Not my Australia: pandemic ethics

A year ago I experienced an ethical dilemma, from the patient’s perspective: a doctor signed a medical report about me, by email signature, without ever meeting or consulting me (I was asleep at the airport hotel), and got it all wrong (said I was non-compliant, that they had reasonable evidence that I would remain non-compliant and that they had no other option but to direct police to detain me) but mostly, they never even said, “Sorry.” All because, “Pandemic.” They probably thought the outcomes justified the means, given public health mantra about acting fast, not correctly. All I needed was an apology. To undo the harms done by the NSW Police Commissioner on national television. Nobody ever apologised. Instead the NSW CHO keeps getting awards, which is great for women in leadership. But I was made to pay. I spent months in counselling, which I started sitting on the toilet (the lid was down) in Hotel Quarantine at the InterContinental in Circular Quay. I had thought I might be psychotic it was all so unreal. Turns out, I wasn’t psychotic, just traumatised and reacting normally to unusual external stressors. AHPRA was not interested in upholding their responsibility for governance of ethical medical practice when I submitted formal complaints about the incident, because “pandemic” and not their jurisdiction. A year on, the Federal Government has now invoked further emergency and extraordinary powers to ban Australians returning home from India, under threat of hefty fines or jail time. During a pandemic. Where lives are at threat. Australians turned back. After we had a year to prepare for their return. We had a year to prepare. The pandemic is the aegis behind which unethical behaviours are foisted onto a scared populace, and accepted. We could be doing much better. We will look back and wish we’d done better.

On one hand this paradigm shift on what is ethical (the greater good, I suppose, for white cis-gendered privileged Australians, of course) has challenged my core values but on the other hand it’s provided an opportunity for personal growth. I’ve changed how I practice as a specialist. I spend substantial more time in pre- and post-procedure counselling, making eye-contact (I find this especially difficult as I can’t concentrate on talking while looking at another’s eyes), and asking for questions, satisfaction and were expectations met. I don’t want to participate in the medical culture of doing things to patients and expecting thanks, when the patients had not been involved in the decision-making, did not ask things to be done to them, and would’ve preferred the other un-offered options. What the media missed last year in reporting the political spin story of, “Doctors absconded from hotel quarantine” was that the S62 PHO third line of defence was, “There is no other way to protect the health of the public” – yet the vast majority of our plane manifest were permitted to self-quarantine in Sydney and NSW at their own expense. We were publicly detained for political convenience, not for public health reasons, even though that’s what was recorded forever on paper.

I don’t know what to say to my Indian colleagues, and there are many, about the catastrophic outbreak of COVID19 in India or, worse, the Federal Health Minister’s overnight declaration that Australians in India cannot return home. The propaganda is that, “It’s a temporary pause”. No, it isn’t. Last year’s ban on cruise ships was, “Temporary” for “a few weeks”. Those Australians have been hung out to dry, and they know it. Outbreaks in the UK or the US have been met with compassion. Outbreaks in Asian countries or cruise ships, “It’s your fault.” That was the sentiment of Premier McGowan’s press release yesterday.

I really wish I’d paid more attention in Medical School ethics classes. I’d just got a new laptop and was playing solitaire on my laptop, instead of listening to the lecturer drone on about deontological and something else. Perhaps if I’d rote-learned more knowledge or applied to my own experience, instead of following the example of my peers and superiors, I’d have been better equipped to understand and adapt to the challenging shifts in examples of what is right and wrong in Australia today. If you work in Canberra it’s wrong to rape somebody but OK for the PM to touch people and “lay-hands” on them without seeking their consent, while acting in his secular role as PM. Australia has become a miso-mash of texts such as, “Animal Farm”, “V For Vendetta” and, I suppose, “12 Monkeys”. Although our leadership has gone off the rails what I observe in my (heavily curated and probably incredible skewed sample population) is a collective outrage at injustice and inequity, at racism and behaviour that is unacceptable.

My decision now: I’m not beaten and I won’t join them; how do I continue the fight?

I suppose it all harks back to my 17-year-old brain’s reasoning for selecting, “medicine” as my first university preference; gay people were treated like shit in hospitals so if I was the doctor I could be better. Maybe it’s not gay people I need to look out for today the most today, it’s anybody. Whoever the next patient is. Unless they’re a Federal government politician. Then, it’s tea-break time. They had their chance. A temporary “pause” in healthcare would be announced, via shouting at the waiting room.

Anyway, it’s the weekend so I need to tidy the house, go to Bunnigns and stop watching hilarious TikTok videos:

@johnmichaelsayshi

you’re supposed to chew apparently

♬ original sound – John Michael

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