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Journal of Long-Term Effects of Medical Implants
Ethics and Constitutional Government
James A. Albright
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 1501 Kings High Way, Shreveport, Louisiana, USA
The term ethics refers to a set of principles that govern acceptable, proper conduct. Attacks on the Constitution of the United States pose the most serious breach of ethics today. Our country was founded as a republic, not as a democracy. Our Founding Fathers' main concern was to protect citizens from the power of the federal government, so constitutionally, the central government has little or no authority over individual citizens except on federal property. One of the major problems today is the fact that we now have professional politicians. This is due in large part to the lure of financial gain from countless special interest groups. This would change under constitutional law because the federal budget would decrease drastically. Article 1 states that all legislative power is vested in Congress. Congress has only 18 enumerated powers, and almost half of these pertain to defense of the country. Many of our current problems are due to regulatory agencies that have become independent fiefdoms with unconstitutional legislative, as well as executive and judicial, powers. The regulatory agency most relevant to medicine, both clinical care and research, is the FDA. It is now obvious that its basic structure needs to be changed or abolished because its actions are identical to those inherent in authoritarian systems. Constructive change could come from Congress, but it would be most desirable if the Supreme Court would take the lead and reestablish the authority of the Constitution as the Supreme Law of the Land. The FDA's function could be limited to the determination of safety, but preferably its mission would be altered to that of product certification. Defenders of the current system claim that such a drastic change would be too dangerous and their prime example is thalidomide. But it is now known that the market has already solved that problem prior to the government-imposed sanctions. Realistically, market forces and their ramifications, including our legal system, provide the most effective methods of protecting the public from harmful drugs and devices. Fortunately, a model for miracles is available. It is New Zealand, which had become increasingly socialistic after WW II. As a result, they had become noncompetitive, and with the formation of the European Union, they lost their major market exports. In order to survive they made some astounding changes in the mid-1980s. They studied every agency that depended on government funding and transferred much of this work over to the private sector. They turned the remaining agencies into profit-making enterprises. These agencies had cost the government about $1 billion/year. Now, they produce about $1 billion in revenue and taxes. Without question, a return to constitutional government would be an invigorating stimulus to bioengineering research in the future. It would flourish. The eminence of this country did not develop from a strong central government. It is due to its absence, but we are rapidly reaching a point of no return.
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