Rudolf Steiner - The threefold social order
- Thomas Jefferson
As state medical licensing laws are not only a meddlesome intrusion into the healthy workings of social intercourse, but a barely concealed assault on human dignity, I offer the following three arguments towards their final revocation:
1) THINKING: It is claimed of medicine that it is both an art and a science. Yet, what art is similarly licensed?-poetry? painting? What other scientists carries a license?-biologists? physicists? Any profession that becomes so burdened by state licensing must thus give up its claim to both art and science. It becomes what is required of it by the state though the circuitous route of statutory law. It becomes, in legal parlance, 'standard medical practice'.
Every state has its own licensing protocol, although fundamentally they hardly differ. The State of New York is rather typical and may therefore be used to illustrate the whole conceptual fabric of licensing statutes:
Education Law 6512 defines the practice of the profession of medicine as "diagnosing, treating, operating or prescribing for any human disease, pain, injury, deformity or physical condition." As far as it goes, this may be an accurate description of the 'what' of medicine, especially if mental, emotional and biographical aspects are ignored. The 'how' is then defined by "licensure" in Ed. Law 6522, and this is subsequently determined in Ed. Law 6523 by a state board of medicine, appointed by the board of regents on recommendation by the commissioner. Although 6522-"only a person licensed...shall use the title 'physician'"-already begs the issue, with 6523 we encounter the first major riddle. It reads: "the board shall be composed of twenty licensed physicians, two of whom shall by osteopaths." Well, if two members of the board are osteopathic physicians, what kind of physicians are the other eighteen? It simply reads: "licensed physicians". Obviously, they are not osteopaths, but what kind of non-osteopathic physician is not determined here.
The 'who' of eligibility for licensure is determined by Ed. Law 6524. To qualify as a physician in New York State, an applicant must fulfill certain requirements, the main being the attainment of a degree of doctor (MD) from a school that has degree-conferring powers by special charter from the state legislature. Until the 20's and 30's, there were three different kinds of medical schools in New York State: allopathic, homeopathic and eclectic. Today, there is only one: allopathic. And this by special charter through the state legislature. Every medical school thus becomes, at least in spirit, a state school for this reason. With Ed. Law 6524, we have come full circle, but with an added little twist or, as we shall see, knot of irony.
A law in the form of a general concept is always meant prohibitively. Such a law is 6512 above. While obviously not written in the negative-"thou shalt not"-it certainly has been consistently interpreted that way. Such laws are called proscriptive laws. While it may appear to define the practice of medicine rather open-endedly, what we find in fact is a medicine of a decidedly narrower scope, thanks to licensure laws 6522, 6523 and 6524 combined: The practice of medicine is to be limited to the licensed allopath only. Within the real world of human suffering, the State has designed the allopath like unto itself: omniscient. That is: to be all things to all people. This absurdity is the result of two things being attempted at once: a proscriptive and a prescriptive law taken together.
Again, laws must be general if they are meant to prohibit behavior. "Thou shall not kill" is such a broadly stated law. "Thou shall not kill with a knife" is rather specific. While the first is all inclusive, the second, representing a particular instance, allows for a greater liberty; in this case, to the would-be assassin. New York State Education Law has done something similar. By limiting the practice of medicine to the licensed allopath, the consumer has been put at a greater risk-the very opposite of the law's supposed intention. In New York State, allopathic medicine has become the defining modality. This has had dire social consequences. Mentioned earlier were the escalating costs and the routine nature of many treatments (i.e. cancer). But nowhere is the calamitous effects of licensing laws more apparent than in the issues now surrounding the so-called 'right to die' movement. Here, again, a single licensed modality is dictating the direction of the entire debate. It would seem that humanity may be betrayed as much by what licensing laws allow as by what they disallow.
