Categories:
Economics of Health Care
From Robin Hanson:
Heroic medicine is just too central to our culture, a culture where economists like me have far less authority than doctors.
From Rudi Giuliani:
Ultimately, a woman should make that [decision whether to get an abortion] with her conscience and ultimately with her doctor.
What?! Exactly what special training do doctors get in medical school that qualifies them to say whether a particular woman should get an abortion? It’s pretty clear that Giuliani isn’t talking about e.g. how far along the pregnancy is. Rather, he imagines that your doctor is also your confessor – or oracle.
Does this seem as weird to you as it does to me?
READER COMMENTS
General Specific
Sep 12 2007 at 3:06pm
Seems like a possibly unfair reading to me. When I decide to rebuild the transmission on the car, it’s a decision between me and the mechanic: tradeoffs, options, etc. (Or mechanics plural.) Same goes with any medical procedure: a discussion between me and the person who can describe the tradeoffs. What Giuliani may be saying is that the contract between the patient and the doctor does not require the state to intervene in between.
Giuliani, in general, is a yahoo, but I’ll give him some slack on this statement.
Mr. Hanson shouldn’t push this analogy–or dis-analogy in this particular case–too far. Economics is often considered a religion and economists the priests. Wasn’t Greenspan often referred to as an Oracle? I think so.
Just food for thought.
Caliban Darklock
Sep 12 2007 at 3:10pm
Fundamentally, an abortion is a medical procedure. While the doctor may not be qualified to tell the woman what she SHOULD do, he is undoubtedly more qualified than she to explain the real-world physical consequences of her options: whether carrying the child to term will endanger her life, what the child’s chances of survival are, how the child’s life will be lived, etc.
Abortion is rarely a simple choice. Most women who contemplate one actually do have a really good reason to do so, and wrestle quite strongly with the decision. It is not the doctor’s place to help her make the decision per se, but without the information he provides, she probably can’t make the decision effectively.
Without a link to Giuliani’s statement, it’s hard to determine whether your analysis accurately accounts for context.
David R. Henderson
Sep 12 2007 at 4:03pm
To answer Bryan’s question, yes.
Les
Sep 12 2007 at 5:37pm
I’m surprised at the comments posted because the commentators seem confused about the distinction between a person (the patient) and a professional advisor (the physician). As our constitution makes clear, each of us owns ourselves and no-one owns us. So each of us makes our own decisions, of course within the law, with due regards for the rights of others.
If we allow a physician to make a decision for us, we have delegated our right to the physician. But, in the absence of delegation, we remain the decision-maker.
Further, it is merely an assumption that the physician is better informed to make the decision. Whether or not that is true is an empirical question in each case. But regardless of the result, better-informed is irrelevant because we are entitled to make our own decisions, well-informed or not.
neworleansbearcub
Sep 12 2007 at 6:11pm
I think Giuliani is taking the stuff about doctors from the Roe decision itself. He seems to be signaling his support for Roe without saying the words “I support Roe.”
General Specific
Sep 12 2007 at 6:20pm
Sure, the woman makes the decision. Giuliani’s language is smearing the responsibilty, worded to make it sound like the doctor is also making the decision. But it’s a common or standard phrase, so reading too much into it doesn’t seem of much value. And to my other point, a shift in focus but still a valid comparison: Greenspan was referred to as an oracle, and nobody gets any say in the value of their greenback except Greenspan–or those who follow him at the Fed. People get to choose their doctors–up to a point, e.g. HMOs. They barely get to choose the inflation rate. Hence economists seems more like Oracles, having great influence.
Brad Hutchings
Sep 13 2007 at 4:12am
Whoah dude. There are hundreds of subtle things he could mean by that, or it might just be a general platitude. And that wouldn’t be so bad because it’s an intractable issue where the status quo won’t budge an inch in any direction as a result of who is elected President.
I say, why not ask? Drop a note to his national campaign manager (Michael Duhaime) and ask what he meant. I hate this game where we try to divine hidden meanings from the tea leaves which are their words.
Buzzcut
Sep 13 2007 at 7:18am
It’s “Rudy”. Not “Rudi”. What were YOU saying with that “typo”.
Dan
Sep 13 2007 at 10:40am
That line is a pretty typical one employed by politicians who want to keep their pro-choice views low key. I think that there are two implications: the first is a validation of the pro-choice stance, if the doctor were to inform the woman that the pregnancy could threaten her health; the second is the (fleeting) hope for pro-lifers that a second opinion might convince the woman to carry the child to term.
liberty
Sep 13 2007 at 1:06pm
with her conscience she decides if its ok (is it human, is it killing, etc) and with her doctor she decides if its safe (whatever medical things– general or local anesthetic etc).
If I need to decide whether or not to terminate life support of someone for whom I have that control, I make the decision with my conscience and with my doctor. My conscience ultimately makes the decision about whether its right, but its informed by what the doctor says.
Zach
Sep 13 2007 at 5:14pm
We get plenty of special training in medical school, residency, and beyond that equips us as physicians to guide people through all kinds of difficult situations, from cancer, to end of life, to difficult pregnancies. The word ‘doctor’ is from the Latin, meaning teacher.
I’d love to see you try to sit with an anxious, confused, hormonal 19 year-old trying to come to grips with her unplanned pregnancy. Yeah, good luck explaining to her the economic rationale and social consequences of her potential decisions. You’d last about 4 seconds. We ARE trained to work with people at crossroads in their lives. It’s a big part of our job.
Is it ‘weird’ that people consult with their ‘oracle’ broker to plan out their financial futures, confessing their wants and desires? Is it ‘weird’ that people work with an ‘oracle’ real estate agent to pick out a house?
Feel free to stick to the economics of health care, there is plenty of work to be done there. Let us (the oracle doctors that we are) take care of the patients.
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