I make the case for renewing the covenant between doctors and society.

Step 1: make doctors draft-eligible
https://www.theatlantic.com/ideas/archive/2020/04/case-drafting-doctors/610696/?utm_source=twitter&utm_medium=social&utm_campaign=share (in @TheAtlantic)

Until a century ago, doctors regularly fled plagues, zones of infection, etc. Then the ethics changed, possibly because of the influence of military medicine—you stay at your post and continue providing care, even at significant risk to yourself. That ethos remains in place.

Doctors (and nurses, other HCWs, etc.) can, however, leave their posts whenever they wish. They are not soldiers or slaves. There is no mechanism to compel them to serve if they refuse to—and no such mechanism is needed in current circumstances, since volunteers remain abundant.

But doctors' willingness to remain at their posts depends on an unwritten covenant between doctor and society. That covenant is in a sorry state.

Hence the need for renewal, and formalization, of that covenant. If society demands heroism and self-sacrifice of doctors, it should make that part of the job, and recognize that heroism with the same forms of respect we accord to others of whom we demand the same heroism.

One model here is law. In fairly rare circumstances, courts will appoint lawyers to represent clients for little or no compensation. (This is distinct from the job of public defender.) If you’re a lawyer, you’re an officer of the court, and sometimes you have to do these things.

You can refuse, but your standing as a lawyer might be in jeopardy. The privileges of being a lawyer come with matching obligations. And the regular exercise of these obligations is good for you, good for society, and good for the profession.

Mutatis mutandis for doctors.

Now we have a perverse situation in which doctors are, at a time of maximum stress, asked to make hard decisions for themselves and their loved ones, while the society that was supposed to protect them casually ignores its side of the covenant in half a dozen unconscionable ways.

The solution is to make that covenant real again. It is not something that doctors individually decide to abide by; it is a non-negotiable obligation of the profession, freely entered by every doc. Society then needs to treat its obligations with the same gravity.