Editor—Since visiting Auschwitz, I have grappled with the question of how I would have behaved as a doctor in Nazi Germany or Stalinist Russia. I hope I would have had the moral courage to refuse to participate in the various perversions of medicine that these regimes demanded—for example, respectively, eugenic “research” and psychiatric “treatment” of dissidents.1
I hope, but not being a very courageous person, I'm not at all sure. My chances of behaving honourably would have been greatest if I had felt part of an independent medical profession with allegiance to something higher and more enduring than the regime of the day. They would have been least if Savulescu's opinions had prevailed (which, I suppose, they did).2
The most charitable interpretation of Savulescu's article was that he wanted to criticise doctors who obstructed women's requests for abortion. If so, he could have made an interesting case on ethical grounds. But by widening his argument, first to the usual suspects of Christians and Americans, and then to anyone who dissents from the current state ideology, he destroyed it. A happy, but unintended, consequence.
Savulescu is entitled to his opinions, but they shouldn't have been presented as received wisdom. Presumably the BMJ published his piece because it is radical and challenging. That's okay, but there are at least 100 000 practising doctors in this country, and, although we are generally intelligent, caring, and skilful, many of us are surprisingly sensitive. We need to be supported as well as challenged. Perhaps the journal could include some encouraging articles from time to time?
After 30 years of reading the BMJ, Savalescu's article was the first one to make me feel physically sick.
Competing interests: None declared.
References
- 1.Nyiszli M. I was Doctor Mengele's assistant. Krakow: Frap-Books, 2001.
- 2.Savulescu J. Conscientious objection in medicine. BMJ 2006;332: 294-7. (4 February.) [DOI] [PMC free article] [PubMed] [Google Scholar]