Introducing the Hippocratic Society

Conservatives should welcome a new group, the Hippocratic Society, which will appeal to medical students and physicians of varied political stripes but will be particularly friendly to conservatives who might otherwise find themselves relegated to the margins of the medical profession.

The Federalist Society is a helpful, if imperfect, analogy. Like the Federalist Society, the Hippocratic Society will be a place where conservative views are hosted and put into debate with progressive perspectives. And undoubtedly, conservative-leaning medical students will find colleagues and mentors among its members.

The Hippocratic Society has another function as well, however, not fully paralleled by its legal cousin, and likely to appeal regardless of political perspective. HippSoc (the abbreviated name of the group) addresses the closely related problems of physician burnout and the bureaucratization of medicine, modeling a return to human-scale doctoring. In furtherance of this, HippSoc reconnects doctors to the philosophical and religious roots of medicine, cultivating an active appreciation of the profession’s higher purpose. HippSoc’s activities on this front will surely appeal to many physicians and medical students, politically conservative or not.

Medicine is arguably more insulated from politics than is law, so the analogy between the Hippocratic Society and the Federalist Society is imperfect. On the other hand, as America’s political-cultural controversies have proliferated, medicine has been anything but immune. Familiar disagreements over abortion have lately been augmented by differences over child gender transition surgery, physician-assisted suicide, Covid, DEI, and the government’s role in health care.

The Hippocratic Society takes no position on these controversies. Nor, as many will be surprised to learn, does the Federalist Society take formal positions on major controversies in law and public policy. What both groups do instead is to facilitate debate on issues that the dominant professional orthodoxy would prefer to treat as settled.

As my Ethics and Public Policy Center colleague and NRO Bench Memos blogger Ed Whelan has explained, sponsoring debates with progressive critics, rather than simply confining itself to conservative speakers, has been the secret of Federalist Society success. This, Whelan says, has kept the organization open and attractive to outsiders, moderated factional conflict, and prevented members’ ideas from going stale. Back when I was advocating for state-level legislation to protect campus free speech, for example, I was invited to debate my proposal with a progressive critic before the Federalist Society of Washington, D.C. The Hippocratic Society clearly draws on this FedSoc model.

As Whelan points out, the Federalist Society itself generally steers clear of endorsing particular policy proposals. Most complaints about the Federalist Society, Whelan says, are really complaints, not about anything the organization itself has done but rather “about things done or said by individuals in the broader network it has helped to build.” Again, from what I can see, the Hippocratic Society plans to operate on the same basis.

That said, HippSoc will undoubtedly sponsor talks on controversial issues by conservative-leaning physicians affiliated with the group. As an example of what we’re likely to see from HippSoc, consider this 2023 talk at the University of South Carolina by Dr. Farr Curlin, a HippSoc board member and co-founder: “What Does Conscience Have to Do with Healthcare?” Curlin’s talk conveys the core argument of his 2021 book with Christopher Tollefsen, The Way of Medicine: Ethics and the Healing Profession.

In his talk, Curlin illuminates a key divide in contemporary medicine by setting up a contrast between what he calls the “provider of services model,” on the one hand, and his own “way of medicine,” on the other. The provider of services model, broadly supported by physicians like Ezekiel Emanuel (probably the most influential American physician on policy issues during the Obama years), holds that doctors are essentially service providers to patient consumers. Therefore, should doctors attempt to withhold professionally approved and patient requested services or procedures (like abortion, physician-assisted suicide, or so-called gender affirming care) on grounds of conscience, they should be penalized in some way. Some even argue that doctors should be prohibited from exercising conscience refusals altogether. The core idea here is that a patient’s autonomous determination of what is required for his or her well-being must be accepted by the doctor (unless it violates standard medical practice, e.g., antibiotics should not be prescribed for viral infections).

By contrast, Curlin’s “way of medicine” is grounded on the Hippocratic imperative to do no harm. In this view, the patient’s subjective desires must give way to objective assessments of the harms to health of procedures like abortion, physician-assisted suicide, and gender transition surgery. Curlin argues that conscience refusals are not based on a doctor’s mere personal beliefs or prejudices (as the provider of services perspective claims), but on knowable determinations that some medical procedures are destructive of health. And Curlin not only makes this case, but very effectively exposes the raft of contradictions that beset the standard “provider of services model.”

This is why the Hippocratic Society is needed. It’s evident that the medical profession’s dominant orthodoxy turns progressive moral and political preferences into officially recognized “truths” and does so in a way that, over time, will strip conservatives of their right to practice medicine, or at least severely curtail it. Unless state legislators are able to hear doctors like Curlin critique progressive orthodoxy, there’s a risk that progressive assumptions, improperly elevated into professional truths, will be enshrined in state law. While the Hippocratic Society won’t be officially endorsing any policy perspective, it will provide the kind of platform for individual advocacy and collective debate that can rightly deprive the progressive left of the medical policy monopoly it seeks.

