Much like a Bill of Rights, a principal function of any Code of Ethics is to set limits, to check the inevitable lust for power, the libido dominandi, that human beings tend to demonstrate when they obtain authority and status over others, regardless of the context.
Though it may be difficult to believe in the aftermath of COVID, the medical profession does possess a Code of Ethics. The four fundamental concepts of Medical Ethics – its 4 Pillars – are Autonomy, Beneficence, Non-maleficence, and Justice.
Autonomy, Beneficence, Non-maleficence, and Justice
These ethical concepts are thoroughly established in the profession of medicine. I learned them as a medical student, much as a young Catholic learns the Apostle’s Creed. As a medical professor, I taught them to my students, and I made sure my students knew them. I believed then (and still do) that physicians must know the ethical tenets of their profession, because if they do not know them, they cannot follow them.
These ethical concepts are indeed well-established, but they are more than that. They are also valid, legitimate, and sound. They are based on historical lessons, learned the hard way from past abuses foisted upon unsuspecting and defenseless patients by governments, health care systems, corporations, and doctors. Those painful, shameful lessons arose not only from the actions of rogue states like Nazi Germany, but also from our own United States: witness Project MK-Ultra and the Tuskegee Syphilis Experiment.
The 4 Pillars of Medical Ethics protect patients from abuse. They also allow physicians the moral framework to follow their consciences and exercise their individual judgment – provided, of course, that physicians possess the character to do so. However, like human decency itself, the 4 Pillars were completely disregarded by those in authority during COVID.
The demolition of these core principles was deliberate. It originated at the highest levels of COVID policymaking, which itself had been effectively converted from a public health initiative to a national security/military operation in the United States in March 2020, producing the concomitant shift in ethical standards one would expect from such a change. As we examine the machinations leading to the demise of each of the 4 Pillars of Medical Ethics during COVID, we will define each of these four fundamental tenets, and then discuss how each was abused.