Medical History — Plagues and Epidemics by Miguel A. Faria, MD

Note: In view of the Coronavirus pandemic (COVID-19), I find it important for readers to receive background information on public health history, plagues and epidemics, from antiquity to more recent times.The COVID-19 pandemic does not approach the virulence of previous epidemics, and I’ve no doubt that God permitting humanity will conquer with a minimum of casualties. — MAF (March 16, 2020)

Since the fall of the Western Roman Empire, there have been three major bubonic plague epidemics, which afflicted large segments of the population in the continuous Eurasian landmass and North Africa. Death quickly followed the trade routes of the times. The death toll is almost incomprehensible. The Plague of Justinian (6th Century A.D.), the Black Death (14th Century A.D.), and the Bubonic Plague (1665-1666, which coincided with the Great Fire of London) caused an estimated 137 million dead in a world much more sparsely populated than it is today.

To make matters even worse, one must also remember that these pestilences assailed and ravaged mankind at a time when the average life span was short — less than two decades during the Middle Ages. Survival to age five was a miracle not only because of endemic disease, dirt and filth, concomitant poor hygiene and sanitation, but also because of the primitive state of medical knowledge. Pestilential disease thrived under such conditions. Moreover, during the Middle Ages, bathing and cleanliness, even in the upper classes, was a rarity, being viewed as unhealthy as well as irreverent — acts of vanity in the face of God.

Epidemics in the Graeco-Roman World

Athenian Plague

During the Peloponnesian War (431-404 B.C.), fought between ancient Athens and Sparta and their allies for supremacy of the Greek world, the Athenian army had to withdraw behind the safety of its city walls after a successful invasion was carried out by Spartan forces. Shortly after, in 430 B.C., the historic Athenian Plague broke out decimating a quarter of the population within the city. The supreme Athenian statesman and leader, Pericles (c. 495-429 B.C.), succumbed to this epidemic after seeing his own sister and two sons contract the disease and die. Historians are not completely sure this pestilence was really the plague. It’s possible it was some other disease such as smallpox.

Plague or otherwise, the historian Thucydides left a poignant account of this catastrophic time recounting that the Athenians, “…fear of gods or law of men there was none to restrain them. As for the first, they judged it to be just the same whether they worshipped them or not, as they saw all alike perishing; and as for the latter, no one expected to live to be brought to trial for his offences.” The historians Frederick F. Cartwright and Michael D. Biddiss in their book, Disease and History, added that Thucydides lamented that “the most staid and respectable citizens devoted themselves to nothing but gluttony, drunkenness and licentiousness.”(1)

Likewise, during the reign of the great Stoic philosopher, the Roman Emperor Marcus Aurelius (emperor, AD 161-180), a great pestilence was brought back to Rome (AD 166-167) by the victorious legions which, led by Lucius Verus (co-emperor, AD 161-169), had been pushing back the invading Parthians pressing on the eastern frontiers of the empire. This pestilence caused the death of approximately 25 million people and was most likely smallpox. Co-emperor Lucius Verus was eventually afflicted and, like Pericles nearly six centuries earlier, succumbed to the disease. One can only imagine the devastation of these epidemics in the midst of wars: the loss of loved ones; the breakdown of societal, civic and learning institutions; the breakdown of law and order, particularly in the countryside where the population was at the mercy of barbarian hordes and brigands; goods not produced; services not rendered; lands not cultivated; crops left unharvested, etc.

The Plagues of the Middle Ages

At the peak of his reign, after accomplishing major political, judicial, and military successes, Justinian, emperor of the Eastern Roman (Byzantine) Empire, suddenly faced an old, ferocious enemy of mankind: pestilence. The bubonic plague, which struck in A.D. 540, is justifiably the worst recorded pandemic to ever afflict humanity. Any hopes of reestablishing the Roman Empire were dashed. Records regarding the dimensions of the devastation and the untold suffering and death were carefully kept by Justinian’s chief archivist and secretary, the celebrated court historian, Procopius.

Albrecht Dürer’s The Four Horsemen From The Apocalypse, 1498

If one considers the dimensions of the devastation of the bubonic plague of the 6th Century in the midst of the Dark Ages — the savage imperial wars waged against the barbarian hordes, the terrible famines, the ubiquity of death and destruction, and finally the unleashing of this cataclysmic epidemic — it should not be difficult to imagine that the people at the time believed that they were being scorched and ravaged by the dreaded Four Horsemen of the Apocalypse, as described in the biblical book of Revelation 6:8, “And I looked, and behold, a pale horse; and his name that sat on him was Death.”

The Emperor Justinian, defeated by the cataclysm of the bubonic plague, saw with horror the disease demolishing his once invincible armies and killing his generals and soldiery alike faster than the wounds inflicted on the battlefield. Entire villages and towns were obliterated; the apocalyptic visitations were considered divine retribution from God as punishment for worldly sins. Demoralized and disheartened, he returned to his capital, Constantinople, only to find that there, too, the terrifying pestilence was relentlessly killing his people, rich and poor, regardless of kinship or station in life. The mortality in the city at this time was approaching 5000 deaths a day and would eventually reach an all-time high of 10,000 deaths daily. In despair and in need to fill the void, Justinian sought solitude, and the comfort and solace of religion.

The learned physicians of Justinian’s day, who at the time followed the precepts of Graeco-Roman medicine, were discredited because their nostrums proved useless at the time of the cataclysm. Instead, the people turned for consolation to monastic medicine and the teachings of Christianity. The Christian church did rush in and, as best it could, tried to fill in the medical void. The monks in the monasteries quickly became the spiritual as well as corporeal healers by tending both to the needs of the soul and the requirements of the body. They used prayer and only the rudiments of physical or herbal medicine to console and heal the sick.

The humbling of the medical profession because of its impotence to control the plague of the 6th Century, essentially halted the advancement of medical knowledge for centuries. Medicine regressed, and disease in general was equated with vice and sin, rather than with filth, poor hygiene, and natural causes.

Yet, medicine was not the only profession in abeyance to disease. Other ancient professions, such as law, engineering, and the natural sciences (not to mention the liberal arts of the Greeks and Romans), were largely erased from the collective memory of humanity. All areas of human endeavor were doomed to intellectual dormancy. Progress stopped. The turning wheels of Western culture and civilization had ground to a shrilling halt as humanity became fully immersed in the Dark Ages. New hordes of barbarians were marauding and ravaging the West, while the plague was humbling the East.(2)

The Black Death (1346-1361)

The great pestilence of the medieval period was the Black Death (1346-1361), the bubonic plague caused by the then highly virulent bacterium, Pasteurella pestis and transmitted generally by the black rat, Rattus rattus. The plague is passed from rat to rat by fleas. Man becomes infected when he unwittingly interrupts the infectious cycle by being bitten by an infected flea. Once the infection takes place, Pasteurella pestis causes disease by septicemia or by invasion of the lymphatics, spreading in the body with two types of presentations. The pneumonic form of the plague is most ominous. In this highly contagious acute form, the disease may also be transmitted directly from person to person via the pulmonary route (i.e., aerosol droplets), and death takes place rapidly. It was said that one day a person would cough-up phlegm and then be dead by the fifth day.

