The Fourth of July is an important time of year to give thanks for the freedoms we enjoy in this country. One of those freedoms, which my patients and I benefit from every day, is medical freedom. People from all over the world come to the United States for its outstanding medical care. The United States leads the world in cancer treatment and health care research. We aren't perfect, by any means, but ours is still a system with high regard for the individual rights of those who use and practice medicine.
Medical freedom dates back to the days of our country's founding. Many of the Founding Fathers were citizen-scientists including Ben Franklin, Thomas Jefferson, John Adams, and George Washington. They understood the importance of science in advancing knowledge and building a democracy. Thomas Jefferson called "the tranquil pursuit of science" his "supreme delight." They were bold people, who knew, firsthand, that science requires putting forth and testing ideas that may be initially controversial and, therefore, need protection from the interference of politics, religion, and ideology.
Medicine is a science, and science is the discipline that is most susceptible to restrictions on freedom. Under oppressive and fundamentalist regimes, science is often the first to go because it encourages citizens to question, innovate, and doubt.
Look at ISIS-controlled territories in Iraq and Saudi Arabia, where doctors are being executed for treating wounded rebels, for refusing to treat ISIS militants, and according to one grisly report, for refusing to participate in organ harvesting from unconsenting people -- a horrifying thought for any doctor sworn by an oath to "do no harm."
Or look at North Korea, where it's tyrannical leadership's nuclear saber-rattling provoked international sanctions, which have put a strain on the country's health care system, already in disrepair because of food shortages, lack of access to clean water, and poor living conditions. Now, despite the regime's promise of universal health care, patients are said to be taking methamphetamine because they cannot afford drugs.
Then there's Afghanistan, where the Taliban has forbidden male doctors from treating women in hospitals, citing a religious decree that no male doctor should touch the body of a woman. Limited educational opportunities for women under the regime has led to fewer women becoming doctors, which means female patients often have to travel great distances for care or completely forgo having any medical care.
Medicine can also be restricted because of a sheer lack of opportunity. Throughout the developing world, countries and individuals cannot afford the quality of medicine we enjoy in our country. Even basic hospitals are often unavailable. Education is also lacking, meaning fewer doctors and outdated practices and technology. Here in the United States, patients can enjoy not just the freedom to make medical choices, but the opportunity to have the best choices available.
Even in our highly effective albeit imperfect system, we have to be diligent about keeping politics and ideology separate from medicine. Science is not a human construct. It's much more than that. We, as doctors, never pretend to fully "understand" it all, but we're honored and humbled to live and work in a country that allows us to "practice" it. I wish you a happy upcoming Fourth of July!