The cadence of law is often marked by a judge's gavel. The People vs Reuben Amber, 1973, is a case in point. Although Reuben Amber was an acupuncturist, and acupuncture was not taught in state-chartered medical schools, the court found that the law was not to be limited to "Western, allopathic medicine". This is interesting: while medicine is to be regarded as potentially limitless, the actual practitioner (MD)-that is, those who may practice medicine as defined by previous law-is to be limited to just that: "Western allopathy." The court went further, maintaining that the law was to be "broad enough to include the gamut of those who know, whether or not recognized, and even those not yet conjured." (A strange word, conjured, to be used when speaking of medicine.) The law is clearly defined here to include the element of time within its scope; all possible ideas, past and future, whether divergent or still yet unformed, are to be contained within its compass. Indeed, a fairly egregious compass. It would appear that the State of New York has assumed a power to restrain thought, and this in an area that purports to be a science. It is the fact that you think, not what you think, that is actually being regulated by such laws. The thought content is either very strictly confined by law or else filtered through the sieve of allopathic training in order to qualify as a legitimate medical idea. These kinds of law, so paradoxical in intention, are intellectually abhorrent; by offering what they cannot give, by prohibiting what they would seem to proffer, they stupefy the mind. All those engaged in the care and healing of the sick must sometimes feel acutely, if not chronically burdened by such laws.
"A license...is a personal privilege to be exercised under restrictions which exist at the time license is granted and such as may thereafter by reasonably imposed." The State has claimed that nobody has a "vested right" to practice medicine. To attempt to heal the sick and disabled, to offer to succor pain and suffering is not to be construed in any way as a human right; it only seems so. It is a privilege granted, on a provisional basis, by the State of New York. But the concept of privilege is ultimately at odds with the real unfoldment of compassion and empathy. Privilege always divides, excludes and isolates. Perhaps the alienation so often felt in the modern clinical situation may not be the result of a sterile technique alone, but may lay much deeper, like some primal fault in the bedrock of fellow-feeling; that which would be whole is splintered by privilege. This is an observation I don't expect the privileged to immediately understand; it takes a sense for the social that privilege abjures. Privilege harms no one more than the privileged themselves.
How are all these statutes defended? The usual argument is an appeal to the, by now, infamous "public welfare" clause. Besides prolonged epidemics, sanitation concerns and environmental pollution, in what sense ever is the treatment of human illness to be considered part of the public welfare? Certainly we all wish the ill to become well, but this cannot become public policy for the simple reason that illness, like death, is a private affair. Secretly, we might want others to join us, but sickness really sets us apart from others, separates us from what is most public, entirely privatizes us. As to the possibility that the unscrupulous may then prey upon this vulnerability, licensing laws offer no real protection. Witness the incredible caseload of medical litigation in today's courts. A license does not protect from malpractice, does not secure from slovenly or inattentive care, does not insure against incompetence. A court does. This is just the point: consumers are already protected by tort law from injury and abuse of whatever kind, including medical. Licensing laws encourage a kind of institutionalized fraud. This is implicit in all of the above. The problem, however, is that because of these same laws, consumers do not have as ready access to the courts as they do with outright abuse.
The state has always maintained that a society of individuals is incapable of self-regulation. The usual rant is that people are generally too gullible, naive, complacent and self-deluded to be trusted to their own judgement in matters as intimate as health and disease. In order to save us from the terrible burden of independent thought, the state has become a kind of pater familias-like some giant Kronos devouring his own, absorbing by degrees both body and mind. Ordinary citizens (excepting legislators!) are obviously capable of the most divergent behavior, of the most vile thoughts; whether ignorant or malicious, we must be protected from ourselves. The state has always held this position in respect to individuality. It is the opinion of a cynic; indeed, of a misanthropist.
