Scotland, the Booze and the Hippocratic Oath

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Something I said during the peak of Labour and Tory blind, destructive opposition to minimum pricing back in November 2010

Moridura Blog - Friday, 12 November 2010

I have been aware of the existence of the Hippocratic Oath for most of my life, have probably glibly referred to it on occasion, but until last night, I have never actually read it or understood its exact place in modern medicine.

Events in the Scottish Parliament this week led me to find out a bit more about it, and I now realise that most of what I believed was based on various misconceptions.

1. I believed that it had existed in an unchanged form since Hippocrates – the father of modern medicine - first set it down several hundred years before the birth of Christ. It hasn’t,  and in fact Hippocrates may have had little to do with it …

2. I believed that every medical practitioner was obliged to take the Hippocratic oath. They are not, at least not in recent years …

In fact, the wording of the original Oath, in translation, astonished me. I had hoped to find something in it that would help me to understand what influence, if any, it might have on medical doctors who get involved in politics – say, Dr. Liam Fox, for example. (You may be able to think of others.)

Would anything in the Oath, in its original form or in the more modern principles favoured by the BMA, that try to hold on to some of the essential sense and principles of the original act as any guide to the ethical and moral behaviour of a doctor involved in the pragmatic and often dirty business of politics?

How, for example, could Liam Fox interpret his responsibilities under the oath when acting as a Defence Minister, commissioning weapons of death and mass destruction, and sending young men and women to kill other human beings, and perhaps to be killed or maimed themselves?

Would he take the ethical position that, since he was not practising medicine in this role, the oath was irrelevant? After all, doctors are not like priests, claiming to draw their authority from their god – they are high-level professionals, with high ethical standards, but ordinary mortals nonetheless.

No answer there – the question is beyond my philosophical and analytical abilities.

But how about, say for example, a doctor/politician who in his or her role is obliged to bring medical knowledge specifically to bear on decisions affecting the health of the population? A thorny question also, but perhaps more amenable to Hippocratic analysis, but certainly not hypocritical consideration.

Doctors, like scientists, often reach different conclusions faced with the same facts, the same evidence: doctors debate, discuss, in fact in recent months, I’ve heard them doing it many times at the end of my beds in St. John’s and the RIE, and at the beds of other critically ill patients. It struck me as a vital dialogue - not always between equals, because the medical profession is hierarchical in the extreme - but one where every view is invited, heard and weighed.

Back to the Hippocratic Oath …

I’ll take the classic version rather than the original, which frankly sounds more than a little odd to a modern ear. (It’s also a little odd in the classic version.)

It’s hard to seize on anything relevant to a modern topic such as, say, dealing with the enormous harm to the health, wellbeing, safety and economic strength of an entire nation because of abuse of a legal and freely available dangerous drug – alcohol.

“I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”

I couldn’t find dietic in my Oxford dictionary, so I presume it means dietetic – relating to diet, i.e. the nature of food and drink ingested.

Alcohol, misused, clearly does harm, and undoubtedly causes injustice, in its supply to people who are by age, immaturity or predisposition to addiction and excess vulnerable to this drug, and to others, who are harmed by violence, by disturbance in public places, in the home, by the overstretching of the caring and public order services, by economic factors – the list is a long one.

Keeping them all from harm and injustice due to alcohol abuse seems to me an appropriate interpretation of the Hippocratic Oath.

“I will neither give a deadly drug to anybody if asked for it, nor will I make suggestion to this effect.”

A difficult one to interpret in the context of a licensed drug and a licensed trade, especially when that drug forms a central part of the economy of my country. One might reasonably expect a doctor to recognise that the drug is only deadly under certain circumstances, and consumed in moderation may actually be beneficial, but to look long and hard at it becoming available too cheaply and too easily to vulnerable groups especially the young and immature.

But where there is a widespread consensus, in the society of which that doctor is a part, by virtually all doctors, the professional association that represents doctors, by the police force of that society, by the established Church of that society, by health workers, addiction workers, careworkers in that country, one might reasonably expect that a doctor/politician would tend to follow that consensus, a consensus of his or her peers and virtually every authoritative voice.

Of course, one must allow for the fact the majority are not always right; that lone voices, driven by burning personal conviction, must follow their consciences, and speak out against the majority if necessary. Such men and women have rendered invaluable service to their profession and to society at great personal cost on occasion.

It would of course be unthinkable that anyone would be influenced significantly or even totally by purely political considerations in going against that consensus, would it not? Let’s hope it never happens …

Well, I am not a doctor, but I owe my life to the medical profession in Scotland, not once, but several times over the last year, and I experienced their dedication,  professionalism and deep humanity at first hand. I also saw how the abuse of alcohol in Scottish society overstretched them, consumed an inappropriate amount of scarce resources, and exposed them personally to violence and intimidation.

