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The Four Pillars of Medical Ethics Were Destroyed in the Covid Response

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Much like a Bill of Rights, a principal function of any Code of Ethics is to set limits, to check the inevitable lust for power, the libido dominandi, that human beings tend to demonstrate when they obtain authority and status over others, regardless of the context.

Though it may be difficult to believe in the aftermath of COVID, the medical profession does possess a Code of Ethics. The four fundamental concepts of Medical Ethics – its 4 Pillars – are Autonomy, Beneficence, Non-maleficence, and Justice.

Autonomy, Beneficence, Non-maleficence, and Justice

These ethical concepts are thoroughly established in the profession of medicine. I learned them as a medical student, much as a young Catholic learns the Apostle’s Creed. As a medical professor, I taught them to my students, and I made sure my students knew them. I believed then (and still do) that physicians must know the ethical tenets of their profession, because if they do not know them, they cannot follow them.

These ethical concepts are indeed well-established, but they are more than that. They are also valid, legitimate, and sound. They are based on historical lessons, learned the hard way from past abuses foisted upon unsuspecting and defenseless patients by governments, health care systems, corporations, and doctors. Those painful, shameful lessons arose not only from the actions of rogue states like Nazi Germany, but also from our own United States: witness Project MK-Ultra and the Tuskegee Syphilis Experiment.

The 4 Pillars of Medical Ethics protect patients from abuse. They also allow physicians the moral framework to follow their consciences and exercise their individual judgment – provided, of course, that physicians possess the character to do so. However, like human decency itself, the 4 Pillars were completely disregarded by those in authority during COVID.

The demolition of these core principles was deliberate. It originated at the highest levels of COVID policymaking, which itself had been effectively converted from a public health initiative to a national security/military operation in the United States in March 2020, producing the concomitant shift in ethical standards one would expect from such a change. As we examine the machinations leading to the demise of each of the 4 Pillars of Medical Ethics during COVID, we will define each of these four fundamental tenets, and then discuss how each was abused.

Autonomy

Of the 4 Pillars of Medical Ethics, autonomy has historically held pride of place, in large part because respect for the individual patient’s autonomy is a necessary component of the other three. Autonomy was the most systemically abused and disregarded of the 4 Pillars during the COVID era.

Autonomy may be defined as the patient’s right to self-determination with regard to any and all medical treatment. This ethical principle was clearly stated by Justice Benjamin Cardozo as far back as 1914: “Every human being of adult years and sound mind has a right to determine what shall be done with his own body.”

Patient autonomy is “My body, my choice” in its purest form. To be applicable and enforceable in medical practice, it contains several key derivative principles which are quite commonsensical in nature. These include informed consent, confidentiality, truth-telling, and protection against coercion

Genuine informed consent is a process, considerably more involved than merely signing a permission form. Informed consent requires a competent patient, who receives full disclosure about a proposed treatment, understands it, and voluntarily consents to it.

Based on that definition, it becomes immediately obvious to anyone who lived in the United States through the COVID era, that the informed consent process was systematically violated by the COVID response in general, and by the COVID vaccine programs in particular. In fact, every one of the components of genuine informed consent were thrown out when it came to the COVID vaccines:

  • Full disclosure about the COVID vaccines – which were extremely new, experimental therapies, using novel technologies, with alarming safety signals from the very start – was systematically denied to the public. Full disclosure was actively suppressed by bogus anti-“misinformation” campaigns, and replaced with simplistic, false mantras (e.g. “safe and effective”) that were in fact just textbook propaganda slogans.
  • Blatant coercion (e.g. “Take the shot or you’re fired/can’t attend college/can’t travel”) was ubiquitous and replaced voluntary consent.
  • Subtler forms of coercion (ranging from cash payments to free beer) were given in exchange for COVID-19 vaccination. Multiple US states held lotteries for COVID-19 vaccine recipients, with up to $5 million in prize money promised in some states.
  • Many physicians were presented with financial incentives to vaccinate, sometimes reaching hundreds of dollars per patient. These were combined with career-threatening penalties for questioning the official policies. This corruption severely undermined the informed consent process in doctor-patient interactions.
  • Incompetent patients (e.g. countless institutionalized patients) were injected en masse, often while forcibly isolated from their designated decision-making family members.