The predominant form of the disease, though, was the subacute bubonic form, characterized by severe involvement of the lymphatic system with the formation of buboes (from which the disease takes its name). The buboes are swollen, infected lymph nodes, most commonly involving the inguinal and/or the auxillary lymph node chains. The buboes may grow to a significant size to erode through the skin and spontaneously burst, draining infectious purulent material. Death came in a slower and more agonizing way. Very few so afflicted lived beyond 10 days, and the affliction still carried a mortality of 90 percent.

The epidemics of bubonic plague were veritably history’s greatest scourges. In the case of the Plague of Justinian, the epidemic ravaged the populace for five decades between A.D. 540 and 590 and, although precise figures are not possible to ascertain, it may have caused the death of one-third of the population. The Black Death, which peaked in 1347-1348, also inflicted morbid devastation and rampant desolation and death in medieval Europe and exacted a death toll of perhaps 27 million lives and lasted 15 to 20 years. The Black Death seriously disrupted the social and economic fabrics of Western society. In Europe, the people began to question religion and faith and looked instead for answers in the emerging science of the medieval universities sprouting up throughout Europe, the reverse of what took place after the Plague of Justinian. Moreover in England, large tracts of land were left uncultivated because of the lack of a work force. Suddenly, labor because precious. Workers demanded higher wages and poor peasants disappeared, at least for a time, and were replaced by more prosperous farmers and landowners, threatening the very structure of feudal society.

Collecting the dead for burial during the Great Plague

The Great Plague of London, which assailed England from 1665 to 1666, at its peak killed 2000 Londoners a week but mercifully only lasted several months, coincidentally ending with the Great Fire of London.

The New World and Disease

With the discovery of the New World in 1492, infectious diseases, such as measles and smallpox were brought to the New World, wreaking havoc in the immunologically susceptible indigenous population. In return, the Europeans carried syphilis back to their homelands. Recently, there have been accusations of European genocide upon native populations of the New World. But, as the author wrote in Vandals at the Gates of Medicine: “This depopulation [of the Americas] was neither officially sanctioned, anticipated, or even intended by the Spanish or Portuguese authorities. These afflictions had more to do with the mingling of two very different and isolated cultures (which up to this time had not been in contact with each other) than with a deliberate act of genocide.”(2)

Dr. Benjamin Rush

In 1647, yellow fever appeared in the colony of Massachusetts assailing the population and killing many inhabitants. To prevent further spread of the disease, quarantine was implemented for the first time in the colonies. In 1665, the quarantine was extended to all ships coming from England to prevent spread of the bubonic plague that was then assailing London. In the eighteenth century, yellow fever reappeared in Philadelphia, particularly in 1793, decimating the population of that city. It is estimated that ten percent of the population died, and according to medical historian Howard W. Haggard, in his book the Doctor in History, “Philadelphia resembled London in the days of the bubonic plague.”(3) Many people fled the city but one doctor who stayed was Dr. Benjamin Rush, an American patriot and one of three physicians who signed the Declaration of Independence in 1776. Dr. Rush indefatigably ministered to the sick with the treatments of the time, purging and bleeding, and became a popular hero.

Humorous medical historian, Art Newman, in his book The Illustrated Treasury of Medical Curiosa, described one such occasion: “[Dr. Rush’s] coach was stopped at Kensington by a crowd of hundreds who begged him to visit their homes and care for their sick. Rush stood up in his curricle and addressed the throng. ‘I treat my patients successfully by bloodletting and copious purging with calomel and jalop, and I advise you, my good friends, to use the same remedies.’ Someone shouted, ‘What, bleed and purge everyone?’ ‘Yes!’ cried the doctor. ‘Bleed and purge all Kensington!’ “(4)

The Final Act in the Drama

The first case of cholera occurred in England in 1831. No explanation can be offered for why cholera, which had been confined to India as an endemic disease for at least 2000 years, suddenly burst forth as a worldwide affliction. We do know that up to the mid-nineteenth century, European cities were reservoirs of disease because of the ubiquity of dirt and filth and poor hygiene and sanitation. Newman recalled: “Down the middle of English streets ran a gutter or kennel into which garbage and refuse were tossed to fester in the hot sun”; and the great Anglo-Irish writer and satirist Jonathan Swift (1667-1745) parodied: “Now from all parts the swelling kennels flow, And bear their trophies with them as they go; Filths of all hues and odours seem to tell/ What street they sailed from by their sight and smell”(4)

Dr. John Snow

Cholera reached New York in 1832 and subsequently spread to Mexico, Cuba, and the rest of the Americas. Credit should be given to the great English physician from Newcastle upon Tyne, Dr. John Snow, whose work solved the problem of the transmission and prevention of cholera in 1849. A fine anesthesiologist and epidemiologist, Dr. Snow proved by scientific investigation that cholera is a water-borne disease, his research eventually led to the conquest of such epidemic diseases as dysentery and typhoid fever.

Snow’s epidemiological studies were momentous discoveries, but they needed to be applied by his successors. Consider that still in the Spanish-American War (1898), the U.S. lost more soldiers to typhoid fever than were killed in the battlefields of Cuba and the Philippines.

In 1885, the French scientist Louis Pasteur (1822-1895) established a clear relationship between microorganisms and disease, formulated and proposed the fundamental principles of the germ theory of disease, and ended the vicious cycle of superstition, ignorance and disease. Pasteur finally demolished and put to rest the old theory of spontaneous generation that had held medicine back for centuries by convincingly demonstrating that living microbes caused not only fermentation but also putrefaction and disease.

Louis Pasteur (1822-1895)

It was Pasteur’s systematized observations and experiments that clearly rejected the theory of spontaneous generation, which had dictated that disease arose from non-living things such as miasmas from marshes rather than living microbes.

The germ theory of disease was the Achilles heel of those old, furious enemies of humanity — plagues and epidemics. Once scientific theory was put into practice with improved hygiene and sanitation, disinfection, and the use of antibiotics — the old bacterial enemy was largely vanquished.(5)

Yet, infectious disease has not been eradicated. In modern times, the Influenza Epidemic of 1918 suddenly erupted and unmercifully killed 20 million people. Of those who survived, many later suffered unusual sequelae, such as atypical Parkinson’s disease.