So in that respect at least, I feel that I have a right – and a duty - to speak.

The BBC

My views on the BBC are well-know by now, and it is clear that a number of nationalists don’t like my defence of the BBC. Since I have an aversion to repeating myself endlessly, here are a few links which say more or less all I have to say about the BBC and its relationship to the independence movement and the SNP.

BBC – Role and future
BBC - political coverage
BBC - hard to defend
BBC- Marr and Purcell
BBC - Call Kaye
BBC - Unionist bias

As can be seen, I have been critical of specific instances that I perceived as bias, inadvertent or conscious, and I will continue to highlight these. Occasionally I have been exasperated by the BBC and sometimes furious at it. So has every other political party, which is evidence to me that it is doing its job as a public service broadcaster.

Over the last five years I have watched thousands of hours of political coverage of news and Scottish affairs, and I have clipped, YouTube posted and commented on over 740 videos. (Most of these I have taken down – but still have on file – because of the workload in managing comments.)

A summary of my position on the BBC -

1. The BBC performs a vital role as a public service broadcaster and has done so since early in the last century. It is widely regarded internationally as the best public service broadcaster in the world.

2. Without BBC coverage of the SNP and the independence movement on news bulletins, political programmes such as Newsnight, Newsnight Scotland, the Daily Politics, the Sunday Politics, the Sunday Politics Scotland, the regular broadcasting of FMQs at Holyrood, The Parliament channel, Good Morning Scotland and radio news broadcasts and discussion programmes, its online sites and by specials devoted to elections and other matters of interest, the SNP would have not achieved the high profile and electoral success it has and Alex Salmond would not have become the towering figure he now rightly is in Scottish, UK, European and international politics.

3. Without all of the above BBC programmes, services, and the dedicated work of its highly professional producers, researchers, technical staff, presenters and commentators, I would have had no blog and no YouTube channel, and other bloggers and online nationalist newspapers would have had a gaping hole in their content. A vital platform for the nationalist case and the nationalist voice would have been absent, and an actively hostile press and indifferent commercial channels would have compounded that.

4. The vast majority of the criticisms I hear of the BBC result from an apparent ignorance of the processes of television journalism, television production and editing, news values, and the role of presenters, commentators and interviewers. They are also characterised by gross stereotyping, highly selective analysis and frankly, naivety.

5. There is also an ugly thread of what I can only describe as McCarthyism among some critics, in their constant references to the backgrounds, partners, spouses and general contacts of BBC presenters and commentators.

I do not think the background of commentators is entirely irrelevant, and I comment when I feel it is appropriate, but I do not expect BBC staff to have had no existence, life, political involvement or career prior to entering the Corporation, nor do I expect them to have taken monastic vows to have no personal views or political allegiances. I also think there should be a statute of limitations on how long they have to have their past roles and affiliations raked up every time they appear on television.

As far as the reference to spouse, partners, etc. is concerned, I think it is offensive and contemptible. BBC staff are not politicians, they are not legislators – they are not bound to make disclosures of interest as MPs or legal professionals are.

SUMMARY

I will continue to comment on aspect of BBC coverage and editorial policy that I feel relevant, and to be trenchant in criticism when I think it is warranted. I don’t need any help with this.

I think the present pattern of criticism of the BBC by some nationalists is profoundly damaging to the independence cause in the crucial lead-up period to the referendum.

I have said all I have say on the BBC in general terms. Please do not offer me an endless stream of comments and emails on what you imagine to be examples of bias. Go to someone who will give you a sympathetic hearing, because I won’t.

Better still, start your own blog and YouTube channel and have your say in that way. Or write to the BBC, or do whatever you feel necessary. Leave me out of it – please ..

“The overwhelming opinion in Scotland”–two versions in the education debate 2nd Feb 2012

It gets interesting at the 13.40 minute mark.

“That dreadful, anti-Scottish, anti-education  trap” is an accurate description of  the Tories/LibDem Coalition, and their Scottish puppets, Labour are edging towards it – let’s not be afraid to say it …

Say it again and louder.

Objectivity, neutrality and myths - Kenny Farquarson, SoS

JOURNALISTS

I expect journalists to be objective, but not neutral. I expect news reporting to be factual, and not to spin the facts, but I do not expect balance, e.g. if there are ten facts that day for one side of an argument and five for another, I don’t expect the journalist to trawl for another five facts to achieve ‘balance’.

