Flat White

Who put the Moral Authority into the AMA?

11 June 2016

8:00 AM

11 June 2016

8:00 AM

In a post-religious world of hollowed out identities, the notion of moral authority is more contested than ever. The former Archbishop of Canterbury Rowan Williams has defined moral authority as the power to argue what should be done as opposed to how things are.

Without the communal structures of clan, religion and community, the one area people can have a sense of authenticity is in their feelings; and the political causes that best exploit them are the most fashionable, progressive ones.

The election of the new AMA President, Micheal Gannon, marks the end of an unusual period for the premier doctor’s lobby. The two year term under neurosurgeon Professor Brian Owler was unusual in its turn towards activism around progressive causes such as asylum seekers and climate change. The WA-based Michael Gannon was elected on the basis he would return the AMA to its core causes, namely protecting the industrial privileges of doctors. He has already targeted the government’s pledge to freeze any increases to Medicare for six years.

I experienced the previous regime’s advocacy parading as medicine at a forum for asylum seeker health earlier this year. Flanked by the Greens leader Richard di Natale and the face of the Human Rights Commission, Professor Gillian Triggs, the President Brian Owler gave an impassioned speech decrying the detention of children. Preceding him was physician Dr David Isaacs comparing the conditions on Nauru to Guantanamo Bay and other emotive speeches by a nurse and paediatrician.

When I asked a question about how the speakers could be so sure about the contribution of detention to the distress of asylum seekers given the evidence was primarily one of association, I was howled down by sections of the crowd for daring to question sacred cows. This would never occur in a scientific or medical meeting. Meanwhile pamphlets from the Socialist Alliance and Labor for Refugees were strewn across the floor.

Dr Micheal Gliksman, a former Vice President of the NSW AMA, approvingly stated that the organization under Brian Owler had never been as left of centre. Former President Dr Bill Glasson raised concerns about activism over-reach, but was ignored. Glasson has since told me the most recent election was a revolt against Owler’s grandstanding and moral posturing. The AMA was increasingly losing relevance after the government started bypassing them in negotiations.

The trend of groups and professions that once held a strong moral authority now looking for it in the warm embrace of progressive causes is also illustrated among big business. For example the umbrella group Corporate Australia, which included the Big Four banks, took out full page advertisements in the Australian last year supporting gay marriage.

Many other corporates have extended the word sustainability into their public relations campaigns to trumpet their climate change credentials. Telstra is struggling to roll out its national broadband effectively, but still thinks it needs to hold coherent positions on indigenous recognition and gay marriage. And who could forget the ridiculous research paper trotted out by Price Waterhouse Coopers on the costs of the gay marriage plebiscite? While business may not have held the quasi religious moral authority entrusted in the past to doctors, they traditionally held considerable weight through their status as employers and generators of prosperity.

In an interview this week to ABC radio about the growth of insurance fraud, the head of a British task force, David Hertzell, spoke of the growing impersonal interactions consumers have with business, usually online, and how it has helped business lose any kind of non- economic authority in the eyes of the public. In his context, it was one of the drivers of greater fraud.

But it could be seen as a broader trend of traditional institutions struggling to maintain authority among a post-religious customer base. Some of the moral planks of business around free markets and efficiency fail to stir the soul in the same way that marriage equality might for some.

Medicine’s quasi-religious authority was in part driven by a strong relationship with the clergy, right up to the middle of the twentieth century. In a book by US Sociology Professor Imber, Trusting Doctors: The Decline of Moral Authority in American Medicine, he recounts how right up to the 1960s the American Medical Association had a committee titled ‘Department of Medicine and Religion’.

But as religious authority has waned in recent decades medical authority has only increased, but it is of a technical kind driven by astonishing advances in technology and medical science.

Doctors are not necessarily seen as broader sources of wisdom anymore, but as technical experts. The rise of alternative medicine is in part a reaction to this trend, where growing numbers of consumers – I would call them suckers – go to naturopaths to have their blood cell count measured or take Chinese herbs in the hope it will rid their body of mysterious, unnamed toxins. Their visits are a marker of a new kind of secular religion.

Likewise, the discipline of public health has shifted from removing toxins from water or microbes from food to attempting to change behavior. As Imber writes ‘the morals of a consumerist health system have become the morals of prevention’. This is noticeably apparent in the zeal that advocates howl against cigarette smoking or even advertising around alcohol or fatty foods.

While doctors within the AMA at least have clearly revolted against their representatives being distracted by moral posturing, the same is not necessarily the case with big business, despite protests from the Catholic Church against companies such as Telstra for their stance on gay marriage. The combination of marketing departments lobbying for branding through fashionable causes supported by CEOs wanting a public platform, and a broader decline in business donating outright to political parties, means moral posturing PR is here to stay.

Health remains one of the great non-security challenges for Western governments amid the combination of whizz-bang technology, an ageing population and a demanding public. Its cost growth threatens the State’s financial stability. The new AMA leader is right to renew focus on core policy issues of how to deliver health care efficiently, but the broader currents of traditional authorities fighting for ground within the greyer, contested realm of moral authority will continue to distract.

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