Thus, enemies of humanity, like viruses (e.g., human immunodeficiency virus [HIV] that causes AIDS), some protozoa (e.g., malaria, toxoplasmosis, etc.) and even infective particles made up of nucleic acids (i.e., DNA and RNA) and/or proteins, such as prions which are posited to cause such dreadful diseases as Jakob-Creutzfeldt disease and Mad Cow Disease — are yet to be subdued. Medicine still has a lot of work to do in the struggle of humanity against epidemic illness, disease, and pestilence.

Read: Medical History — Hygiene and Sanitation

References

1. Cartwright FF, Biddiss MD. Disease and History. New York, NY, Dorset Press, 1991, pp. 29-53, 113-166.
2. Faria MA Jr. Vandals at the Gates of Medicine: Historic Perspectives on the Battle Over Health Care Reform. Macon, GA, Hacienda Publishing, Inc., 1995, pp. 161-165.
3. Haggard HW. The Doctor in History. New York, NY, Dorset Press, 1989.
4. Newman A. The Illustrated Treasury of Medical Curiosa. New York, NY, McGraw-Hill, Inc., 1988.
5. Williams G. The Age of Miracles: Medicine and Science in the Nineteenth Century. Chicago, IL, Academy Chicago Publishers, 1987.

Written by Dr. Miguel Faria

Miguel A. Faria, Jr., M.D. is Editor emeritus of the Medical Sentinel of the Association of American Physicians and Surgeons (AAPS), https://haciendapublishing.com. This article on the history of medicine is excerpted in part from Dr. Faria’s Vandals at the Gates of Medicine (1995) and Medical Warrior: Fighting Corporate Socialized Medicine (1997). Copyright ©2002 Miguel A. Faria, Jr., MD.

This article may be cited as: Faria MA. Medical History — Plagues and Epidemics. HaciendaPublishing.com, March 16, 2020. Available from: https://haciendapublishing.com/medical-history-plagues-and-epidemics-by-miguel-a-faria-md/

Originally published in the Medical Sentinel 2002;7(4):119-121. The photographs used to illustrate this article came from a variety of sources and did not appear in the original Medical Sentinel article. They were added here for the enjoyment of our readers.

Copyright ©2002-2020 Miguel A. Faria, Jr., M.D.


The AMA, Ethics and Gun Control — Part III: AMA, Medical Liability and HMO Lawsuits by Miguel A. Faria, MD

[Ed: This is the conclusion of Dr. Faria’s three-part series, originally published at Newsmax.com on May 21, 2001. Links to Parts I and II will follow.]

In the early spring of 1995, the House of Representatives passed a bipartisan medical liability bill (tort reform) by a significant margin (247 to 171), despite a strong opposition by the trial lawyers. This legislation was a sweeping tort reform bill that would have gone a long way towards reforming medical “malpractice” and alleviating the adversarial and litigious climate in which physicians have been practicing medicine for the last three decades. It included a $250,000 cap on non-economic damages, limits on “joint and several” liability, and even a provision for “loser pays” rule that would have penalized plaintiffs for filing frivolous lawsuits.

Robert E. McAfee, M.D., then president of the American Medical Association, called it “a giant leap forward”; not surprisingly, the AMA flexed its heretofore flabby abdominal musculature claiming victory for “its decade long advocacy on behalf” of physicians.(1) But, unfortunately, it was a premature muscle flexing exercise.

Something happened on the way to the forum in the high stakes of politics. Less than two months later, the U.S. Senate, led by then-Majority Leader Bob Dole, R-Kan., and outflanked by his own Sen. Fred Thompson, R-Tenn., passed a different version of the proposal, which focused solely on product liability reform and which had no medical liability relief. The two disparate bills then went to a conference committee, where legislators were to iron out the significant differences. In the process, the entire medical care liability reform proposal, despite the AMA’s assurance that it would continue “to press the issue,” was completely extirpated out of the conference committee legislation.

The issue then became moot when the Clinton White House threatened to respond to the possible compromise with a presidential veto. And so, medical liability reform never saw the light of day, although some product liability did pass.

American Medical News (AMNews) reported that “one particular last ditch effort to pass tort reform” could have been made had the AMA played hardball and consented to attach medical liability reform to the Kassebaum-Kennedy bill, which it was also supporting. Unfortunately, James S. Todd, M.D. (then AMA executive vice-president emeritus, now deceased) explained the AMA had pledged “not to play that card” and would not risk endangering what later became the Trojan horse of deleterious incremental health care reform in the form of the disastrous Kassebaum-Kennedy law.(2)

You can say this maneuver was a clear case of throwing the baby out while saving the dirty bath water. The Kassebaum-Kennedy law that was passed by the U.S. Senate (unanimously) in 1996 with the support of the AMA has been a terrible piece of legislation that has not improved but actually worsened the climate of the American health care system.

Threats to Privacy

It has enforced draconian fraud and abuse provisions harmful to patients and physicians; implemented administrative simplification requirements that threaten medical privacy and patient record confidentiality (i.e., with proposed Unique Patient Identifiers, establishment of databases, and other privacy-eroding provisions); increased health insurance premiums because of proposed guaranteed coverage and renewability requirements; and caused an actual increase in the number of the uninsured for the same misguided reason, namely higher insurance premiums that have priced many individuals and their families out of the insurance market, etc.

Yet, other industries did lobby and obtained legal protection from the litigation juggernaut. Writing in The Wall Street Journal, John Stossel reported: “The single-engine airplane business came back from the dead after the General Aviation Revitalization Act made it harder to sue. Vaccine makers were helped by the Vaccine Injury Compensation Program. Silicon Valley will be helped by the Private Securities Litigation Reform Act, passed in December [1995] by Congress over President Clinton’s veto.”

He then questions why is it fair to pass piecemeal reforms for powerful industries. “And anyway, the lawyers just move on to the next hot area of litigation.”(3) And yes, he was prescient. Lawyers have moved on to expand litigation as far as the eye can see: to tobacco, the gun industry, sexual harassment and domestic violence,(4,5) and now back to one of the most lucrative industries of all, another facet of the health care industry: managed care and HMOs.(6)

Pyrrhic Victories

In the Oct. 21, 1996 issue of AMNews, the headlines blared, “Doctors win big in Washington — AMA persistence delivers powerful results.” But those items listed in the article attributable to the AMA scorecard are dubious claims for victory at best.(7) The major defeat of medical liability reform, of course, was not listed. The battle-ax issue the AMA swore it would not abandon and would continue to press died a quiet but painful death.

