Given moral choices, doctors today can’t be bystanders, says Don Berwick

Today’s doctors face moral choices all the time, including those that challenge their personal honesty, the organizations they work for and the society they live in, says Donald M. Berwick, M.D.

As times have changed, the stakes are higher and doctors can no longer be bystanders and avoid the political fray by being silent, writes Berwick, president emeritus and senior fellow of the Institute for Healthcare Improvement in Cambridge, Massachusetts, in an opinion piece published in JAMA.

“The work of a physician as healer cannot stop at the door of an office, the threshold of an operating room or the front gate of a hospital. The rescue of a society and the restoration of a political ethos that remembers to heal have become the physician’s jobs, too. Professional silence in the face of social injustice is wrong,” says Berwick, a former administrator of the Centers for Medicare & Medicaid Services.

The role of bystander is no longer a choice, he says. Silence has become political, according to Berwick, and physicians can either engage in the discussion or assist the harm that is taking place in society. There is no third choice, he writes.