There are those who claim that the practice of medicine must always be subsumed within the general rubric of science; that the consumer must somehow be guaranteed the scientific training of today's practitioner; as if science itself were an end and not a means; as if science were not a heterodoxy. What is usually meant by science in this context, though, is the exact and detailed knowledge of anatomy and physiology as it has developed especially in the West in the last two or three hundred years. However, it must be said that this knowledge is not limited to allopathic medicine, but is available to anyone who would take the trouble to learn it. A part of medicine no doubt is this knowledge; the better part, though, is in the doing. Some, for instance, may extend this knowledge anthroposophically, while still others would entirely sublimate it homeopathically. Medicine, therefore, is an art and a science inextricably bound in the practitioner's judgement. Those who say that medicine is a science only have never yet observed a living human being.
The term 'physician' implies a knowledge of 'physis' or nature. Only a philistine would automatically couple this knowledge with licensure. The state has turned medical sapiens into medical fungens.
2) FEELING: Licensure is contrary to the egalitarian nature of modern Western society. It is actually antithetical to democracy itself. A doctor endorsed by government exhibits all the markings of an advantaged class. How can a state which grants privileges to selected individuals still claim to represent equity interests? Today, with few exceptions, it is generally allopathic medicine that claims the prerogative of dictating the who, how, why, and when of medicine. Largely because of licensing laws. But this situation is not immutable, and has been called into question before. In order to grasp the full significance of a legalized privilege, it may be instructive to take a brief look at the history of medical licensing laws in this country. 3
During the period from 1827 to 1830, there was a countrywide effort, both within homeopathic and allopathic medicine, to establish state medical societies. Licensure developed in tandem to this effort. As homeopathy had yet to receive universal condemnation, in 1830 the Medical Society of the County of New York conferred an honorary membership on Dr. Samuel Hahnemann, only to quickly rescind this membership as homeopathy became more popular. By 1841, however, a general anti-monopolistic movement, fired by the Jacksonian Democrats, began to sweep through this country, and by 1844, licensure was repealed in New York State, and by 1849, all licensing laws in almost every State of the Union had been repealed. The main point was constitutional: whether the legislature had the right to give to any profession a monopoly on medical care. A healthy instinct was in operation here: "For the common man, it was a triumph of democracy." (Kaufman)
During the remainder of the 19th Century, homeopathic and allopathic practitioners battled each other vociferously for public recognition, for state funding of their schools, for medical commissions in the military and for the right to be allowed to treat in municipal hospitals. During this same period, state medical societies, and the newer national organizations, the American Institute of Homeopathy and the American Medical Association, functioned as quasi-licensing boards, interfacing unceremoniously with the state. The allopathic AMA was the dominant force, often effectively censoring the so-called 'irregular physician' by way of the infamous consultation clause of their Code of Ethics. Sectarianism, homeopathy and quackery were often uttered in one breath. But the homeopaths were no better, accusing the ordinary allopath of barbarism, incompetence and downright treachery. The uncompromising zealotry of both actually left the public less confused than mocking.
Towards the end of the century, something very strange and ironic occurred . The allopaths and the homeopaths began to close rank and to petition the state legislatures to re-enact restrictive statutes out of concern for the rapid development and growing popularity of the upstart chiropractors, osteopaths and Christian Scientists. 4 Just as they had attempted to do to each other previously, "allopathy and homeopathy were forced to unite behind legislation which would guarantee their own existence, but would eliminate the minor sects." (Kaufman) Power, fear and privilege make for strange bedfellows!
The rest is part of the public record. The State of New York established three licensing boards in 1891: allopathic, homeopathic and eclectic. By 1917, these three boards had become one: an allopathic medical board. The practice of medicine had become more restrictive and centralized. Later, the beleaguered homeopaths would try to persuade the AMA that homeopathy was really a sub-specialty of medicine, "homeotherapeutics", and that all the animosity of before had only been the result of a misguided fanaticism. Thus, the pathos of the outmaneuvered loser....
It could, perhaps, have gone the other way. (It could not, but for argument's sake, one could imagine it so.) The tides of fortune could have flowed differently, and homeopathy could have become the medical majority, the prevailing sect, able to then subjugate, politically and economically. All those it perceived as dissenters or equivocators of Similitude. One should not be naive or hypocritical about this: homeopaths would likely have been as ruthless, suppressive and intolerant to its opponents as any group latched legally to the state. To think otherwise is disingenuous. There is the old adage, as true in medicine as anywhere, about the nature of power and corruption.