It should not have been that way. In fact, there is still time for the AMA to renew the fight for tort reform with renewed vigor. It is time for a group of young, bright attorneys and judges in concert with a group of like-minded activist-physicians, businessmen and other professionals to roll up their sleeves and get to work for an uncompromising and vigorous push to change the litigation rules that are wreaking social and economical devastation on plaintiffs and defendants alike and return them to the standards of ethics and justice where they originated.(8) Under the current rules, two groups, the trial lawyers, are enriching themselves at the expense of the rest of society, while the other group, demagogic politicians, are arrogating to themselves political power from their political contributions.

But don’t wait for the AMA to lead the charge!

You would think that by now the largest physician group would be experienced and sensitive to the issue of medical liability and lawsuits. You would think that despite all the shortcomings and failures of managed care and HMOs, the AMA and organized medicine would remain sensitive to the problem of medical litigation and the pain and suffering lawyers and lawsuits have inflicted on medical practitioners for decades. You would think that despite the tragic setback of 1995 and the Pyrrhic victory of 1996, the AMA with full coffers to spend(9) would this time face the trial lawyers and say, “No more lawsuits!”

No. The AMA, claiming to represent “organized medicine,” has instead said “Yes!” thus potentially opening a new venue for trial lawyer litigation.

Lets face it. It has been an agonizing decision for many of us to determine where we stand on this issue of HMO lawsuits.

I have vehemently denounced managed care as corporate socialized medicine and have pleaded for physicians to return to the ethics of Hippocrates and reassert their role as true advocates for their patients. And yet, even this sensitive and passionate issue must be faced objectively. Carried by passions and the heat of the debate, do we really want medical care to be subjected to more lawsuits? Is it beneficial to subject sick and vulnerable patients to more litigation-on-demand, when in reality, what they really need when their lives and health are at stake is prompt medical care?

It sounds good to make the law easier for patients to sue their HMOs and perhaps even their employers for delayed or mismanaged care, but, after all, who is really going to benefit from opening another Pandora’s box of litigation? The trial lawyers, of course, not the patients, who most likely will die or whose health will worsen as they wait and wait stressfully and in adversarial fashion for the slow wheels of civil litigation to turn in their favor.

Civil lawsuits take time, months and years pass as the process rolls, discovery, trial, appeals, more appeals, etc. Immediate (within 48 hours) external mediation (with an impartial, outside party) is cheaper, faster, and more effective than lawsuits.

Yet, the AMA, as in other areas, has moved to the left and now, on the issue of HMO lawsuits, has jumped in bed with the trial lawyers! Not only has the AMA, in the last three to four years in an incredible volte-face, militated for unlimited lawsuits against the HMOs, the same HMOs their leaders helped create and encouraged physicians to join, but, according to National Review, even helped defeat three GOP senators, Sens. Slade Gordon (Washington), Spencer Abraham (Michigan; now secretary of energy), and John Ashcroft (Missouri; now attorney general); all of whom opposed the AMA on unlimited HMO lawsuit liability.(10)

On this issue, as far back as 1998, the AMA, according to the same National Review article, has alienated the Who’s Who in the Republican Party from Georgia Rep. Charlie Norwood and Oklahoma Sen. Don Nickles to affable House Speaker Dennis Hastert, who complained that “these guys [AMA leaders] are — as far as I am concerned — toadies of the Democrats.”(10)

The AMA now considers HMO lawsuits more important than tort reform, despite the fact that about 90 percent of physicians support tort (malpractice) reform, and conversely, 75 percent of them believe that trial lawyers would have the most to gain from HMO lawsuits.

The magnificent exposé of the trial lawyers published in 1991, The Litigation Explosion: What Happened When America Unleashed the Lawsuit, by then Manhattan Institute scholar, Walter K. Olson, is a momentous book that needs to be resurrected. What a pity it’s now out-of-print! It would certainly add to the present debate and place it in the proper perspective for the AMA leaders who have lost sight of their mission and no longer recognize the face of the enemy.(11)

In conclusion, the AMA needs to feel well-deserved heat from physicians to change its leftward political course and place the profession back on the right ethical track. If it does not, it will continue to be less and less relevant, while becoming more and more of a joke on Capitol Hill.

The AMA spent $18 million lobbying in Washington, D.C., last year and got nothing for it. For years, the AMA worked hard to get a seat at the Clinton table. We heard repeatedly buzzwords such as “compromise,” “cooperation,” “partnership,” etc. Now, the medical politicians of the AMA have lost their seat at the table, and soon they will be fortunate if they are even allowed to enter the room to get the scraps!

[Editor’s note: This is the conclusion of a three-part series, The AMA, Ethics and Gun Control. See Part I: Full AMA Coffers to Push for Gun Control, and Part II: Medical Journalism and Physician Unionization.]

References

1. AMA delivers in liability reform. AMNews, April 10, 1995.

2. McCormick B. Tort reform dropped from product liability bill: future damp. AMNews, March 25, 1996.

3. Stossel J. Protect us from legal vultures. Wall Street Journal, Jan. 2, 1996.

4. Moore S. The trial lawyers: a clear and present danger. Human Events, Dec. 17, 1999.

5. Schlafly P. Feminist-inspired law violates the Constitution. Human Events, Dec. 17, 1999, p. 15.

6. Hoff J. Patients’ rights: a double standard. National Center for Policy Analysis, Brief Analysis, No. 307, Dec. 3, 1999.

7. Doctors win big in Washington — AMA persistence delivers powerful results. AMNews, Oct. 21, 1996, p. 1.

8. Faria M.A., Jr. The litigation juggernaut. Part I: The dimensions of the devastation and Part II: Strategies and tactics for victory. J Med Assoc Ga 1993;82(8):393-398 and J Med Assoc Ga 1993;82(9):447-451. Although this two-part article touches on all aspects of the lawsuit crisis, it emphasizes medical liability and tort reform.

9. Faria M.A., Jr. The AMA, ethics, and gun control (Part I). NewsMax.com, May 3, 2001.

10. Catanzaro M. Whats up docs? — The democratization of the AMA. National Review, May 14, 2001, pp. 28-30.

11. Olson W.K. The Litigation Explosion: What Happened When America Unleashed the Lawsuit. Truman-Talley Books, Dutton, N.Y., 1991.

Written by Dr. Miguel Faria

Miguel A. Faria, Jr., M.D. is a retired Clinical Professor of Neurosurgery and Adjunct Professor of Medical History at Mercer University School of Medicine. He is Associate Editor in Chief and World Affairs Editor of Surgical Neurology International. He served on the CDC’s Injury Research Grant Review Committee.

This article may be cited as: Faria MA. The AMA, Ethics and Gun Control — Part III: AMA, Medical Liability and HMO Lawsuits. HaciendaPublishing.com, July 11, 2016. Available from: https://haciendapublishing.com/the-ama-ethics-and-gun-control–part-iii-ama-medical-liability-and-hmo-lawsuits-by-miguel-a-faria-md/.

