Straight to the point

The beginning of wisdom is the definition of terms.

Socrates

The phrase “medical freedom” has become common usage in the wake of the Covid-19 catastrophe. But like many buzzwords and neologisms, “medical freedom” is perhaps ill-defined or even undefined. We all know more or less what it means in our own minds, or at least we think we do. But when speaking about medical freedom with others, are we talking about the same thing?

In fact, “medical freedom” has become more than a buzzword. It is also a movement, with its advocates, experts, and critics. Multiple medical freedom conferences have been organized and are taking place in the United States and abroad, and political parties under its banner have formed.

As Socrates warns, the lack of a standard definition for an important concept, much less an active movement, is a problem. Like the proverbial blind men describing an elephant to each other, when we lack a standard definition, persons with different perspectives end up talking at rather than to each other about different ideas, while thinking they are meaningfully communicating about the same thing.

What follows is a brief summary of my efforts to find a standard definition of medical freedom. (Spoiler alert: I failed to find one, so I wrote the best definition that I could.)

For what it’s worth, Wikipedia does not have an entry for “medical freedom” as of this writing. However, it defines “health freedom” as follows: “The health freedom movement is a libertarian coalition that opposes regulation of health practices , and advocates for increased access to “non-traditional” health care.” 

It goes on to associate said movement with such luminaries as former Congressman Ron Paul, former Beatle Paul McCartney, and yes, the John Birch Society. 

In the mainstream media, starting about 2 years ago – soon after the onset of the Covid-19 vaccine mandates – published articles appeared that characterized “medical freedom,” at least in part, as a sort of rallying cry for right-wing militia initiatives.

For example, in an article dated August 7, 2021, the Washington Post reported on the then-burgeoning medical freedom movement in Western New York. The Post described the movement as a recruitment tool for far-right militia groups, even referencing the remote and entirely unrelated incidents of Ruby Ridge, Idaho, Waco, Texas, and even the Oklahoma City bombing. The Post article states:  

Far-right groups have aligned themselves with those opposed to masks and vaccines, seeking new allies around the issue of “medical freedom” while appearing to downplay their traditional focus on guns, belief in the tyranny of the federal government and calls by some for violent resistance.

Notably, the article’s author, one Razzan Nakhlawi, is currently listed on the Post website as “a researcher on The Post‘s National Security desk.” 

More recently, with public distrust in vaccines reaching historic highs, the media has shifted its characterization of medical freedom from a domestic terror threat to a cabal of ingenious and industrious hucksters. (After all, how can a few crackpot far-right militiamen sway mass public opinion so successfully?)

In a March 24, 2023 article, the far-left magazine the Nation described “The Medical Freedom Hustle” as follows: 

Under the great dispensation of our new age of medical freedom, these disparate forces—ambitious Republican politicians, self-interested medical professionals, profiteering quacks, and nihilist visionaries—have melded.

It would be a subject for another day and another essay to unpack all the psychological projection concentrated in that quote. Suffice it to say that the traditional far-left – insofar as outlets like the Nation represent it – has come to characterize “medical freedom” largely as a kind of scam or confidence game, allegedly designed to draw the population away from legitimate mainstream medicine and toward the folly of snake-oil and naturopathic quackery.

Those more supportive of “medical freedom” see it very differently than legacy media such as the Post or far-left outlets like the Nation.

Florida Governor Ron DeSantis has declared his state “the Medical Freedom State.” In May of 2023 he signed 4 pieces of legislation that were touted as “the strongest legislation in the Nation for medical freedom.” Most prominent among these was:

Senate Bill 252 – Most Comprehensive Medical Freedom Bill in the Nation:

• Prohibiting business and governmental entities from requiring individuals to provide proof of vaccination or post-infection recovery from any disease to gain access to, entry upon, or service from such entities.
• Prohibiting employers from refusing employment to or discharging, disciplining, demoting, or otherwise discriminating against an individual solely on the basis of vaccination or immunity status.
• Preventing discrimination against Floridians related to Covid-19 vaccination or immunity status, etc.

The other 3 laws 1) banned gain-of-function research in Florida, 2) provided protections for physicians’ freedom of speech, and 3) provided “an exemption from public records requirements for certain information relating to complaints or investigations regarding violations of provisions protecting from discrimination based on health care choices.”

As politics is, in Bismarck’s words, “the art of the possible,” it is difficult at best to reverse-engineer passed legislation into a clear understanding of the underlying principles that generated it.