Politics is all too often characterized as a mad scramble for privilege. One should consider carefully the social consequence of the present system of state-mandated medicine. This is not to deny the emotional aspect of medicine, and the fact that the sick want and deserve confidence in their physician, but the present system is not the only, nor, in the sense of equity issues, the best system to assure such confidence. Ultimately, licensure precludes such confidence as "real trust can only develop outside any authority, governmental or economic" (Steiner).
3) WILLING: The present exclusive fixation on allopathic medicine is reminiscent of the situation in Europe before the Renaissance and Reformation in the realm of religion. 5 It was then that the state felt it had a proprietary interest in the spiritual welfare of its citizenry, and religion was prescribed by law. Any deviation was punishable by death. Analogous to the arguments for medical licensing today, the ordinary citizen was obviously incapable of treading the thorny path to God alone without the solicitous, if despotic hand of the Church working in close, if not virtual union with the state. 6 From birth to death, the Church/state ordained all aspects of social intercourse, for how could the common sinner ever expect to fathom the mysteries of God's ways on earth? It was the Church/state that had been appointed by God as the final arbiter of conscience. (The parallel between the perilous labyrinth of medieval theology and the arcane world of today's medicine should not be lost on the reader.)
Now, almost 500 years later, what the individual does in the realm of religion-in however unorthodox a manner they may seek the spirit-is of no concern to the state: a complete separation has occurred. After centuries of bloody agitation, the state has conceded to the individual the right, if not the capacity of spiritual judgement. The terrible conflicts that have surrounded statemandated religion in the past (and the debate that will soon overtake education as well) must now spread to other areas of cultural life; specifically, to the care and treatment of disease, to medicine.
This is an exact analogy: Allopathic medicine is today's Church. The one caveat, though, is that instead of death, the power of the economic sword now hangs over anyone who would challenge the present unholy conjunction of medicine with the state. Is it not really still the soul that hangs now in a kind of medical balance? As it ordinarily takes longer to become an ordained priest than it does to become a state licensed physician, where are the social safeguards? To claim, for instance, that a state licensed allopath is now fully qualified to practice homeopathy as well is equivalent to a fraud. It would have been as rational to have claimed that a twelfth-century ecclesiastic was then fully competent to represent Hinduism!
It is said that the whole person is a being of body, soul and spirit. Well, as noted, the state can no longer dictate religious belief; we are free to find our own path to the spirit. And at the level of the soul, most states require little or no licensing for the practice of psychotherapy, or soulcare. But as to the physical body-there are laws pertaining to every centimeter of one's corporeality! Compared to one's immortal soul, and to the prospect of eternal damnation, why would anyone think it was important to the state what therapy or therapist one chose? This witless irony of history highlights with a kind of poignancy the dualism of materialistic thought: While in the past it was one's spiritual life that was circumscribed by law, today it is merely the body!
Rudolf Steiner wrote in 1919: "Religion is a man's private affair" expresses what is a right perception, but in a one-sided way. In a healthy society, all spiritual life must in this sense be a private affair as far as the state and economic life are concerned."
The repeated phrases, "spiritual life" and "cultural/spiritual", are used very broadly throughout this essay to describe not so much a condition as an activity. Such activity within the social organism is directed to the development of all human capacities, and not primarily to the yielding-up of articles of commerce per se. Such activity most obviously includes religion, but also art, education, science and medicine.
In matters of conscience and destiny, the state can have no voice. It is the single individual who must find his/her own way in those concerns that involve them most intimately. And it is these same individuals who, out of those concerns, may then find their own way back to one another, not as something prescribed by law, but freely. Here freedom implies not license (sic) but thought activated will.