Copyright ©2001-2016 Miguel A. Faria, Jr., M.D.


The AMA, Ethics and Gun Control — Part II: Medical Journalism and Physician Unionization by Miguel A. Faria, MD

[Ed: This is the second part of Dr. Faria’s series, originally published at Newsmax.com on May 15, 2001. The double-standard held by the AMA and its organs about using its position “for political purposes” is remarkable. Links to Parts I and III will follow.]

I was struck one particular morning when I heard on the radio on January 15, 1999, that the editor of the Journal of the American Medical Association (JAMA), George D. Lundberg, M.D., had been fired by the AMA for using JAMA for his own political purposes. The chickens had come home to roost, I thought.

JAMA and Medical Journalism

In 1991 when the AMA launched a major campaign against domestic violence, I joined in this campaign as a member of organized medicine, although admittedly, with significant skepticism. What I found over the next four years, particularly after I became editor of the Journal of the Medical Association of Georgia (JMAG) was that instead of providing a balanced and honest approach to socioeconomic and political issues based on facts and scientific data, as would be required by professional, objective medical journals, JAMA and other AMA literature, echoed the emotionalism, rhetoric, and political correctness (and particularly so with fashionable and trendy issues) championed by the mass media.(1) This was particularly dishonest because physicians, policy makers, and the general public place a great deal of trust and credibility in the AMA, its press releases, and the studies it sponsors and publishes.

I found that despite the expressed sentiments and wishes of the rank-and-file, dues-paying members of the AMA, the vast majority of physicians who wanted to preserve the individual-based ethics and medical tradition inherent to the Oath of Hippocrates, AMA leaders prodded by medical journal editors were spearheading efforts in health care reform in the opposite direction, towards population-based ethics and the step-by-step socialization of American medicine.(2)

There is no question that Dr. Lundberg had a great deal to do with all that. He had been editor of JAMA for 17 years, and he had hoped to break the record set by his great predecessor Morris Fishbein, M.D., the prolific, outspoken, long-time editor of JAMA (from 1924 to 1949), who had himself been ousted because he had “outshined” the AMA leadership, and the Board of Trustees came to resent his influence.(3) Now, it was Dr. Lundbergs turn, although, he had been promoted by the AMA to be in charge of Scientific Information and Multimedia. (He now heads Medscape, an internet website for marketing health care products and services.)

After the 1999 coup, at a press conference, AMA Vice President Ratcliffe Anderson, M.D. said that Dr. Lundberg “inappropriately and inexcusably had interjected JAMA into a major political debate that had nothing to do with science and medicine.”

Supposedly, the AMA leadership was “outraged” because he had published an article that concluded from a survey of college students that oral sex did not constitute “having sex.” The study had been expedited for publication over other articles to coincide with the “scientific” whitewashing of the oral sex allegations involving President Bill Clinton and White House intern Monica Lewinsky.

Political expediency and social embarrassment — about kinky sex similar to what you’d find on Internet websites as well as lies, perjury, and the appearance of JAMA and the AMA closing ranks behind a disgraced president — forced the AMA leadership to do what principles and militant ideology had not: Fire Dr. Lundberg and attempt to get the house of JAMA in order!(2)

Yet the AMA was not faultless. In fact, the AMA leadership shared a great portion of the blame for the journalistic debacle. JAMAs mission statement under which Dr. Lundberg operated was approved by the AMA Board of Trustees which included in part: “To foster responsible and balanced debate on controversial issues”(3) “To inform readers about non-clinical aspects of medicine and public health,” including the political, environmental and cultural issues.

JAMAs statement of principles also included a blanket statement about “a social responsibility” to some greater societal purpose. One should question whether JAMA and the AMA then could really pick a bone of contention with Dr. Lundberg, when the organization itself bandied about such objectives and used such liberal left buzzwords as “social responsibility,” terms frequently abused and exploited for political purposes. Thus, the AMA leadership had set themselves up for the Lundberg fiasco, when they allowed politics to enter the picture masquerading as objective, scientific medical journalism. This fiasco now added another laundry item to the long list of AMA scandals, e.g., Sunbeam, CPT code monopoly, E&M guidelines, etc. which had been accumulating since the late 1990s.

The fact is that in the last two decades, the AMA had opened itself to denunciation for the overt politicization of science and medicine, both through the type of social and politically correct “research” it has sponsored, the public relations campaigns it funds (i.e., domestic violence, gun control, etc.) and the medical publications it publishes and disseminates.

Physician Unionization

When many physicians became dissatisfied with managed care, HMOs, and the increasing corporativism of American medicine — which organized medicine has supported in the last two decades — the AMA began to consider options to counteract the very problems it had helped to create, vis-à-vis the socialization of American medicine, by supporting physician unionization.

Yes, instead of returning to the individual-based ethics of Hippocrates and re-invigorating the profession by opposing head-on the real iniquities in today’s medical care incarnated in managed care and HMOs and government intervention, organized medicine decided, instead, to patch the system here and there by clamoring for more government intervention — that is, when not passively going along with the flow, a flow that always seems to carry the organization in the leftward direction. Again and again, the AMA leadership forgets that medicine is a profession, a calling, and not a trade, thus agreeing to the formation of physician unions for collective bargaining, as is the case with the labor unions.

As I wrote in a special Labor Day article last year: “Under siege, discouraged and demoralized, many physicians see no way out and have turned to the formation of [doctor] unions. Many young physicians, particularly in California and Florida, have actually joined physician unions thinking it would protect them from the abuses of managed care and the exigencies of the corporate practice of medicine, telling themselves, “Lets fight fire with fire.” So they think…!”(4)

Indeed, as I wrote in the same article: “One of President Ronald Reagan’s most memorable actions early in his first term of office was the firing of striking air traffic controllers en masse for violating federal labor laws. His actions were loudly applauded throughout the land.

“Question: Did anyone feel sorry for the union members [then] making $40,000 a year or more, despite their high level of responsibility? Did anyone feel their pain? So, consider this: Who is going to feel sorry for striking American physicians making, for the most part, more than $75,000 a year and who, for years, the mass media have hammered as greedy and uncaring?

“Although managed care and HMOs have been hard on physician and patient autonomy, physicians experience its iniquities day in and day out and patients when they get sick or seriously ill. Frankly, physicians have been led (or rather, misled) by the leaders of organized medicine. These medical politicians caught up in the trappings of office have allowed the ethics of the profession to be transmogrified from the Oath and tradition of Hippocrates and individual-based ethics to the heavily government-regulated, collectivist corporate practice of medicine.”(4)

Physicians who have unionized, encouraged by the AMAs new leftward direction, not only have joined in solidarity with some of the most radical left movements in the political spectrum such as the labor unions and the National Education Association, but also have placed themselves in a great ethical dilemmas. Will these physicians set on this path eventually refuse to care for their patients, joining the strike and abandoning those with whom they have established a patient-doctor relationship? It goes without saying these actions would go against whatever remains of the grain of medicine, a sacred calling according to the tradition of Hippocrates.

