jueves, 1 de octubre de 2015

It is a grave mistake to distort medicine for ideological purposes.

Medicine, Health, and Sexual Liberation: Friends or Foes?

by Carlos D. Flores

More than a year later, it is still painful to recall the silly talking points that supporters of sexual liberation bellowed when the Supreme Court was preparing to hand down its decision in the Burwell v. Hobby Lobby case. It’s even more painful to recall their reaction after the ruling was made. According to Sandra Fluke, for example, the Hobby Lobby decision was an attempt “to limit access to comprehensive women’s health care from all directions.”

Others, echoing Justice Ginsburg’s concerns, argued that allowing closely held businesses to decline to provide certain forms of contraception and abortifacients because of a religious objection would also allow businesses to refuse to provide blood transfusions in their employee healthcare plan. Not providing the employees of Hobby Lobby with certain forms of contraceptives, they argued, was to fail to provide an essential medical service to them, just as it would be to refuse to cover the cost of blood transfusions. Fluke, once again, provides a pithy encapsulation of Ginsburg’s objection: “Why is birth control—an uncontroversial form of [health] care used by an astonishing number of women—different from blood transfusions and vaccines, which many individuals have religious objections to?”

More recently, the release of damning videos exposing Planned Parenthood’s depraved practice of selling the body parts of the unborn children they have dismembered has reminded the public that Planned Parenthood is a repugnant enterprise that profits from the killing and commodification of human beings. Yet Hillary Clinton recently warned that the Republican-led effort to defund Planned Parenthood amounts to “an attack on women’s health—nothing more, nothing less,” adding that Republicans “should be ashamed.” Senator Bernie Sanders also echoed Clinton’s remarks, averring that “the attempt by Republicans to cut off support for Planned Parenthood is an attack on women’s health.”

Such appeals to “women’s healthcare” are tired talking points. But they reveal something that is rarely, if ever, noted: that sexual liberation and its sacred cows—abortion, contraception, sex-reassignment surgery, etc.—depend crucially on a particular view of medicine and health. As it happens, this account of medicine and health is false. A sound account of medicine and health, which I defend below, reveals that abortion, contraception, and sex-reassignment surgery are not medical procedures—and, in fact, they are in most cases utterly antithetical to the practice of medicine.
  • A Proper Account of Health and Medicine
As Dr. Leon Kass elegantly puts it, “medicine is an art which aims at health.” And health is the proper functioning of bodily faculties.

This is simple enough to see when we consider bodily faculties in isolation: a healthy eye is one that sees well, healthy lungs are those that respire well, and healthy hearts are those that pump blood well. But one should also speak of health as not merely the proper functioning of a particular bodily faculty but the proper functioning of the human organism considered as a whole. Thus, ahealthy human is one whose parts function well in unison toward the end of the bodily life of the whole. Of course, it bears noting that bodily health is necessary but not sufficient for the holistic flourishing of the human person.

In order to know what medicine is not, one needs to know what medicine is. 

Consider the following cases.

- A man whose eyesight has recently worsened visits an ophthalmologist to see what is the matter with his eye. The doctor identifies the problem with his eye and restores the man’s eye to its proper function.

- A physician giving his patient a routine check-up notices that, if left untreated, his patient’s cholesterol levels will kill him by way of cardiac arrest. The doctor recommends that his patient change his diet, and he prescribes cholesterol-reducing medication and physical exercise.

- A woman books an appointment with a plastic surgeon because she believes that her nose is aesthetically displeasing. There is nothing functionally wrong with her nose—she can breathe comfortably and easily detect different smells. The surgeon proceeds to remove some cartilage from her nose to mold it into a more aesthetically pleasing shape.

- A man with perfectly functioning arms desires to have one of his arms removed. In his opinion, doing so would allow him truly to “be himself” and to “be more comfortable” in his own body. Besides the desire to remove his arm, the man seems perfectly reasonable. The man books an appointment with a surgeon and the surgeon agrees to remove the man’s arm.

The first two cases seem quite clearly to be medical procedures. The third case is questionable. The fourth example certainly does not qualify as medicine.

The first two cases reveal important truths about medicine. First, medicinerestores bodily faculties to their proper function. Second, medicine prevents the dysfunction of bodily faculties. Indeed, this is the account of medicine that has prevailed for thousands of years and that explains the content and spirit of the Hippocratic Oath, particularly its primum non nocere (“first, do no harm”) maxim. Call this account of medicine, then, the Hippocratic account.

Our hesitation to consider the third case a medical procedure is because the procedure is not oriented toward either the restoring of a bodily faculty to its proper function or preventing a bodily faculty’s dysfunction. Likewise, in the fourth case, rather than being oriented toward the restoring of a faculty to its proper function or preventing its dysfunction, the procedure intentionally frustrates and damages the proper operation of bodily faculties. Because of this, we can say something much stronger about the fourth case: it is contrary to the aims of medicine.

  • Contraception and Sterilization
  • Abortion and Abortifacients
  • “Sex-Reassignment Surgery” and “Conversion Therapy”

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