"Sometimes it is said that man cannot be trusted with the government of himself. Can he, then, be trusted with the government of others? Or have we found angels in the form of kings to govern him?"
Thomas Jefferson
1) THINKING: It is claimed of medicine that it is both an art and a science. Yet, what art is similarly licensed?-poetry? painting? What other scientists carries a license?-biologists? physicists? Any profession that becomes so burdened by state licensing must thus give up its claim to both art and science. It becomes what is required of it by the state though the circuitous route of statutory law. It becomes, in legal parlance, 'standard medical practice'.
Every state has its own licensing protocol, although fundamentally they hardly differ. The State of New York is rather typical and may therefore be used to illustrate the whole conceptual fabric of licensing statutes:
Education Law 6512 defines the practice of the profession of medicine as "diagnosing, treating, operating or prescribing for any human disease, pain, injury, deformity or physical condition." As far as it goes, this may be an accurate description of the 'what' of medicine, especially if mental, emotional and biographical aspects are ignored. The 'how' is then defined by "licensure" in Ed. Law 6522, and this is subsequently determined in Ed. Law 6523 by a state board of medicine, appointed by the board of regents on recommendation by the commissioner. Although 6522-"only a person licensed...shall use the title 'physician'"-already begs the issue, with 6523 we encounter the first major riddle. It reads: "the board shall be composed of twenty licensed physicians, two of whom shall by osteopaths." Well, if two members of the board are osteopathic physicians, what kind of physicians are the other eighteen? It simply reads: "licensed physicians". Obviously, they are not osteopaths, but what kind of non-osteopathic physician is not determined here.
The 'who' of eligibility for licensure is determined by Ed. Law 6524. To qualify as a physician in New York State, an applicant must fulfill certain requirements, the main being the attainment of a degree of doctor (MD) from a school that has degree-conferring powers by special charter from the state legislature. Until the 20's and 30's, there were three different kinds of medical schools in New York State: allopathic, homeopathic and eclectic. Today, there is only one: allopathic. And this by special charter through the state legislature. Every medical school thus becomes, at least in spirit, a state school for this reason. With Ed. Law 6524, we have come full circle, but with an added little twist or, as we shall see, knot of irony.
A law in the form of a general concept is always meant prohibitively. Such a law is 6512 above. While obviously not written in the negative-"thou shalt not"-it certainly has been consistently interpreted that way. Such laws are called proscriptive laws. While it may appear to define the practice of medicine rather open-endedly, what we find in fact is a medicine of a decidedly narrower scope, thanks to licensure laws 6522, 6523 and 6524 combined: The practice of medicine is to be limited to the licensed allopath only. Within the real world of human suffering, the State has designed the allopath like unto itself: omniscient. That is: to be all things to all people. This absurdity is the result of two things being attempted at once: a proscriptive and a prescriptive law taken together.
Again, laws must be general if they are meant to prohibit behavior. "Thou shall not kill" is such a broadly stated law. "Thou shall not kill with a knife" is rather specific. While the first is all inclusive, the second, representing a particular instance, allows for a greater liberty; in this case, to the would-be assassin. New York State Education Law has done something similar. By limiting the practice of medicine to the licensed allopath, the consumer has been put at a greater risk-the very opposite of the law's supposed intention. In New York State, allopathic medicine has become the defining modality. This has had dire social consequences. Mentioned earlier were the escalating costs and the routine nature of many treatments (i.e. cancer). But nowhere is the calamitous effects of licensing laws more apparent than in the issues now surrounding the so-called 'right to die' movement. Here, again, a single licensed modality is dictating the direction of the entire debate. It would seem that humanity may be betrayed as much by what licensing laws allow as by what they disallow.