I expect a sharp distinction to be made between news reporting and commentary. I never expect neutrality, only objectivity. I expect individual journalists to have a viewpoint and an interpretation of events. I accept that entire newspapers and magazines have a viewpoint, a position, and editors that identify with that position, providing they observe good journalistic practice in relation to factual reporting and veracity.

I deeply distrust newspapers and periodicals where the viewpoint is that of the owners, rather than the journalist.

I am not, and never have been a journalist, and I have never worked for a newspaper or magazine in any capacity, nor in media. I believe strongly in a free press and media, especially in print journalism and public service broadcasting.

KENNY FARQUARSON’S MYTHS

In the context that Kenny uses the word myth, the definition is a widely held but false notion. Norman Mailer called mythical facts factoids - something everybody know is true except it ain’t.

Today he sets out to demolish what he see as six myths about the SNP and the referendum. To some degree, he has set up straw men to knock down by stating a myth that either never existed, or exists only in the minds of a few unionist commentators. Let’s deal with Kenny’s myths briefly -

1. Holyrood’s voting system was designed to stop the SNP getting a majority

Kenny says it wasn’t - it was designed to stop Labour getting a majority. He describes his myth as “a cornerstone of the SNP’s persecution complex”.  The SNP don’t have a persecution complex, Kenny, but they could be forgiven if they had, given the history of the party, and the role of successive UK Governments and Scottish Secretaries, as revealed under the 30 year rule so cogently by Diomhair and other analyses, not to mention the hysterical campaign of abuse and flagrant misrepresentation directed at them since may 2007.

The d’Hondt system of proportional voting was set up to stop any party having an overall majority in the Scottish Parliament, and in that objective, all Westminster parties were as one. As unionist parties, they last thing they wanted was any devolved administration having any real power over the levers of government in Scotland, including their own regional parties.

Since the Labour Party and Tony Blair were the key drivers of devolution, and since the only threat to London Labour’s dominance in Scotland was the SNP, there can be little doubt as to their prime motivation - the voting system was designed to keep the SNP out of power for ever.

The stunned shock of Labour when, in 2007 the Scottish people cautiously gave the SNP a chance to show what they could do, albeit in a minority government, was such that for some months Labour could not adjust to the fact that they were no longer in government - Jack McConnell was like a headless chicken for some time.

2. A devo-max option would put Alex Salmond “in a win-win situation” in the referendum.

3, Devo max requires a second question in the referendum

I’m not sure who Kenny is quoting here on win-win, but it must be either a unionist politician’s quote or an ill-informed metropolitan commentator - the SNP have never driven the so-called devo max option. They have recognised, since the previous consultation document and in the new one, that as far as polls are an indicator, there seems to be a substantial body of the Scottish electorate who do not want independence but want radically increased powers for Scotland within the UK.

We now have Civic Scotland and Henry McLeish saying that such an option must be on the ballot paper, and since the SNP is a democratic party and recognises a responsibility to the entire people of Scotland, not just those who elected them, they are prepared to respond to that wish.

Such democratic concepts are, I know, deeply alien to UK politicians, since they preside over a power structure that is only partly democratic, given the existence of the House of Lords and the visceral commitment - recently strengthened by a viciously fought referendum campaign that served only politicians - to a first-past-the-post system of government for Westminster.

The position of the SNP Government, of Alex Salmond, of his ministers, is that they want one question, they want independence, but will recognise the people’s apparent wish for another option. My own position is that I do not want devo max - I consider it a trap, and an option which, if selected by the electorate, would not be delivered by Westminster. Far from thinking it would offer Alex Salmond a win-win, I think it would represent a failure of the highest aspirations of those who want independence.  Nonetheless, I think it must be offered if the people want it as an option. The other strand of opinion that I see in the SNP is of direct opposition to devo max being offered.

Kenny’s myth no. 3 solution - don’t have a second question, just let the Scotland Act and devolution evolution do the trick reflects the unionist trap. Not only will we not get more powers, we risk  a clawback of exisitng powers caused by an English reaction against independence ambitions.

So, yes, it is a myth, Kenny - a unionist politicians’ myth, and a myth propounded by ill-informed media commentators, not by the SNP.

4. Debate on more powers for Holyrood should be left until after the independence referendum

Kenny sees this as a Labour and LibDem myth, and I agree with him on that perception. If they maintain it, they betray their own supporters in Scotland. In my more ignoble moment - and I have many - I secretly hope they do maintain it. But then the democrat in my psyche pops up again …

5. Alex Salmond is a godlike political figure with superhuman powers who can do no wrong.

If Kenny had presented this as a unionist and media myth solely, I might have agreed with him. The idea that - other than few starry-eyed, hero-worshipping groupies on the fringe - that anyone in the SNP believes in this myth is risible, as my private email correspondence demonstrates daily.