It must be emphasized that under the tendentious, punitive, and coercive conditions of the COVID vaccine campaigns, especially during the “pandemic of the unvaccinated” period, it was virtually impossible for patients to obtain genuine informed consent. This was true for all the above reasons, but most importantly because full disclosure was nearly impossible to obtain. 

A small minority of individuals did manage, mostly through their own research, to obtain sufficient information about the COVID-19 vaccines to make a truly informed decision. Ironically, these were principally dissenting healthcare personnel and their families, who, by virtue of discovering the truth, knew “too much.” This group overwhelmingly refused the mRNA vaccines.

Confidentiality, another key derivative principle of autonomy, was thoroughly ignored during the COVID era. The widespread yet chaotic use of COVID vaccine status as a de facto social credit system, determining one’s right of entry into public spaces, restaurants and bars, sporting and entertainment events, and other locations, was unprecedented in our civilization. 

Gone were the days when HIPAA laws were taken seriously, where one’s health history was one’s own business, and where the cavalier use of such information broke Federal law. Suddenly, by extralegal public decree, the individual’s health history was public knowledge, to the absurd extent that any security guard or saloon bouncer had the right to question individuals about their personal health status, all on the vague, spurious, and ultimately false grounds that such invasions of privacy promoted “public health.”

Truth-telling was completely dispensed with during the COVID era. Official lies were handed down by decree from high-ranking officials such as Anthony Fauci, public health organizations like the CDC, and industry sources, then parroted by regional authorities and local clinical physicians. The lies were legion, and none of them have aged well. Examples include: 

  • The SARS-CoV-2 virus originated in a wet market, not in a lab
  • “Two weeks to flatten the curve”
  • Six feet of “social distancing” effectively prevents transmission of the virus
  • “A pandemic of the unvaccinated”
  • “Safe and effective”
  • Masks effectively prevent transmission of the virus 
  • Children are at serious risk from COVID
  • School closures are necessary to prevent spread of the virus
  • mRNA vaccines prevent contraction of the virus
  • mRNA vaccines prevent transmission of the virus
  • mRNA vaccine-induced immunity is superior to natural immunity
  • Myocarditis is more common from COVID-19 disease than from mRNA vaccination

It must be emphasized that health authorities pushed deliberate lies, known to be lies at the time by those telling them. Throughout the COVID era, a small but very insistent group of dissenters have constantly presented the authorities with data-driven counterarguments against these lies. The dissenters were consistently met with ruthless treatment of the “quick and devastating takedown” variety now infamously promoted by Fauci and former NIH Director Francis Collins. 

Over time, many of the official lies about COVID have been so thoroughly discredited that they are now indefensible. In response, the COVID power brokers, backpedaling furiously, now try to recast their deliberate lies as fog-of-war style mistakes. To gaslight the public, they claim they had no way of knowing they were spouting falsehoods, and that the facts have only now come to light. These, of course, are the same people who ruthlessly suppressed the voices of scientific dissent that presented sound interpretations of the situation in real time.

For example, on March 29, 2021, during the initial campaign for universal COVID vaccination, CDC Director Rochelle Walensky proclaimed on MSNBC that “vaccinated people do not carry the virus” or “get sick,” based on both clinical trials and “real-world data.” However, testifying before Congress on April 19, 2023, Walensky conceded that those claims are now known to be false, but that this was due to “an evolution of the science.” Walensky had the effrontery to claim this before Congress 2 years after the fact, when in actuality, the CDC itself had quietly issued a correction of Walensky’s false MSNBC claims back in 2021, a mere 3 days after she had made them.

On May 5, 2023, three weeks after her mendacious testimony to Congress, Walensky announced her resignation.

Truth-telling by physicians is a key component of the informed consent process, and informed consent, in turn, is a key component of patient autonomy. A matrix of deliberate lies, created by authorities at the very top of the COVID medical hierarchy, was projected down the chains of command, and ultimately repeated by individual physicians in their face-to-face interactions with their patients. This process rendered patient autonomy effectively null and void during the COVID era.

