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Physicians as Citizens—Reply
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In Reply: We agree with Drs Wynia and Clark about the importance of collective action and the potential role of medical societies in addressing physicians' civic responsibilities. Medical organizations that promote the ideals of professionalism are well placed to focus attention on public health concerns and to advocate for change. These activities are, however, most robust when supported by evidence of disease causation. Civil disobedience against laws that unduly affect patients' health through mechanisms such as deportation fits into our model as a valid evidence-based public role.
Professional organizations may also be able to identify threats to patients' well-being, for which evidence of causation is less clear. Public policies affecting antecedents of illness and health care delivery are examples. An appropriate response should include gathering evidence about health effects that may subsequently augment calls for action.
Both social contract theory and the notion of collective public trusts give rise to . . . [Full Text of this Article]
Russell L. Gruen, MBBS;
Steven D. Pearson, MD, MSc;
Troyen A. Brennan, MD, JD, MPH
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