Do Medical Professionalism and Medical Education Involve Commitments to Political Advocacy?
Bibliographic record
Abstract
To the Editor: We respectfully disagree with Dr. Huddle's opinion, expressed in his March article,1 that political advocacy should not be a physician's responsibility. From the time of Hippocrates, advocacy and service to society have been duties of physicians. Although Dr. Huddle accepts that he has an obligation to advocate on behalf of specific patients, he limits himself to this narrow commitment. What he does not acknowledge is the social contract between society and the medical profession, which gives the latter autonomy and self-regulation in return for fostering the health of society—an activity that, at times, can include political advocacy. Advocacy by physicians does not mean that physicians become politicians. It means that they are sufficiently aware of the determinants of health, as well as problems and resources in the specific communities where their practices are located, to know when a situation requires them to become advocates for the individual or collective well-being of their patients. Physicians are ideally placed to observe the health impacts of socioeconomic factors, which puts them in an advantageous position to promote the health of patients and communities as a professional responsibility. To go farther in political advocacy than is warranted by that professional responsibility is the physician's individual choice, which we maintain should be respected. The kind of behavior that Dr. Huddle proposes, in which physicians turn their backs on their professional responsibilities to the health of their communities, will continue to undermine public trust in doctors and the health care system. Jeannine Girard-Pearlman Banack, MEd PhD candidate, Ontario Institute for Studies in Education, University of Toronto Faculty of Medicine, and research fellow, Wilson Centre, Toronto, Ontario, Canada; [email protected]. Niall Byrne, MA, PhD Professor emeritus, University of Toronto Faculty of Medicine, and coordinator, International Visiting Professors Program, Wilson Centre, Toronto, Ontario, Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.096 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.010 |
| Scholarly communication | 0.008 | 0.010 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.031 | 0.039 |
| Insufficient payload (model declined to judge) | 0.008 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".