However, it does appear that the Florida “medical freedom” legislation attempts to address aspects of 3 problems that became obvious during the Covid-19 era. These are 1) the medical and public health infringement on citizens’ fundamental civil liberties, 2) the systematic and oppressive control and silencing of physicians during the pandemic, and 3) the apparently out-of-control, dangerous, and unethical research that spawned the pandemic in the first place.

Extrapolated further, these pieces of legislation appear to be steps toward reestablishing 3 things: patient autonomy, physician autonomy, and truly ethical practice across all of medicine, from bench research to bedside patient care.

The Medical Freedom Party, a political party formed in New York City in April 2022 in the wake of Covid-19 mandates, states in its platform: 

The Medical Freedom Party believes the individual is endowed by his or her creator with the inalienable right to bodily autonomy. The Medical Freedom Party asserts that bodily autonomy is the basis from which all freedoms flow. 

The party’s platform goes on to make several more detailed assertions, all of which expand on their insistence for absolute bodily autonomy. This appears to be their principal and perhaps overwhelming concern with regard to medical freedom.

Also notable in their platform is their clear use of language from the Declaration of Independence. To them, bodily autonomy is a fundamental right, fully equivalent to life, liberty, and the pursuit of happiness.

While this points us in a clearer direction regarding the priorities and views of medical freedom advocates, we still lack an explicit definition for medical freedom. Furthermore, it becomes apparent that different groups may focus on one particular part of the concept, possibly ignoring or underestimating the importance of others.

I would like to propose my definition of medical freedom here. 

I submit it as a serious and genuine effort at establishing a sound working definition for this important concept, so that interested parties discussing medical freedom can be confident that they are speaking about the same thing. I welcome discussion about its finer points, or even its larger ones, as others feel necessary. After all, that is one of the prime purposes of a working definition – to invite discussion and to work toward the best consensus possible.

In my research, I drew on conversations from many colleagues who are knowledgeable on this issue. I also referred to foundational medical ethics writings, many of which I have written about in the past. 

As an American, I also referred in detail to the founding documents of our country, specifically the Declaration of Independence and the Bill of Rights. I did so for a couple of reasons. First, they are commonly cited by medical freedom advocates, as seen above. Second, it is undeniable that in the name of “public health,” numerous freedoms clearly stated in the Bill of Rights were taken away from citizens during the Covid-19 lockdowns, by extralegal executive fiat, at multiple levels of government.

Finally, I made a genuine effort to assess negative views of the concept, such as those at the beginning of this essay. Ultimately, I must admit I gave up in cases such as those cited above. I believe that many of these characterizations from the mainstream media and/or the far-left have been made in conscious bad faith. I have come to know numerous medical freedom advocates, and accusations, for example, that they are the tools of covert, nascent Timothy McVeighs are too patently absurd not only for me to believe, but for me to believe the purveyors of such claims believe themselves.

One can be opposed to a concept and still be willing to work toward a rational definition of it. I am personally opposed to communism, but I am able to refer to it, at least definitionally, as something like “a Marxist, socialist economic theory whereby Government controls all means of production, in pursuit of a classless society.”

If I refuse to accept any definition other than “a bunch of murderous bastards,” then there’s not much hope discussing its pros and cons, is there? I fear this is more or less where we are, at least at present, with many opponents to the notion of medical freedom.

I sought to make my definition broad enough to cover all of the main ideas it must contain, but brief enough to be useful and memorable. I settled upon a 3-part definition. 

One might think of this definition of medical freedom as something like a three-legged stool. All 3 legs must be in place for the stool to remain standing. The first component (or “leg”) of medical freedom focuses on the individual patient, the second addresses public health and providers of health care, and the third emphasizes the philosophical, ethical, and even legal underpinnings of the concept.

I addended the definition with a longer list of related but subsidiary concepts that I felt must be considered as well. If one envisions the definition per se as a sort of “Declaration of Independence,” the list that follows it might be thought of as analogous to a “Bill of Rights.”

Here is my definition of medical freedom:

Medical freedom is a moral, ethical, and legal concept, essential to the just and proper practice of medicine, that asserts the following:

1. The individual patient’s autonomy over his or her own body with regard to any and all medical treatment is absolute and inalienable.

2. Physicians and public health officials do not possess the authority to deprive any citizen of their fundamental civil rights, including during a declared medical emergency.

3. The four fundamental pillars of medical ethics – autonomy, beneficence, non-maleficence, and justice – are essential to medical practice and must be observed at all times by all physicians, nurses, public health officials, researchers, manufacturers, and all others involved in health care.