Patient autonomy in general, and informed consent in particular, are both impossible where coercion is present. Protection against coercion is a principal feature of the informed consent process, and it is a primary consideration in medical research ethics. This is why so-called vulnerable populations such as children, prisoners, and the institutionalized are often afforded extra protections when proposed medical research studies are subjected to institutional review boards.

Coercion not only ran rampant during the COVID era, it was deliberately perpetrated on an industrial scale by governments, the pharmaceutical industry, and the medical establishment. Thousands of American healthcare workers, many of whom had served on the front lines of care during the early days of the pandemic in 2020 (and had already contracted COVID-19 and developed natural immunity) were fired from their jobs in 2021 and 2022 after refusing mRNA vaccines they knew they didn’t need, would not consent to, and yet for which they were denied exemptions. “Take this shot or you’re fired” is coercion of the highest order.

Hundreds of thousands of American college students were required to get the COVID shots and boosters to attend school during the COVID era. These adolescents, like young children, have statistically near-zero chance of death from COVID-19. However, they (especially males) are at statistically highest risk of COVID-19 mRNA vaccine-related myocarditis.

According to the advocacy group nocollegemendates.com, as of May 2, 2023, approximately 325 private and public colleges and universities in the United States still have active vaccine mandates for students matriculating in the fall of 2023. This is true despite the fact that it is now universally accepted that the mRNA vaccines do not stop contraction or transmission of the virus. They have zero public health utility. “Take this shot or you cannot go to school” is coercion of the highest order.

Countless other examples of coercion abound. The travails of the great tennis champion Novak Djokovic, who has been denied entry into both Australia and the United States for multiple Grand Slam tournaments because he refuses the COVID vaccines, illustrate in broad relief the “man without a country” limbo in which the unvaccinated found (and to some extent still find) themselves, due to the rampant coercion of the COVID era.

Beneficence

In medical ethics, beneficence means that physicians are obligated to act for the benefit of their patients. This concept distinguishes itself from non-maleficence (see below) in that it is a positive requirement. Put simply, all treatments done to an individual patient should do good to that individual patient. If a procedure cannot help you, then it shouldn’t be done to you. In ethical medical practice, there is no “taking one for the team.”

By mid-2020 at the latest, it was clear from existing data that SARS-CoV-2 posed truly minimal risk to children of serious injury and death – in fact, the pediatric Infection Fatality Rate of COVID-19 was known in 2020 to be less than half the risk of being struck by lightning. This feature of the disease, known even in its initial and most virulent stages, was a tremendous stroke of pathophysiological good luck, and should have been used to the great advantage of society in general and children in particular. 

The opposite occurred. The fact that SARS-CoV-2 causes extremely mild illness in children was systematically hidden or scandalously downplayed by authorities, and subsequent policy went unchallenged by nearly all physicians, to the tremendous detriment of children worldwide.

The frenzied push for and unrestrained use of mRNA vaccines in children and pregnant women – which continues at the time of this writing in the United States – outrageously violates the principle of beneficence. And beyond the Anthony Faucis, Albert Bourlas, and Rochelle Walenskys, thousands of ethically compromised pediatricians bear responsibility for this atrocity.

The mRNA COVID vaccines were – and remain – new, experimental vaccines with zero long-term safety data for either the specific antigen they present (the spike protein) or their novel functional platform (mRNA vaccine technology). Very early on, they were known to be ineffective in stopping contraction or transmission of the virus, rendering them useless as a public health measure. Despite this, the public was barraged with bogus “herd immunity” arguments. Furthermore, these injections displayed alarming safety signals, even during their tiny, methodologically challenged initial clinical trials. 

The principle of beneficence was entirely and deliberately ignored when these products were administered willy-nilly to children as young as 6 months, a population to whom they could provide zero benefit – and as it turned out, that they would harm. This represented a classic case of “taking one for the team,” an abusive notion that was repeatedly invoked against children during the COVID era, and one that has no place in the ethical practice of medicine.

Children were the population group that was most obviously and egregiously harmed by the abandonment of the principle of beneficence during COVID. However, similar harms occurred due to the senseless push for COVID mRNA vaccination of other groups, such as pregnant women and persons with natural immunity.

