14 , 2002 9:30 a.m.
One’s a General
By Dave Kopel
& Timothy Wheeler
estosterone is in again. Witness the ascent of Dr. Richard Carmona, the
true-to-life hero nominated by President Bush for the post of surgeon
general and recently confirmed, unanimously, by the Senate. Our new surgeon
general displays the manly virtue of courage that our nation has again
learned to admire since we went to war. The confirmation process reflects
our rediscovered consensus that real men aren't afraid to use force
even deadly force when necessary to protect a woman from a violent
life story is one of overcoming adversity and excelling in service to
others. A high-school dropout from Harlem, he joined the Army and won
two Purple Hearts, serving as a medic and a Green Beret. After distinguishing
himself as a soldier he resumed his education, becoming a trauma surgeon
and earning a postgraduate degree in health policy and administration.
Carmona also directed the first trauma care program in southern Arizona.
Along the way, the
surgeon-soldier-administrator became an expert on bioterrorism and an
advocate for bioterrorism preparedness several years before September
11. So far, shining credentials for a surgeon general.
But Carmona's other
high-profile accomplishments stirred a controversy that highlights Americans'
ambiguity about the use of force. In 1999 Carmona, a sheriff's deputy
and SWAT-team member, encountered a man assaulting a woman. As the Los
Angles Times later explained, Carmona had "stumbled onto a killer
who was holding a woman hostage. The man, who police later determined
had stabbed his father to death and was on his way to kill an old girlfriend,
grazed Carmona's head with a bullet before the doctor, also a badge-carrying
sheriff's deputy, fired a single shot to kill him."
Carmona had done his job as a sworn peace officer and saved the life of
an innocent woman, as well as his own.
But University of
Arizona colleague Dr. Charles Putnam denounced Carmona for allegedly violating
the physician's duty to do no harm. But in fact, the "do no harm"
phrase is a simplification of language from the
I will follow that
system of regimen which, according to my ability and judgment, I consider
for the benefit of my patients, and abstain from whatever is deleterious
and mischievous. I will give no deadly medicine to any one if asked.
This language is,
by its terms, confined to the physician's role in treating his patients
not in his role as a father defending a home from a violent invader,
or a peace officer defending his community from a murderer.
When the Hippocratic Oath is meant to apply to a physician's non-professional
life, the oath specifically says so, for a physician is bound to keep
secret he learns "in connection with my professional practice or
not in connection with it."
In modern times, most medical ethicists have not delved into issues involving
homicidal attacks on medical personnel. Three authors who have, however,
are Harvard psychiatry professor Arthur Z. Berg, University of Illinois
at Chicago psychiatry and public health professor Carl C. Bell, U-Cal.
Davis psychiatry professor Joe Tupin. In their article "Aspects of
Violence: Issues in Prevention and Treatment" (published in vol.
86 of the journal New Directions for Mental Health Services, Summer
2000). Advising mental-health workers on dealing with violent patients,
Berg and his co-authors explain:
The idea of harming
someone is foreign to most mental health workers. Nonviolent methods
that do not cause harm are appropriate for management of aggressive
patients. But when faced with serious bodily injury or death, those
methods may not apply. The clinician must be prepared to do whatever
violence is necessary to save himself or herself and other. In these
situations, "First do no harm" has no place.
verbal attack on Carmona escalated when Dr.
James Curran, the Dean of the Rollins School of Public Health at Emory
University weighed in. Because of Emory's proximity to the federal
Centers for Disease Control, also located Atlanta, its school of public
health tends to get a good deal of media attention.
Dean Curran announced
that he was not "proud that our surgeon general shoots people."
He denounced Carmona as "a cowboy."
Consistent with Dean
Curran's aversion to Carmona's use of a firearm, Emory University has
long served as a center of antigun propaganda, most notably from Dr. Arthur
Kellermann, a tireless producer of dubious antigun
factoids. More recently, Emory has become infamous as the home of
history professor Michael Bellesiles, author of the now-exposed hoax book
Because Dr. Carmona
was carrying a gun and knew how to use it, a violent criminal died, and
two or more innocent women and men survived. By the moral calculus of
most people, this would seem a very good result. Had Dr. Carmona "done
no harm" to the harmful predator, then the innocent hostage would
have been assaulted and perhaps murdered. The killer might have gone to
murder his ex-girlfriend, as well as any peace officers (Carmona included)
who attempted to interfere. To be explicit: A dead male violent predator
is a better public-health result than several innocent women and men brutalized,
severely injured, and possibly murdered.
As Dean Curran's denunciation of the life-saving Dr. Carmona highlights,
"public health" is, in some hands, increasingly becoming an
instrument of moral intolerance, rather than of genuine public health.
This is why the "public-health" campaign against guns and gun
owners tends to ignore or disparage lawful defensive uses of firearms
against criminals, or against genocidal governments even though
genocide is surely the worst possible "health outcome."
Rather notably, many of the prime targets of today's "public-health"
puritans are same targets which have always been so bothersome to people
who insist that everyone live by a single standard of moral purity: tobacco,
alcohol, and food. But rather than make the straightforward (and not implausible)
moral arguments against smoking, drinking, and gluttony, the "public
health" puritans wrap their claims in spurious factoids created by
They campaign for smoking prohibition on the ludicrous grounds that inhaling
secondhand smoke is more dangerous than smoking cigarettes. They campaign
against alcohol by raising scare statistics about "binge drinking"
and rather significantly, their "binge drinkers" include
people who drink at levels which leave them stone cold sober. Likewise,
the "public-health" puritans rail against gluttony by
producing bogus statistics about "obesity" which define NFL
running-backs as "obese."
Of course there are many serious, dedicated public-health workers and
scholars who really do protect public health. The genuine health professionals
are busy fighting against infectious diseases, monitoring the safety of
drinking water, and studying how viruses spread from one population to
Yet too often, the "public-health" voices which appear in the
newspapers aren't the voices of health advocacy, but the voices of neo-puritanism,
masked in public-health rhetoric and waving phony and frightening statistics.
In a sense, Dean Curran's attack on Dr. Carmona serves the useful of purpose
of revealing how extreme the Puritans of Public Health Agenda can be.
It's not really about reducing how often innocents are harmed by guns;
the agenda won't even allow rampaging murderers to be harmed with guns.
Our United States Senate, happily, found nothing immoral in Dr. Carmona's
record. Had Dr. Carmona ever performed an abortion, or if he had ever
volunteered at a pro-life medical counseling center, you can be sure that
at least a few senators would have found the doctor's actions morally
disturbing. But saving women by shooting a rampaging murder there's
nothing at all morally disturbing about that at least according
to the 98 United States senators who voted for Dr. Carmona. (Two were
Dr. Richard Carmona is a physician and educator with demonstrated ability
under fire, both metaphorically and literally. He has stood in that dark
place where evil threatens, and he has prevailed. What better person could
serve as surgeon general for a nation at war?
Dave Kopel is an NRO contributing
editor. Timothy Wheeler is president of Doctors
for Responsible Gun Ownership, a project of The