The cadence of law is often marked by a judge's gavel. The People vs Reuben Amber, 1973, is a case in point. Although Reuben Amber was an acupuncturist, and acupuncture was not taught in state-chartered medical schools, the court found that the law was not to be limited to "Western, allopathic medicine". This is interesting: while medicine is to be regarded as potentially limitless, the actual practitioner (MD)-that is, those who may practice medicine as defined by previous law-is to be limited to just that: "Western allopathy." The court went further, maintaining that the law was to be "broad enough to include the gamut of those who know, whether or not recognized, and even those not yet conjured." (A strange word, conjured, to be used when speaking of medicine.) The law is clearly defined here to include the element of time within its scope; all possible ideas, past and future, whether divergent or still yet unformed, are to be contained within its compass. Indeed, a fairly egregious compass. It would appear that the State of New York has assumed a power to restrain thought, and this in an area that purports to be a science. It is the fact that you think, not what you think, that is actually being regulated by such laws. The thought content is either very strictly confined by law or else filtered through the sieve of allopathic training in order to qualify as a legitimate medical idea. These kinds of law, so paradoxical in intention, are intellectually abhorrent; by offering what they cannot give, by prohibiting what they would seem to proffer, they stupefy the mind. All those engaged in the care and healing of the sick must sometimes feel acutely, if not chronically burdened by such laws.
"A license...is a personal privilege to be exercised under restrictions which exist at the time license is granted and such as may thereafter by reasonably imposed." The State has claimed that nobody has a "vested right" to practice medicine. To attempt to heal the sick and disabled, to offer to succor pain and suffering is not to be construed in any way as a human right; it only seems so. It is a privilege granted, on a provisional basis, by the State of New York. But the concept of privilege is ultimately at odds with the real unfoldment of compassion and empathy. Privilege always divides, excludes and isolates. Perhaps the alienation so often felt in the modern clinical situation may not be the result of a sterile technique alone, but may lay much deeper, like some primal fault in the bedrock of fellow-feeling; that which would be whole is splintered by privilege. This is an observation I don't expect the privileged to immediately understand; it takes a sense for the social that privilege abjures. Privilege harms no one more than the privileged themselves.
How are all these statutes defended? The usual argument is an appeal to the, by now, infamous "public welfare" clause. Besides prolonged epidemics, sanitation concerns and environmental pollution, in what sense ever is the treatment of human illness to be considered part of the public welfare? Certainly we all wish the ill to become well, but this cannot become public policy for the simple reason that illness, like death, is a private affair. Secretly, we might want others to join us, but sickness really sets us apart from others, separates us from what is most public, entirely privatizes us. As to the possibility that the unscrupulous may then prey upon this vulnerability, licensing laws offer no real protection. Witness the incredible caseload of medical litigation in today's courts. A license does not protect from malpractice, does not secure from slovenly or inattentive care, does not insure against incompetence. A court does. This is just the point: consumers are already protected by tort law from injury and abuse of whatever kind, including medical. Licensing laws encourage a kind of institutionalized fraud. This is implicit in all of the above. The problem, however, is that because of these same laws, consumers do not have as ready access to the courts as they do with outright abuse.
The state has always maintained that a society of individuals is incapable of self-regulation. The usual rant is that people are generally too gullible, naive, complacent and self-deluded to be trusted to their own judgement in matters as intimate as health and disease. In order to save us from the terrible burden of independent thought, the state has become a kind of pater familias-like some giant Kronos devouring his own, absorbing by degrees both body and mind. Ordinary citizens (excepting legislators!) are obviously capable of the most divergent behavior, of the most vile thoughts; whether ignorant or malicious, we must be protected from ourselves. The state has always held this position in respect to individuality. It is the opinion of a cynic; indeed, of a misanthropist.
There are those who claim that the practice of medicine must always be subsumed within the general rubric of science; that the consumer must somehow be guaranteed the scientific training of today's practitioner; as if science itself were an end and not a means; as if science were not a heterodoxy. What is usually meant by science in this context, though, is the exact and detailed knowledge of anatomy and physiology as it has developed especially in the West in the last two or three hundred years. However, it must be said that this knowledge is not limited to allopathic medicine, but is available to anyone who would take the trouble to learn it. A part of medicine no doubt is this knowledge; the better part, though, is in the doing. Some, for instance, may extend this knowledge anthroposophically, while still others would entirely sublimate it homeopathically. Medicine, therefore, is an art and a science inextricably bound in the practitioner's judgement. Those who say that medicine is a science only have never yet observed a living human being.