Non-Maleficence

Even if, for argument’s sake alone, one makes the preposterous assumption that all COVID-era public health measures were implemented with good intentions, the principle of non-maleficence was nevertheless broadly ignored during the pandemic. With the growing body of knowledge of the actual motivations behind so many aspects of COVID-era health policy, it becomes clear that non-maleficence was very often replaced with outright malevolence.

In medical ethics, the principle of non-maleficence is closely tied to the universally cited medical dictum of primum non nocere, or, “First, do no harm.” That phrase is in turn associated with a statement from Hippocrates’ Epidemics, which states, “As to diseases make a habit of two things – to help, or at least, to do no harm.” This quote illustrates the close, bookend-like relationship between the concepts of beneficence (“to help”) and non-maleficence (“to do no harm”).

In simple terms, non-maleficence means that if a medical intervention is likely to harm you, then it shouldn’t be done to you. If the risk/benefit ratio is unfavorable to you (i.e., it is more likely to hurt you then help you), then it shouldn’t be done to you. Pediatric COVID mRNA vaccine programs are just one prominent aspect of COVID-era health policy that absolutely violate the principle of non-maleficence.

It has been argued that historical mass-vaccination programs may have violated non-maleficence to some extent, as rare severe and even deadly vaccine reactions did occur in those programs. This argument has been forwarded to defend the methods used to promote the COVID mRNA vaccines. However, important distinctions between past vaccine programs and the COVID mRNA vaccine program must be made. 

First, past vaccine-targeted diseases such as polio and smallpox were deadly to children – unlike COVID-19. Second, such past vaccines were effective in both preventing contraction of the disease in individuals and in achieving eradication of the disease – unlike COVID-19. Third, serious vaccine reactions were truly rare with those older, more conventional vaccines – again, unlike COVID-19. 

Thus, many past pediatric vaccine programs had the potential to meaningfully benefit their individual recipients. In other words, the a priori risk/benefit ratio may have been favorable, even in tragic cases that resulted in vaccine-related deaths. This was never even arguably true with the COVID-19 mRNA vaccines.

Such distinctions possess some subtlety, but they are not so arcane that the physicians dictating COVID policy did not know they were abandoning basic medical ethics standards such as non-maleficence. Indeed, high-ranking medical authorities had ethical consultants readily available to them – witness that Anthony Fauci’s wife, a former nurse named Christine Grady, served as chief of the Department of Bioethics at the National Institutes of Health Clinical Center, a fact that Fauci flaunted for public relations purposes.

Indeed, much of COVID-19 policy appears to have been driven not just by rejection of non-maleficence, but by outright malevolence. Compromised “in-house” ethicists frequently served as apologists for obviously harmful and ethically bankrupt policies, rather than as checks and balances against ethical abuses.

Schools never should have been closed in early 2020, and they absolutely should have been fully open without restrictions by fall of 2020. Lockdowns of society never should have been instituted, much less extended as long as they were. Sufficient data existed in real time such that both prominent epidemiologists (e.g. the authors of the Great Barrington Declaration) and select individual clinical physicians produced data-driven documents publicly proclaiming against lockdowns and school closures by mid-to-late 2020. These were either aggressively suppressed or completely ignored.

Numerous governments imposed prolonged, punishing lockdowns that were without historical precedent, legitimate epidemiological justification, or legal due process. Curiously, many of the worst offenders hailed from the so-called liberal democracies of the Anglosphere, such as New Zealand, Australia, Canada, and deep blue parts of the United States. Public schools In the United States were closed an average of 70 weeks during COVID. This was far longer than most European Union countries, and longer still than Scandinavian countries who, in some cases, never closed schools.

The punitive attitude displayed by health authorities was broadly supported by the medical establishment. The simplistic argument developed that because there was a “pandemic,” civil rights could be decreed null and void – or, more accurately, subjected to the whims of public health authorities, no matter how nonsensical those whims may have been. Innumerable cases of sadistic lunacy ensued.