In the wake of the Covid-19 catastrophe, and in light of the innumerable abuses and affronts to basic civil rights that the public health establishment and the physicians under them inflicted upon citizens, several derivative statements follow.

1.  Patient autonomy depends upon informed consent, confidentiality, truth-telling, and protection against coercion. 

2. Informed consent must be obtained for all health care interventions, including but not limited to invasive procedures, vaccinations, and medications. To be valid, informed consent requires a competent patient (or a competent proxy representing the patient’s best interest) who receives full disclosure, and after understanding it, voluntarily agrees.

3. Confidentiality is central to patient autonomy. Specifically, any “health passport” type of public health approach violates patient autonomy, and must be forbidden.

4. Truth-telling. Physicians and health officials are duty-bound to tell the truth. Willful deviation from this violates patient autonomy, and must result in professional discipline.

5. Coercion of any kind, applied to patients or health care providers, violates patient autonomy. This includes bribery, incentivization, threats, blackmail, public shaming, scapegoating, exclusion or ostracization from society, deceptive advertising, and all other forms of coercion.

6. Beneficence requires that all treatments given to a patient should be done only when the prospect, intention, and likelihood of providing genuine benefit to that patient exists. There must be no “taking one for the team.”

7. Non-maleficence refers to the “First, do no harm” precept of medical practice. No medical treatment should be imposed on any patient that is likely to harm the patient, or where the risk/benefit ratio is negative for that patient.

8. Justice requires that both the benefits and burdens of medical care must be distributed equally throughout the population. A new emphasis on the protection of vulnerable populations, especially children, is essential.

9. Public health directives that impact citizens’ civil rights in any way must be enacted lawfully through legislation, not by emergency declaration or by executive or bureaucratic fiat.

10. Refusal of treatment should never result in punishment. Specifically, it must not preclude a patient from receiving other treatments, except where the first treatment is an absolute medical prerequisite for the second treatment.

11. Open and honest debate. The medical profession must allow, and indeed encourage, open and honest debate within its ranks, without fear of reprisal.

12. Censorship, silencing, intimidation, and punishment of physicians and other health providers for making statements contrary to the officially approved or majority medical narrative must be prohibited, under penalty of professional and/or legal punishment of the censors.

13. Patient redress. Patients must have the right to seek real and meaningful redress for any kind of negligent or malicious harm done to them by any physicians, health care systems, public health officials, or producers of drugs or other health care products. No one involved in the healthcare enterprise may be immune, and laws providing such immunity must be removed.

14. Outside influences. The medical profession must eliminate all undue outside influences from its decision-making process, including financial incentives from industry, private foundations, insurance companies, and unelected international entities.

15. The patient-physician partnership. The patient, working one-on-one with their physician, must make clinical care decisions, with the patient reserving ultimate authority to decide. Clinical care decisions must not be predetermined by government bureaucrats, statistical analyses, industry influence, insurance carriers, or other outside influences. 

16. Protocols. The mandated or coerced use of strict or inflexible protocols in medical practice must be prohibited. Variation from protocols, to allow for individualized patient care decisions, must be allowed.

Multiple public health officials, including current CDC Director Mandy Cohen, have noted the loss of public trust in the medical establishment, the public health enterprise, and physicians in general, in the wake of Covid-19. While they are correct that trust has been lost, many appear oblivious to the reason for it, namely the appalling abuses of power they themselves oversaw during the Covid-19 era.

The only real way to restore public trust in medicine is for those in charge to acknowledge their wrongdoing, accept responsibility for it, and for medicine to reform, from the oppressive and overbearing population-based system of the Covid-19 era, into a truly patient-centered system that serves the individual patient first and foremost.

I am hopeful that this definition of medical freedom – and the “bill of rights” that follows from it – will invite productive discussion and debate, and will prove beneficial to this vitally important process of reforming the entire medical enterprise. 

Acknowledgments: When writing this essay, I drew from conversations and communications with numerous people who are knowledgeable on the subject in question. These include (but are not limited to): Kelly Victory MD, Meryl Nass MD, Kat Lindley MD, Peter McCullough MD, Ahmad Malik MD, Drew Pinsky MD, Jane Orient MD, Lucia Sinatra, Bobbie Anne Cox, Tom Harrington, Shannon Joy, and my editor Jeffrey Tucker. I am gratefully indebted to these people. They deserve recognition for much of whatever is of value here. For any errors, confusion, or dross, I claim full credit. 

Source: Brownstone Institute Read the original article here: https://brownstone.org/