Medical Ethics

Kenneth Feucht (
Wed, 29 May 96 03:14:55 UT

Several comments have been made regarding my comments and the comments of Paul
Arveson regarding the economics of medical care. I will make my comments few.

1. A few people felt the language I used regarding Paul Arveson thinking "as a
Communist" was inappropriate. I agree and apologize. Ad hominem arguments and
deliberately laden categorizations do not contribute to intelligent rapport
among Christians, let alone scientists.

2. Jim Benke requested an in depth Biblical review of the Christian response
to charity. Unfortunately, I don't think a reflector is the best medium for
this sort of discussion. It is not that I could not provide a rebuttal. It is
that any response should be articulate, complete, and logical. That is
difficult to do in the space of a reflector. I would only refer one to the
writings of Olasky, Beisner (Prosperity and Poverty), Schlossberg (Idols for
Destruction) and numerous articles from the Journal of Biblical Ethics in
Medicine, and the writings of the American Association of Physicians and
I will only afford you a trivial response at this time. I certainly agree
with much of what you say. One of my favorite saints is Francis of Assisi, and
he most certainly would not quarrel with your statements. When I look at my
own practice, I write off at least 70% of my billings, and those are billings
at the new reduced "Medicare" rates. No other business in the world (except
for the U.S. government) could operate at 70% of their billings being written
off. I'm not talking about making a great income. I do like the freedom to
choose to whom I wish to be charitable. If a patient drives up in the latest
BMW on DSHS (Medicaid) charity care, and can't make a $10 co-pay, my desire
for Christian compassion falters. As I said before, this happens all the time.
Really! It happens all the time! When I take care of a DSHS patient, I don't
even break even in my billings. It costs me more to take care of the patient
than I get in return. Yet, the patient considers me obliged to care for them,
because of the kindness of Uncle Sam at offering them my free service.
In regard to Scripture obligation to provide free care to my brother, I agree
(in part). Let the churches provide free service. The church can provide a
moral context or environment to make that compassionate provision meaningful.
The U.S. Government cannot. I refer you to the writings of Hauerwas in this
regard (eg, Resident Aliens).

3. In regard to Comrade Pauls' comments about germs spreading to us
Republicans, I also agree. My rebuttal is that most communicable diseases are
controlled not with specific health care, but with public health measures. TB,
polio, and many other diseases were in decline long before vaccinations became
available or appropriate antibiotics developed. AIDS is a classic example of a
disease which could have been controlled by the quarantine measures which
worked so effectively with other diseases. The politicization of AIDS control
infuriates me. I cannot even test a person for AIDS without their informed
consent, let alone warn others if a person is infected with AIDS. All the
bleeding heart compassion of man cannot control a disease without certain
public health measures which were obvious enough to the Israelites in the
Desert, but less obvious to enlightened contemporary intellectuals.

4. Samuel Olsen remarked about the quality of health care in Norway. I'm sure
it was. I was stationed at an evacution hospital in England during Desert
Storm and got to know the physicians at Radcliffe Infirmary and the Cotswolds
quite well, and they seem to have quite pesimisstic reflections of their own
system. Maybe the physicans are not the best people to ask. As you wander
through the quaint little villages of central England, many towns will have
one building which is quite dilapidated and perhaps fit for the wrecker. These
buildings usually are the village medical facilities. I'm sure you can get
reasonable care at these facilities. Perhaps that is what Americans want;
disgruntled physicians with extreme economic constraints. It is the sure
set-up for the institution of such abominable practices as physician-assisted
I ask Samuel to not look at systems which have been in place only a short
period of time, such as the Canadian system. I am not familiar with the
Norwegian system, and perhaps you could enlighten us on how long that system
is in place. I want to discuss a system, such as the Soviet system or English
system, which has been around long enough to allow collapse of the entire
infra-structure of that system. Indeed, that is happening in Canada at this
time. The infrastructure of American medicine is mostly maintained by private
entrepreneurial activity. I will take out loans and invest in nice clinics
because I anticipate at least some return on my investment. If the investment
into the American health care infrastructure is non-rewarding, I'll sink my
small extra capital (to help fund the college education of my four children)
into Microsoft, Gene-Tech, or other Wall street companies where I won't feel
guilty about trying to get a return on an investment. I don't think that even
Jesus would have objected to us being shrewd with our use of Mammon.
Deus Vobiscum
Kenneth A. Feucht, MD, PhD, FACS or