At one point at the height of the pandemic, in this author’s locale of Monroe County, New York, an idiotic Health Official decreed that one side of a busy commercial street could be open for business, while the opposite side was closed, because the center of the street divided two townships. One town was code “yellow,” the other code “red” for new COVID-19 cases, and thus businesses mere yards from one another survived or faced ruin. Except, of course, the liquor stores, which, being “essential,” never closed at all. How many thousands of times was such asinine and arbitrary abuse of power duplicated elsewhere? The world will never know.

Who can forget being forced to wear a mask when walking to and from a restaurant table, then being permitted to remove it once seated? The humorous memes that “you can only catch COVID when standing up” aside, such pseudo-scientific idiocy smacks of totalitarianism rather than public health. It closely mimics the deliberate humiliation of citizens through enforced compliance with patently stupid rules that was such a legendary feature of life in the old Eastern Bloc.

And I write as an American who, while I lived in a deep blue state during COVID, never suffered in the concentration camps for COVID-positive individuals that were established in Australia.

Those who submit to oppression resent no one, not even their oppressors, so much as the braver souls who refuse to surrender. The mere presence of dissenters is a stone in the quisling’s shoe – a constant, niggling reminder to the coward of his moral and ethical inadequacy. Human beings, especially those lacking personal integrity, cannot tolerate much cognitive dissonance. And so they turn on those of higher character than themselves.

This explains much of the sadistic streak that so many establishment-obeying physicians and health administrators displayed during COVID. The medical establishment – hospital systems, medical schools, and the doctors employed therein – devolved into a medical Vichy state under the control of the governmental/industrial/public health juggernaut. 

These mid- and low-level collaborators actively sought to ruin dissenters’ careers with bogus investigations, character assassination, and abuse of licensing and certification board authority. They fired the vaccine refuseniks within their ranks out of spite, self-destructively decimating their own workforces in the process. Most perversely, they denied early, potential life-saving treatment to all their COVID patients. Later, they withheld standard therapies for non-COVID illnesses – up to and including organ transplants – to patients who declined COVID vaccines, all for no legitimate medical reason whatsoever.

This sadistic streak that the medical profession displayed during COVID is reminiscent of the dramatic abuses of Nazi Germany. However, it more closely resembles (and in many ways is an extension of) the subtler yet still malignant approach followed for decades by the United States Government’s medical/industrial/public health/national security nexus, as personified by individuals like Anthony Fauci. And it is still going strong in the wake of COVID.

Ultimately, abandonment of the tenet of non-maleficence is inadequate to describe much of the COVID-era behavior of the medical establishment and those who remained obedient to it. Genuine malevolence was very often the order of the day.

Justice

In medical ethics, the Pillar of justice refers to the fair and equitable treatment of individuals. As resources are often limited in health care, the focus is typically on distributive justice; that is, the fair and equitable allocation of medical resources. Conversely, it is also important to ensure that the burdens of health care are as fairly distributed as possible.

In a just situation, the wealthy and powerful should not have instant access to high-quality care and medicines that are unavailable to the rank and file or the very poor. Conversely, the poor and vulnerable should not unduly bear the burdens of health care, for example, by being disproportionately subjected to experimental research, or by being forced to follow health restrictions to which others are exempt.

Both of these aspects of justice were disregarded during COVID as well. In numerous instances, persons in positions of authority procured preferential treatment for themselves or their family members. Two prominent examples:

According to ABC News, “in the early days of the pandemic, New York Governor Andrew Cuomo prioritized COVID-19 testing for relatives including his brother, mother and at least one of his sisters, when testing wasn’t widely available to the public.” Reportedly, “Cuomo allegedly also gave politicians, celebrities and media personalities access to tests.”

In March 2020, Pennsylvania Health Secretary Rachel Levine directed nursing homes to accept COVID-positive patients, despite warnings against this by trade groups. That directive and others like it subsequently cost tens of thousands of lives. Less than two months later, Levine confirmed that her own 95 year-old mother had been removed from a nursing home to private care. Levine was subsequently promoted to 4-star Admiral in the US Public Health Service by the Biden Administration.