The term 'physician' implies a knowledge of 'physis' or nature. Only a philistine would automatically couple this knowledge with licensure. The state has turned medical sapiens into medical fungens.
2) FEELING: Licensure is contrary to the egalitarian nature of modern Western society. It is actually antithetical to democracy itself. A doctor endorsed by government exhibits all the markings of an advantaged class. How can a state which grants privileges to selected individuals still claim to represent equity interests? Today, with few exceptions, it is generally allopathic medicine that claims the prerogative of dictating the who, how, why, and when of medicine. Largely because of licensing laws. But this situation is not immutable, and has been called into question before. In order to grasp the full significance of a legalized privilege, it may be instructive to take a brief look at the history of medical licensing laws in this country. 3
During the period from 1827 to 1830, there was a countrywide effort, both within homeopathic and allopathic medicine, to establish state medical societies. Licensure developed in tandem to this effort. As homeopathy had yet to receive universal condemnation, in 1830 the Medical Society of the County of New York conferred an honorary membership on Dr. Samuel Hahnemann, only to quickly rescind this membership as homeopathy became more popular. By 1841, however, a general anti-monopolistic movement, fired by the Jacksonian Democrats, began to sweep through this country, and by 1844, licensure was repealed in New York State, and by 1849, all licensing laws in almost every State of the Union had been repealed. The main point was constitutional: whether the legislature had the right to give to any profession a monopoly on medical care. A healthy instinct was in operation here: "For the common man, it was a triumph of democracy." (Kaufman)
During the remainder of the 19th Century, homeopathic and allopathic practitioners battled each other vociferously for public recognition, for state funding of their schools, for medical commissions in the military and for the right to be allowed to treat in municipal hospitals. During this same period, state medical societies, and the newer national organizations, the American Institute of Homeopathy and the American Medical Association, functioned as quasi-licensing boards, interfacing unceremoniously with the state. The allopathic AMA was the dominant force, often effectively censoring the so-called 'irregular physician' by way of the infamous consultation clause of their Code of Ethics. Sectarianism, homeopathy and quackery were often uttered in one breath. But the homeopaths were no better, accusing the ordinary allopath of barbarism, incompetence and downright treachery. The uncompromising zealotry of both actually left the public less confused than mocking.
Towards the end of the century, something very strange and ironic occurred . The allopaths and the homeopaths began to close rank and to petition the state legislatures to re-enact restrictive statutes out of concern for the rapid development and growing popularity of the upstart chiropractors, osteopaths and Christian Scientists. 4 Just as they had attempted to do to each other previously, "allopathy and homeopathy were forced to unite behind legislation which would guarantee their own existence, but would eliminate the minor sects." (Kaufman) Power, fear and privilege make for strange bedfellows!
The rest is part of the public record. The State of New York established three licensing boards in 1891: allopathic, homeopathic and eclectic. By 1917, these three boards had become one: an allopathic medical board. The practice of medicine had become more restrictive and centralized. Later, the beleaguered homeopaths would try to persuade the AMA that homeopathy was really a sub-specialty of medicine, "homeotherapeutics", and that all the animosity of before had only been the result of a misguided fanaticism. Thus, the pathos of the outmaneuvered loser....
It could, perhaps, have gone the other way. (It could not, but for argument's sake, one could imagine it so.) The tides of fortune could have flowed differently, and homeopathy could have become the medical majority, the prevailing sect, able to then subjugate, politically and economically. All those it perceived as dissenters or equivocators of Similitude. One should not be naive or hypocritical about this: homeopaths would likely have been as ruthless, suppressive and intolerant to its opponents as any group latched legally to the state. To think otherwise is disingenuous. There is the old adage, as true in medicine as anywhere, about the nature of power and corruption.