But what SNP supporters believe, what the vast majority of the Scottish electorate believe, what a rapidly increasing number of international commentators believe is that the Scottish people in this point in their history are fortunate to have a consummate politician and a visionary statesman who eclipses any other British or European political leader, yet a man who’s the goud for a’ that, and just one of Jock Tamson’s bairns - fallible, and above all a real Scot. Gaun yersel, Alex!

6. The SNP speaks for Scotland

This is no myth - it is a fact. It is also a fact that all the other parties, as well as the SNP, claim to speak for Scotland, and it’s their job to say that, otherwise, what the hell are they for?

But what is uniquely true is that the SNP speaks only for Scotland - all the other parties, by their own repeated proclamations, have at best a wider loyalty and at worst a deeply divided - and divisive - loyalty to the United Kingdom.

The Scottish Government speaks for Scotland, and they were elected by a massive majority to do just that.

Kenny’s last sentence is contemptible, not worthy of him, so I won’t repeat it here. It is regrettably typical of much unionist comment, and it’s why they’re losing the argument.

Who are You?–Who?Who? Who,who?

It’s not often I’ll quote a lyric from song from what I think of as the modern songbook, which I define as from about 1955 onwards. I know that covers almost 60 years, but we’re talking history here, the perspective of over a century of popular song. From about 1890-1955 can reasonably be seen as the classic period at least of Western popular song, and in that period, that meant mainly American popular song.

This was the time when the songwriter - the melody man (it usually was a man, with apologies to the great Dorothy Fields) and the lyricist – the wordsmith – were usually different people, with formidable exceptions like Cole Porter.

Anything Goes - Cole Porter

The singer/songwriter was a comparatively rare bird back then, and I have to say I would have been a happier man for the last fifty years or so had it remained a rare species. There was a kind of brief renaissance of quality popular song in the mid-sixties to the seventies, and since then the great musical desert, with the odd oasis and many mirages.

So unashamedly, my tastes lie with BCCA music (Before the Crap Came Along) and with melodies that span more than half a diatonic octave, with harmonies a little more ambitious than four simple chords.

Take time out now to dismiss me as an old man out of synch with popular culture, then we can move on. Get to the point, for ****’s, Peter! I hear you –I hear you …

The Who’s little anthem embedded itself in my mind with the CSI series, and despite my earlier rant, I admire the Who for their longevity and formidable achievements in modern popular music, and there can be no doubt that their music and lyrics, for many, reflect the culture and the times of the last half century.

Their question – Who are you – Who? Who? Who, who? – resonates in Britain and in Scotland at the moment over national identity, and polls on perceptions of that identity, or multiple identities, pop up all over the pace, prompted by the resurgence of Scottish national identity and its questioning of Britishness, a cobbled-together identity designed to support an uneasy union of vigorous and distinctive national identities subsumed within an Empire, one now in terminal decline.

The Guardian has an interesting piece today by David Marquand, principal of Mansfield College, Oxford, author of The End of the West, which is not about the last days of Wyatt Earp, but a a rather bigger topic. Entitled England’s identity crisis - England's visceral Europhobia may break up the UK – it is a short, but important piece, and it has two paragraphs that contain fundamental insights and truth that are rare from south of the border -

“… The Scots and Welsh know who they are. For centuries, they have had two identities – their own, and a wider British one. They are unfazed by the discovery of a third European identity as well. They are at home in Europe, where multiple identities are becoming the norm. To them, it seems only right that Europe's once monolithic sovereign states now have to share power, both with a supranational union and with rediscovered nations, principalities and provinces within their borders. Along with Catalans, Basques, Flemings, Walloons, Corsicans, Sardinians and even Bretons, the Scots and Welsh are emerging from a homogenising central state of the recent past.”

“… Above all, the English of the 21st century no longer know who they are. They used to think that "English" and "British" were synonymous. Now they know that they are not. But they don't know how Englishness and Britishness relate to each other, and they can't get used to the notion of multiple identities. Until they do, I don't see how the crisis in Britain's relationship with continental Europe can be resolved. If it isn't, the most likely prospect is of further European political union and the break-up of the UK, with England staying out and Scotland and Wales going in.”

Any Scot who still thinks that Scotland is not now set upon an inevitable path towards independence – not separation - in a new, interdependent relationship with its European – and Scandinavian - neighbours is engaged in nostalgic self-delusion, and is on the wrong side of of an inevitable historical process.

Who are we? Who? Who? Who, who? We are the sovereign Scottish people, ancient and proud Europeans and good neighbours. And that includes our English neighbours, slightly confused about who they are at the moment …

Alex Salmond on The One Show