The burdens of lockdowns were distributed extremely unjustly during COVID. While average citizens remained in lockdown, suffering personal isolation, forbidden to earn a living, the powerful flouted their own rules. Who can forget how US House Speaker Nancy Pelosi broke the strict California lockdowns to get her hair styled, or how British Prime Minister Boris Johnson defied his own supposedly life-or-death orders by throwing at least a dozen parties at 10 Downing Street in 2020 alone? House arrest for thee, wine and cheese for me.

But California Governor Gavin Newsom might take the cake. At first glance, given both his BoJo-esque, lockdown-defying dinner with lobbyists at the ultra-swanky Napa Valley restaurant The French Laundry, and his decision to send his own children to expensive private schools which were fully open for 5-day in-school learning during the prolonged California school closures, one might think of Newsom as a COVID-era Robin Hood. That is, until one realizes that he presided over those same punishing, inhumane lockdowns and school closures. He was actually the Sheriff of Nottingham.

To a decent person with a functioning conscience, this level of sociopathy is difficult to comprehend. What is crystal clear is that anyone capable of the hypocrisy that Gavin Newsom displayed during COVID should not be anywhere near a position of power in any society. 

Two additional points should be emphasized. First, these egregious acts were rarely, if ever, called out by the medical establishment. Second, the behaviors themselves show that those in power never truly believed their own narrative. Both the medical establishment and the power brokers knew the danger posed by the virus, while real, was grossly overstated. They knew the lockdowns, social distancing, and masking of the population at large were kabuki theater at best, and soft-core totalitarianism at worst. The lockdowns were based on a gigantic lie, one they neither believed nor felt compelled to follow themselves.

Solutions and Reform

The abandonment of the 4 Pillars of Medical Ethics during COVID has contributed greatly to an historic erosion of public trust in the healthcare industry. This distrust is entirely understandable and richly deserved, however harmful it may prove to be for patients. For example, at a population level, trust in vaccines in general has dramatically reduced worldwide, compared to the pre-COVID era. Millions of children now stand at increased risk from proven vaccine-preventable diseases due to the thoroughly unethical push for unnecessary, indeed harmful, universal COVID-19 mRNA vaccination of children.  

Systemically, the medical profession desperately needs ethical reform in the wake of COVID. Ideally, this would begin with a strong reassertion of and recommitment to the 4 Pillars of Medical Ethics, again with patient autonomy at the forefront. It would continue with prosecution and punishment of those individuals most responsible for the ethical failures, from the likes of Anthony Fauci on down. Human nature is such that if no sufficient deterrent to evil is established, evil will be perpetuated.

Unfortunately, within the medical establishment, there does not appear to be any impetus toward acknowledgement of the profession’s ethical failures during COVID, much less toward true reform. This is largely because the same financial, administrative, and regulatory forces that drove COVID-era failures remain in control of the profession. These forces deliberately ignore the catastrophic harms of COVID policy, instead viewing the era as a sort of test run for a future of highly profitable, tightly regulated health care. They view the entire COVID-era martial-law-as-public-health approach as a prototype, rather than a failed model.

Reform of medicine, if it happens, will likely arise from individuals who refuse to participate in the “Big Medicine” vision of health care. In the near future, this will likely result in a fragmentation of the industry analogous to that seen in many other aspects of post-COVID society. In other words, there is apt to be a “Great Re-Sort” in medicine as well.

Individual patients can and must affect change. They must replace the betrayed trust they once held in the public health establishment and the healthcare industry with a critical, caveat emptor, consumer-based approach to their health care. If physicians were ever inherently trustworthy, the COVID era has shown that they no longer are so.

Patients should become highly proactive in researching which tests, medications, and therapies they accept for themselves (and especially for their children). They should be unabashed in asking their physicians for their views on patient autonomy, mandated care, and the extent to which their physicians are willing to think and act according to their own consciences. They should vote with their feet when unacceptable answers are given. They must learn to think for themselves and ask for what they want. And they must learn to say no.



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Author

  • Clayton J. Baker, MD

    C.J. Baker, M.D. is an internal medicine physician with a quarter century in clinical practice. He has held numerous academic medical appointments, and his work has appeared in many journals, including the Journal of the American Medical Association and the New England Journal of Medicine. From 2012 to 2018 he was Clinical Associate Professor of Medical Humanities and Bioethics at the University of Rochester.

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