Politics is all too often characterized as a mad scramble for privilege. One should consider carefully the social consequence of the present system of state-mandated medicine. This is not to deny the emotional aspect of medicine, and the fact that the sick want and deserve confidence in their physician, but the present system is not the only, nor, in the sense of equity issues, the best system to assure such confidence. Ultimately, licensure precludes such confidence as "real trust can only develop outside any authority, governmental or economic" (Steiner).
3) WILLING: The present exclusive fixation on allopathic medicine is reminiscent of the situation in Europe before the Renaissance and Reformation in the realm of religion. 5 It was then that the state felt it had a proprietary interest in the spiritual welfare of its citizenry, and religion was prescribed by law. Any deviation was punishable by death. Analogous to the arguments for medical licensing today, the ordinary citizen was obviously incapable of treading the thorny path to God alone without the solicitous, if despotic hand of the Church working in close, if not virtual union with the state. 6 From birth to death, the Church/state ordained all aspects of social intercourse, for how could the common sinner ever expect to fathom the mysteries of God's ways on earth? It was the Church/state that had been appointed by God as the final arbiter of conscience. (The parallel between the perilous labyrinth of medieval theology and the arcane world of today's medicine should not be lost on the reader.)
Now, almost 500 years later, what the individual does in the realm of religion-in however unorthodox a manner they may seek the spirit-is of no concern to the state: a complete separation has occurred. After centuries of bloody agitation, the state has conceded to the individual the right, if not the capacity of spiritual judgement. The terrible conflicts that have surrounded statemandated religion in the past (and the debate that will soon overtake education as well) must now spread to other areas of cultural life; specifically, to the care and treatment of disease, to medicine.
This is an exact analogy: Allopathic medicine is today's Church. The one caveat, though, is that instead of death, the power of the economic sword now hangs over anyone who would challenge the present unholy conjunction of medicine with the state. Is it not really still the soul that hangs now in a kind of medical balance? As it ordinarily takes longer to become an ordained priest than it does to become a state licensed physician, where are the social safeguards? To claim, for instance, that a state licensed allopath is now fully qualified to practice homeopathy as well is equivalent to a fraud. It would have been as rational to have claimed that a twelfth-century ecclesiastic was then fully competent to represent Hinduism!
It is said that the whole person is a being of body, soul and spirit. Well, as noted, the state can no longer dictate religious belief; we are free to find our own path to the spirit. And at the level of the soul, most states require little or no licensing for the practice of psychotherapy, or soulcare. But as to the physical body-there are laws pertaining to every centimeter of one's corporeality! Compared to one's immortal soul, and to the prospect of eternal damnation, why would anyone think it was important to the state what therapy or therapist one chose? This witless irony of history highlights with a kind of poignancy the dualism of materialistic thought: While in the past it was one's spiritual life that was circumscribed by law, today it is merely the body!
Rudolf Steiner wrote in 1919: "Religion is a man's private affair" expresses what is a right perception, but in a one-sided way. In a healthy society, all spiritual life must in this sense be a private affair as far as the state and economic life are concerned."
The repeated phrases, "spiritual life" and "cultural/spiritual", are used very broadly throughout this essay to describe not so much a condition as an activity. Such activity within the social organism is directed to the development of all human capacities, and not primarily to the yielding-up of articles of commerce per se. Such activity most obviously includes religion, but also art, education, science and medicine.
In matters of conscience and destiny, the state can have no voice. It is the single individual who must find his/her own way in those concerns that involve them most intimately. And it is these same individuals who, out of those concerns, may then find their own way back to one another, not as something prescribed by law, but freely. Here freedom implies not license (sic) but thought activated will.
"Sometimes it is said that man cannot be trusted with the government of himself. Can he, then, be trusted with the government of others? Or have we found angels in the form of kings to govern him?"
Thomas Jefferson
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