisemitic commentary on X. These posts have been screenshotted.
In their posts that I read on X, they clearly indicate that they refused to speak with their Jewish classmates by calling them “Zionist med students”, and being dismissive of their concerns despite being the elected leader of the class whose mandate is to listen to the concerns of all.
This behaviour and attitude can damage the reputation of the institution training them, questions whether they can provide care to the groups that they have been denigrating, the effect this has on their colleagues including the medical students that I am presently teaching at my office, and the distress that they have mentioned and related to me.
I think the public needs to know that this matter is taken very seriously and that a person in the position of trust must safeguard that trust in this situation, this has been breached.
I also want to be clear. This applies in any situation where one group is denigrated. In this instance, it is antisemitism. Tomorrow it can be another identifiable group that is treated similarly. It is wrong every time.
The public needs to know that the physicians that they will be seeing now and in the future are behaving in a responsible, respectful, and caring manner. Imagine the discomfort if you discovered that the physician you just saw professed hatred and bias towards you. It would make the encounter extremely difficult and introduce skepticism about whether you were getting the best possible care.
On a personal note, it is most distressing to me that there are individuals in Canada that that express hatred towards me and my colleagues and friends because we are Jewish. The students that are training to be your future doctors, are now learning in an environment where they feel unsafe, hated, and denigrated. This type of vitriol and hatred does not occur in a vacuum. Historically, it also does not stay within one specific group.
Our universities and our country need moral clarity to act and respond to this in a reasonable and rational manner. Racial and religious hatred is a cancer. It has clearly impacted me and I’m at the end of my career. I am concerned about the effect it has on our students and new physicians that feel unprotected, vulnerable, and demoralized.
Those that promote hate, vitriol, and by extension harm to a minority group, and I want to be clear, in this instance it is predominantly antisemitism, should not be able to provide care to patients. There is a difference criticizing Government policies wherever they may be, and professing hatred towards an entire race or religion.
People should be allowed to express their opinions and disagreements. But when it extends into the arena of directly supporting or promoting physical harm to others, that steps over the line. Today, universities are showing no backbone, no clarity of purpose, and by such inaction, end up condoning the behaviors that have shocked and created tremendous dismay frustration, and angst amongst most Canadians.
It is as if you’re watching a movie, empathize with the injustice being perpetrated against the characters and yelling at the screen “why don’t you do this, the solution is in front of your nose?” You see clearly what should be done. When universities try to please every group, it ends up negatively affecting the group that is by far experiencing the most distress. It is not leadership when the response should be straightforward by any moral measure.
So, the answer to the question about whether physicians are held to a different standard or whether they should be is: yes. It is an extension of our duty to care for others and because the contract for trust is the mainstay of any successful doctor-patient relationship, breaching that trust is tantamount to inflicting harm on the patient. That runs contrary to what physicians have pledged to do.
And what is most distressing, is that I have to say this in 2023.
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