A complete divorce of medicine from healthcare

In the first sentence of his Nicomachean Ethics, probably the most influential work on morality ever written, Aristotle declares “Every art and every inquiry, and similarly every action and pursuit, is thought to aim at some good.”

Although a profound philosopher, Aristotle did not need any special insight for this observation, for he was merely summarizing a truism. Only a madman acts without purpose, without having in mind some objective good that guides his actions and distinguishes success from failure. By this standard, the Biden administration’s new directives for non-discrimination in healthcare are textbook madness.

Our word “health” comes from the same root as our word “whole”—to restore something to health, it used to be understood, meant to bring it back to its fullness. The art of healthcare was, quite simply, aimed at the good of the body, conceived in terms of its proper functioning. Disease or injury impedes the body from attaining its natural goodness, and it is the task of medicine to restore it.

There were, of course, any number of things that medicine can do, as a matter of pure technique—lop off a limb at random, or cause a patient’s lungs to fill with fluid, but to do these would no longer be medicine, whose first rule is “do no harm.” The current craze for “transgender healthcare,” then, is quite simply a contradiction in terms, no more coherent than “underground aeronautics.”

According to the Department of Health and Human Services’ proposed new non-discrimination regulations under Section 1557 of the Patient Protection Act, the task of medicine is to be reduced to pure technique, detached from any objective medical end or good. As Rachel Morrison of the Ethics and Public Policy Center summarizes the new policy, “doctors and hospitals will be required to provide gender transition services, including for children, if they provide the same services for non-transition related purposes” and insurance agencies will be required to cover them. Put more bluntly, if a viable medical procedure exists, whatever it is, it must be available for gender transitions, and anything else is classified as discrimination.

Let’s pause to unpack this breathtaking claim.

If the HHS gets its way, then the use of a mastectomy to treat breast cancer will be deemed medically indistinguishable from a mastectomy to turn a 13-year-old girl into a “boy.” Any procedure formerly devised to treat some particular physical disease or condition now needs to be on the table to treat a wholly different—and purely psychological—condition.

This represents the complete divorce of medicine from healthcare, understood as the restoration of a body to its proper good. Instead, we have the new idea of medicine as pure technological power to achieve whatever results the patient—or his manipulative clinicians—desire. By the same token, a delusional patient identifying as a snake could be treated to a quadruple amputation, and any refusal to do so deemed unjust discrimination.

It takes little reflection to realize that this train of thought, if carried any distance toward its logical conclusion, would undermine the entire legal order currently governing healthcare, an order predicated on notions of harm, health, and proper treatment. Medical malpractice law, for instance, presupposes that doctors may cause injuries by failing to prescribe appropriate treatments or by undertaking inappropriate procedures. Under the new standard, however, the idea of “injury” loses any objective grounding, and the only way to distinguish “appropriate” and “inappropriate” procedures is the whims of the patient—or worse, the whims of those who have power over the patient. Medicine is one area where the craze for “equality” runs headlong against reality—a patient with Stage IV cancer cannot be treated “equally” as one who is cancer-free.

To be sure, the proposed regulations still allow doctors some discretion to refuse transgender procedures to a particular patient, but the language boldly declares that “a provider’s view that no gender transition or other gender-affirming care can ever be beneficial for such individuals is not a sufficient basis for a judgment that a health service is not clinically appropriate.” In other words, a doctor may just get by with deciding not to remove a particular patient’s organs, but doing so on the basis that it is never wise or safe to amputate well-functioning parts of a healthy person’s body is sheer bigotry.

If there is a silver lining to the current cloud of delusion, it is the opportunity it affords for Christians to take a stand as the true humanists. Often maligned as anti-body and otherworldly, it is Christians who are now most willing to fight for the integrity and goodness of the human body as something well-designed for the world it inhabits. In a world gone mad, the remaining voices of sanity offer a refreshing blast of reality—but only if we are relentless in exposing the delusions currently seeking to smother our judgment in a fog of misnamed “equality” and “care.”