Medicine Lacks Doctors Content To Heal
Dr. Henry Foster Jr. has become the Greta Garbo of American politics.
Nobody knows quite what to make of the man. Depending upon who’s doing the telling, the 61-year-old obstetriciangynecologist is either an amiable country doc or the Mengele of the Meharry Medical School, a surgeon who sterilized women of low intelligence and limited means.
By now, everyone in America knows that the president’s nominee for surgeon general has performed abortions and that he has enormous difficulty explaining when, how many and why. His performances have been so embarrassing that the administration has tried to slap the “extremist” label on anybody who tries to pry a straight answer from the man.
Despite all this, Dr. Foster seems to have enjoyed a perfectly normal career - which is precisely the problem. The triumph of wonder drugs and gosh-golly machines have transformed medicine from a healing art into a form of gadgethappy mysticism. Doctors no longer feel constrained just to fix broken body parts: They have begun mulling over more fundamental questions, like how to fix up the human race.
Foster has ridden this wave. Late last week, the administration revealed that he performed a series of involuntary sterilizations - perhaps hundreds - on retarded women between 1965 and 1973. Clintonites quickly explained that everybody in the obstetrical profession was doing that sort of thing back in the 1970s.
But that’s just not true. Although the U.S. Supreme Court upheld involuntary sterilization in a 1927 case involving a retarded 18-year-old mother in Virginia, physicians began shying away from the practice of eugenics after Hitler gave playing God a bad name. By the early 1970s, all but a handful of states had outlawed or restricted the practice of removing a woman’s reproductive organs without her permission. Furthermore, doctors and philosophers had mounted a furious debate about the propriety of performing such operations even with the consent of the person involved.
The few who still performed complimentary hysterectomies explained their handiwork with a pretty standard argument: Retarded people cannot delay gratification as well as the rest of us. They are easily exploited by sexual predators. They make poor parents because they can’t cope with the stresses of handling young children. Therefore, fix them - rather than dooming their kids to misery.
In a 1981 article for the Florida State University Law Review, Deborah Hardin Ross identified the missing ingredient in this logical chain - compassion. “Involuntarily sterilized persons tend to perceive sterilization as a symbol of reduced or degraded status, of punishment synonymous in their minds with castration, and of self as deviant and unworthy of parental rights.”
Since then, sterilization has fallen out of vogue as a way of holding down unwanted pregnancies, and abortion has taken its place. In a publicrelations bungle worthy of the White House, the American College of Obstetrics and Gynecology voted on Valentine’s Day to make medical schools teach abortion procedures to all obstetrics students. Institutions that refuse will risk losing their accreditation. In the future, students who wish to obey the Hippocratic Oath will be treated like “extremists,” and every potential Ob/Gyn will have to master a procedure performed by only about 13 percent of the profession.
But the field of reproductive medicine abounds in surprises. Technology soon will let families use in vitro fertilization to customize their babies by picking out embryos with genetic characteristics. So while Dr. Foster cleans the bottom of the gene pool, his colleagues have begun to manipulate what goes in as well.
Henry Foster’s backers are right: He has been vilified by people who don’t know him, and he deserves a chance to restore his good name. But members of Congress have an obligation to demand answers - about his career in the operating room, about the Meharry Medical School, which lost its accreditation when he was in charge, and about the ethics of a profession that seems to be moving unchecked into a new age of eugenics.
The position of surgeon general has become a silly thing. Ever since C. Everett Koop came to Washington, people in the office have focused on three things: condoms, cigarette smoke and military uniforms stolen from the prop room of “The Love Boat.” The Foster hearings, if handled like an inquiry and not an inquisition, offer a chance to relieve the tedium. Inquiring minds might want to shift attention from abortion to the broader question: Whatever happened to a doctor who was content just to heal someone?
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