What can physicians and other health care providers really do to combat managed care (corporate socialized medicine)?(5) Obviously, put patients first, like the Association of American Physicians and Surgeons’ (AAPS) motto — Omnia pro aegroto (All for the patient)!

Suffice to say, the issue of whether physicians survive as professionals, practicing according to the tradition of Hippocrates and respected as independent practitioners, on the one hand, or become a government-controlled trade union, on the other, will likely be decided in our generation. The informed public then must watch the medical profession closely. Much more than politics is at stake, when the perversion of medical ethics is involved. Our health and our lives are at stake too!

(Continue to Part III, the conclusion of Dr. Miguel Faria’s three-part series, or go back to read Part I.)

References

1. Faria MA, Jr. Medical Warrior: Fighting Corporate Socialized Medicine. Macon, Georgia, Hacienda Publishing, Inc., 1997, pp. 107-120, 170-178.

2. Faria MA, Jr. The Medical Sentinel — A Breath of Fresh Air. Medical Sentinel 1999;4(3):94-99.

3. Wolinsky H, Brune T. The Serpent on the Staff: The Unhealthy Politics of the American Medical Association. G.P. Putnam and Sons, New York, 1994, pp. 19-20, 24, 35.

4. Faria MA Jr. Physician unions not the answer to managed care. NewsMax.com, September 1, 2000.

Written by Dr. Miguel Faria

Miguel A. Faria, Jr., M.D. is a retired Clinical Professor of Neurosurgery and Adjunct Professor of Medical History at Mercer University School of Medicine. He is Associate Editor in Chief and World Affairs Editor of Surgical Neurology International. He served on the CDC’s Injury Research Grant Review Committee.

This article may be cited as: Faria MA. The AMA, Ethics and Gun Control — Part II: Medical Journalism and Physician Unionization. Doctors for Responsible Gun Ownership, June 30, 2016. Available from: https://haciendapublishing.com/the-ama-ethics-and-gun-control–part-ii-medical-journalism-and-physician-unionization-by-miguel-a-faria-md/.

Copyright ©2001-2016 Miguel A. Faria, Jr., M.D.


The AMA, Ethics and Gun Control — Part I: Full AMA Coffers to Push for Gun Control by Miguel A. Faria, MD

[Ed:  Dr. Faria originally published this three-part article at Newsmax.com on May 3, 2001.  We felt it well worth reprinting. The story is 15 years old, but the plot is the same in 2016, only more so, with the AMA’s recent decision to increase its gun control advocacy. Links to Parts II and III will follow.]

The AMA is joining the gun prohibition movement in full force. Led by the long-time speaker of the AMA’s House of Delegates, now president-elect, organized medicine has joined the gun control movement full steam ahead. Its new leader, Richard F. Corlin, M.D., will call for the AMA to increase funding to “study data on firearms injuries” at its June 20 annual meeting.(1)

The fact is that the public health establishment, incarnated in the CDC, other government agencies and the myriad of schools of public health, has been sponsoring and conducting “gun research” for nearly two decades that has been found to be biased, result-oriented, and based on what has been characterized by a number of serious investigators as junk science.(2)

The AMA, using its publication empire, has been publishing this “research” in its journals, including the Journal of the American Medical Association (JAMA). Essentially only those researchers who embraced the politically correct, preordained conclusions that “easy gun availability results in crime” and that “guns and bullets are pathogens that must be eradicated” were published. Contrary views have been censored.

The monolithic wall of censorship was only breached by the Journal of the Medical Association of Georgia (JMAG) while I was editor from 1993-1995. I recounted the story of my travails in a chapter entitled “Censorship and Editorial Lynching in the Deep South” in my book, Medical Warrior: Fighting Corporate Socialized Medicine (1997).

The wall cracked further with the advent of the Medical Sentinel, which was the official, peer-reviewed journal of the Association of American Physicians and Surgeons. So I am intimately knowledgeable about this subject from personal experience and 10 years of research into this subject.(3)

In the spring of 1996, Drs. Timothy Wheeler (Doctors for Responsible Gun Ownership), William Waters IV (Doctors for Integrity in Policy Research), myself (as editor of the then newly founded Medical Sentinel), and the legal scholar Don B. Kates testified before a congressional subcommittee about this biased, result-oriented research conducted by the CDC and its politicized branch, the National Center for Injury Prevention and Control (NCIPC), and as a result the latter entity was ordered by Congress not to conduct tainted gun control research at taxpayers’ expense.(4)

The story about how that episode came about was published in the Medical Sentinel in my four-part article (Spring and Summer 1997) entitled “The Perversion of Science and Medicine”.(5)

I can testify that the AMA has been moving steadily to the left in a variety of issues, from the perversion of medical ethics to gun control.(6) Yet it has not always been that way. In Medical Warrior I also described how, over the years, the AMA tried to please everyone but has ended up pleasing no one! The AMA has tried to be all things to all people, pragmatic at all costs, whether in discussion of socioeconomic policies or medical ethics.(7)

I have been told, by at least one AMA defender, “It’s just politics.” That may be, but when dealing with ethics and constitutional issues, principles should not be compromised by playing politics. There is simply too much at stake!

But now the AMA is moving definitely to the left. No wonder President George W. Bush refused to deliver the traditional first health care address to the AMA. Nevertheless, while AMA membership remains low, its coffers remain full. The AMA has plenty of money to fund gun control efforts and ingratiate itself with the establishment’s media and the liberal left camp, which lately it has joined. Indeed, the AMA’s finances are said to be in the best shape that they have been in over 15 years, despite dwindling membership and questionable relevance to health care policy and medical affairs.

In the March/April 1998 issue of the Medical Sentinel, we reported that in 1996, three AMA officers were paid more than $200,000 for their time “playing politics” within organized medicine. AMA reimbursement figures then, according to Physicians Weekly, were:

AMA Officers Position held in 1996 & Reimbursement Figures:

Dr. Nancy Dickey Chairman $258,790
Dr. Lonnie Bristow Immediate Past Pres. $229,540
Dr. Daniel Johnson Jr. President $221,970
Dr. Percy Wootton President-elect $168,720
Dr. Thomas Reardon Vice-Chairman $147,929
Dr. Robert McAfee* Immediate Past President $135,440
Dr. Yank Coble Jr. Trustee $105,915
Dr. Randolph Smoak Jr. Secretary-Treasurer $99,087
Dr. Regina Benjamin Trustee $91,716
Dr. Timothy Flaherty Trustee $90,792
Dr. John Nelson Trustee $90,405
Dr. Donald Lewers Trustee $87,521
Dr. Richard Corlin Speaker $85,875
Dr. William Jacott Trustee $82,369
Dr. Palma Formica Trustee $75,492
*Term ended in June 1996
Source: Physicians Weekly (07/21/97)

There is no reason to suppose that since that time those reimbursement figures have not increased, along with the AMA’s operating budget, which was $200 million in 1998 and has risen to $247 million today.