Also, as noted above, the Hippocratic Society is dedicated to revisiting the deeper purposes of the medical profession in ways that will appeal to physicians of many political stripes. Physician burnout is a growing problem, exacerbated by proliferating bureaucratic rules and complex formulae for calculating compensation. Too often, the result is that doctors’ time with their patients is shortened and their scope for exercising professional judgment limited. Yet medicine’s core satisfactions grow out of the doctor-patient relationship and the related art (not just technical skill) of medical judgment. The shrinking human component of doctoring is the deeper cause of burnout. It’s gotten to the point where medical students are sometimes subtly discouraged by older physicians from pursuing the profession.

HippSoc addresses the problem by unpacking (over a meal shared by medical students and more senior professionals) case studies that require of the physician an exercise of various virtues, like compassion, curiosity, devotion, fortitude, hope, humility, integrity, and such. The discussions draw on everything from clinical experience to the ethics of Aristotle to address real-life dilemmas. So, for example, what difference would — or should — it make to the stress of treating severe gunshot wounds in a trauma room, knowing that the victim was a pastor trying to break up a fight, rather than a gangbanger?

The Hippocratic Society also sponsors a series of podcasts that tackle similar issues, everything from the challenge of particularly difficult patients to the implications of “new natural law” theory for medicine. In one episode, a particularly powerful anecdote (24:45 min.—27:20 min.) conveys some of the core ideas behind the Hippocratic Society’s approach to medical virtue.

As this story goes, a medical team of plastic surgeons visited Guatemala to operate on severe burns, cleft lips, and cleft palates. Patients were booked in advance, and the list was full. Then a man with cleft lip and cleft palate who lived 30–40 miles away heard about the clinic, traveled to the site, and begged to be operated on. He was told that the list was full and that he’d have to wait a year for the next visit. This man then slept on the stairs at the entrance to the clinic for five days straight. As the clinic’s time was ending and the team was breaking down the operating room, one of the doctors said he was going to operate on the man out of turn. Everyone agreed to stay. It took hours of extra work as they operated on both the palate and the lip in one sitting (contrary to conventional practice). The procedures were highly successful. This meant more work and more exhaustion for the doctors, and of course it contravened the bureaucratic constraints. Yet the patient was healed, and the doctors got some profound and lasting satisfaction for their trouble.

Something more should be said about the Hippocratic Society’s name. Hippocrates of Cos (ca 460–370 B.C.) was the father of ancient Greek medicine. He initiated the medical tradition ancestral to our own, grounded in meticulous empirical observation. Hippocrates is most famous, of course, for his oath, the code of medical ethics that many or most modern doctors once swore to uphold. The original Hippocratic oath forbade both abortion and physician-assisted suicide. Most medical schools therefore now either forgo the oath altogether or rewrite it to modify or eliminate those and other provisions.

Most Hippocratic Society members, by contrast, tend to remain loyal to the original oath and to the more encompassing “do no harm” morality that lies behind it. Also, as we’ve seen, HippSoc works to revive knowledge of the philosophical and religious (Jewish, Christian, and Muslim) foundations of medicine, going back as far as Aristotle. It’s a return to medicine in the great tradition.

I only recently learned about the Hippocratic Society from my EPPC colleague Aaron Kheriaty, who is on the group’s board, and immediately realized that news of a medical counterpart to the Federalist Society would be of interest to conservatives generally.

Dr. Kheriaty’s new book, Making the Cut: How to Heal Modern Medicine, explores the problem of physician burnout and the numerous other ailments besetting his profession. Toward the end of the book, Kheriaty calls for the creation of a series of alternative medical institutions to help shift the profession’s current direction. Sounds like a good idea to me. Stanley Goldfarb’s group, Do No Harm, which addresses the harmful effects of identity politics on medicine, is another excellent example of the sort of thing that is needed, I’d say.

The Hippocratic Society is growing rapidly. When Kheriaty wrote his book, published in September of this year, HippSoc chapters for premedical and medical students had been established at nine universities. I now count 28. (If you’d like to join, or start a chapter of your own, go here.)

What Kheriaty recommends for medicine applies more broadly. We need to establish a set of alternative institutions across many fields of endeavor in order to break monolithic progressive control of our institutions under the guise of “professional” consensus. The Federalist Society established the model. The Hippocratic Society, with modifications, continues it. With luck, we’ll see yet more to come.