In fact, AMA finances have been so good and its coffers so full that in 1997, Dr. Randolph Smoak Jr., who was then AMA secretary-treasurer and who is now the president, reported that every revenue category had increased except for membership dues. Furthermore, Smoak noted, “This good news should continue to keep the AMA relevant for the physicians of 1997 and the future. Indeed, the AMA is projected to receive an $8.2 million gain in real estate sales. And will end 1997 with $5.9 million in the black … and robust reserve levels that should exceed $148 million in 1999.”(8)

These predictions, for the most part, materialized. As a result, rumors circulated that the AMA no longer needed members to remain financially afloat. The rumors were confirmed by the Chicago Tribune, which reported in the fall of 1997 in the midst of the AMA-Sunbeam scandal that over 70 percent of the AMA’s revenues “came from sources other than membership — including real estate and the publication of coding books, which are revised annually and required for physician compliance with government rules and regulations.”(8) [Emphasis added.]

Despite an embarrassingly low membership at 32 percent of American physicians, the AMA claims to represent all physicians and the medical profession. And make no mistake about it, the AMA may not have the membership numbers, but it has ample finances to fund gun control efforts and other leftward leaning projects.

What is the source of this wealth? It’s the AMA’s publication empire, which rests solidly on a monopolistic pact with the Health Care Financing Administration (HCFA), a secret agreement that was brought to light in an article by AAPS General Counsel Andrew L. Schlafly in the Summer 1998 issue of the Medical Sentinel.(9) The AMA leadership even refused to show those documents to the rank-and-file membership. But the Association of American Physicians and Surgeons (AAPS), not so easily thwarted, obtained the documents from a source independent from the AMA and HCFA.

Schlafly revealed that under provisions of this pact, the AMA was given a monopoly over the government-imposed coding standards for physicians. By contractual obligation, HCFA must enforce the coding systems developed by the AMA upon the same physicians the AMA purportedly serves and represents. This contract has been in effect since 1983 when AMA Executive Vice President James H. Sammons, M.D., signed the agreement. The AMA continues to impose these money-making but onerous coding regulations on physicians in the name of HCFA.

Who pays for this government-granted AMA monopoly and regulatory burden? Ultimately, the patient does. Year after year, American physicians must purchase the new coding books in order to bill the government and third-party insurance carriers for medical services rendered to patients. Codes must be current, and physicians must not make billing errors. Coding errors may result in the government accusation of fraud and abuse, prosecution, and jail time.

Schlafly is indeed correct when he asserts: “Virtually every crime has a motive, and the motive here is money. Lots of it. The AMA declares on its website that the AMA ‘generates approximately two-thirds of its annual $200 million operating budget from non-dues sources.’ Of that $133 million in non-dues revenue, the AMA’s publication revenue, including sales of those expensive CPT code books, is its most prominent source. The victims of these endlessly complicated revisions to coding are physicians rendering private medical care. Each year physicians pay substantial costs and expend precious hours trying to keep up with the rules imposed by the AMA’s CPT moneymaking machine. The time and money lost by physicians due to the AMA could be far better spent in the service of patients.”(9) Amen!

In a subsequent parts of this article (Part II and Part III), we will discuss other topics which confirm the AMA is moving leftward in the political spectrum, whether it is medical journalism, ethics, unionization, or the corporate practice of medicine.

References

1. AMA Joins Gun Grabbers. NewsMax.com, May 1, 2001.

2. Kates DB, Schaffer HE, Lattimer JK, Murray GB, Cassem EH. Guns and public health: epidemic of violence or pandemic of propaganda? Tennessee Law Review 1995;62:513-596; and Suter E. Guns in the medical literature — a failure of peer review. J Med Assoc Ga 1994;83(3):137-148.

3. Faria MA Jr. Medical Warrior: Fighting Corporate Socialized Medicine. Macon, Georgia, Hacienda Publishing Inc., 1997, pp. 184-191.

4. Waters WC, IV, Faria MA Jr., Wheeler TW, Kates DB. Testimony before the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, House Committee on Appropriations. March 6, 1996. Hearing Volume, Part 7:935-970.

5. Faria MA Jr. The perversion of science and medicine (Parts III-IV). Medical Sentinel 1997;2(2):46-53 and Medical Sentinel 1997;2(3):81-86.

6. Faria MA Jr. The transformation of medical ethics through time (Part II). Medical Sentinel 1998;3(2):53-56. See also reference #3 above.

7. Faria, MA. Medical Warrior, op. cit., pp. 142-146 and 164-169. 8. AMA reimbursement figures and Financially, to AMA, membership may be optional? News and Analysis. Medical Sentinel 1998;3(2):42.

9. Schlafly AL. AMAs secret pact with HCFA. Medical Sentinel 1998;3(4):149-150.

Additional Reading:

10. Wolinsky H and Brune T. The Serpent on the Staff: The Unhealthy Politics of the American Medical Association, G. P. Putnam’s Sons, New York, NY. 1994, p. XVII.

11. Wheeler T. The AMA’s Long March for Gun Control. DRGO, August 25, 2015.

Written by Dr. Miguel Faria

Miguel A. Faria, Jr., M.D. is a retired Clinical Professor of Neurosurgery and Adjunct Professor of Medical History at Mercer University School of Medicine. He is Associate Editor in Chief and World Affairs Editor of Surgical Neurology International. He served on the CDC’s Injury Research Grant Review Committee.

This article may be cited as: Faria MA. The AMA, Ethics and Gun Control — Part I: Full AMA Coffers to Push for Gun Control. Doctors for Responsible Gun Ownership, June 21, 2016. Available from: https://haciendapublishing.com/the-ama-ethics-and-gun-control–part-i-full-ama-coffers-to-push-for-gun-control-by-miguel-a-faria-md/.

Copyright ©2001-2016 Miguel A. Faria, Jr., M.D.


Religious morality in Western civilization — Part II: Secular man needing no religious guidance?

It has been argued that secular (non-religious) individuals and organizations display highly moral standards without belief in god or religion. Admittedly, this is true as far as organizations, such as Doctors Without Borders, but not necessarily true of the individuals who actually do the work, many of them are quiet or religious people operating with compassion under religious morality. These humanitarians keep their religion to themselves, although they might be working under the umbrella of a secular organization. Others have been influenced by religious principles earlier in life, even if they no longer are practicing Christians or Jews. In our present age openly espousing religion is not faddish but politically incorrect and can get one into trouble. And yes, there might be others, who are avowed secular humanists and who do humanitarian work under a moral and personal ethic. But some do it to advertise their “altruism.” Others ask questions of faith that are pointed less because they seek no answer, only to shake the faith of others. David Mann was correct to quote G.K. Chesterton, “The point of having an open mind, like having an open mouth, is to close it on something solid.”

Aristotle mentions intelligent individuals who live virtuously, guided by reason in the pursuit of goodness. But these “noble” individuals, who are intrinsically good, needing no education, training, or religion to exercise virtue, are the happy few. Most people need morality and the guidance of religion. Aristotle writes, “For each state of character has its own ideas of the noble and the pleasant, and perhaps the good man differs from others most by seeing the truth in each class of things, being as it were the norm and measure of them.” Secular humanists refer to these few gifted and selfless individuals when they announce that man is the measure of all things as earlier promulgated by the Epicurean philosophers of antiquity. But Plato and Aristotle denied this and criticized the Epicureans who preceded them and the Sophists who followed them.

Lucky few perhaps, but for the vast, common humanity, we must cultivate the moral virtues, achieve them through discipline, moderation, education, habit, and religious morality, as discussed by both Plato and Aristotle, and the great theologians, St. Augustine and St. Thomas Aquinas.

Happiness and “the good life” come from exercising the moral and intellectual virtues and never doing evil. This is also what the Judeo-Christian ethic and all good religions espouse and fortify in the people because religious morality not only provides spiritual solace but also promotes moral guidance and ethical behavior. Most people will not act virtuously of their own initiative without moral guidance. Those “brutish persons lacking self-control,” the intemperate, and the wicked, posited Aristotle, must be made to behave properly and punished for their crimes by the force of law.

In the end, like St. Thomas Aquinas and Aristotle, I prefer individualism, freedom, and humanitarianism stemming from religious and philosophical precepts, rather than to depend on the secular humanist notions of collectivist utopias and the purportedly intrinsic goodness and capabilities of a rational and ideal man. These are misguided notions that failing in their dreams of creating paradises on earth, have been conducive, as history has shown, to the expansion of government, the use of force, curtailment of liberty, censorship, collectivism, and the creation of veritable hells on earth, as in Nazi Germany and the communist Soviet Union.

Read Part I of this article.

This article is excerpted from a longer essay, fully annotated, and posted at the author’s website.

Article written by: Dr. Miguel Faria

Dr. Miguel A. Faria is an associate editor in chief and world affairs editor of Surgical Neurology International. His website is HaciendaPublishing.com.

This article may be cited as: Faria MA. Religious morality in Western civilization — Part II: Secular man needing no religious guidance? Haciendapublishing.com, December 17, 2015. Available from: https://haciendapublishing.com/religious-morality-in-western-civilization-part-ii-secular-man-needing-no-religious-guidance/.

Copyright ©2015 Miguel A. Faria, Jr., MD


Religious morality in Western civilization — Part I: The twin pillars of the West

In the course and development of Western culture, the Judeo-Christian and the Graeco-Roman heritages became inextricably entwined becoming the twin pillars of Western civilization that have withstood the test of time. With the Hebrew experience, the Ten Commandments, the Old Testament, man was seen as having free will and having the capacity to do good or evil — i.e., develop moral conduct, for which he would be rewarded or punished in the afterlife.

Christianity and the New Testament came almost a millennium later. The resulting Judeo-Christian morality formulated a code of moral conduct to preserve order in society and cement the fellowship of men. Constantine the Great (reigned A.D. 306–337) and his successors made Christianity and Christian religious morality the order of the day in the Roman Empire. The Graeco-Roman pillar stemmed from the natural philosophers of ancient Greece in the 6th century B.C. But it was not cemented, as far as moral conduct and ethics, until the advent of Socrates (469–399 B.C.), Plato (427–347 B.C.), and Aristotle (384–322 B.C.).

In his Ethics, Aristotle stressed that human action and ethics seek moral goodness — i.e., justice, temperance, courage, moderation, self-control, etc. — and the source of these moral virtues was God, eternal and immutable, the Prime Mover, who gave order to all things and was the Final Cause, the reason and purpose for existence. For Plato, God was transcendent, the highest intelligence, who can punish those who performed wicked actions in this life. Death in the good man unites him with God and the universe. Thus, St. Augustine was able to reconcile Plato with Christian dogma (even crediting Neo-Platonism with facilitating his own spiritual journey toward Christianity), while St. Thomas Aquinas reconciled Aristotle to Christianity in a momentous step in Western philosophy and Christian morality and ethics.

Without the support of religion and our churches, crime and mayhem in society would increase, giving the State the reason (or excuse) to step in to fight the lawlessness  — ominous steps that frequently end up restricting freedom and creating tyranny. Agent provocateurs have purposely elicited violence, instigating government reprisals throughout history that predictably result in assaults on liberty and propitiating the imposition of tyranny as we witnessed in the 20th century.

Horrible crimes were committed in war and peace in the name of religion, but much of this evil was committed by “brutish individuals lacking self-control,” acting on their own, doing evil for their own sake — although institutions or governments may be erroneously blamed. The Church has erred, and religious inquisitions and wars conducted on her behalf have been repeatedly condemned without judging by the standards or the circumstances of the times. Nevertheless, religious institutions that survive the test of time, survive because in the balance of human experience they are found to be of net benefit to mankind. Such is the case with the Christian churches and temples of various other sects — and the Judeo-Christian ethics of the West.

Modern angst and anxiety aside, faith and religion provide an invisible support to the moral code, encourage discipline, and promote civility. Endless and pointless theological questions and arguments are intended to undermine the faith of others, not in seeking answers (or truth), because questions of faith are not answerable by rational analysis, and certainly not amenable to the scientific method.

Read Part II of this article.

This article is excerpted from a longer essay, fully annotated, and posted at the author’s website.

Article written by: Dr. Miguel Faria

Dr. Miguel A. Faria is an associate editor in chief and world affairs editor of Surgical Neurology International. His website is HaciendaPublishing.com.

This article may be cited as: Faria MA. Religious morality in Western civilization — Part I: The twin pillars of the West. Haciendapublishing.com, December 17, 2015. Available from:  https://haciendapublishing.com/religious-morality-in-western-civilization-part-i-the-twin-pillars-of-the-west/.

Copyright ©2015 Miguel A. Faria, Jr., MD