View report page

similar 'interferences', until the Totalitarian State takes over. Any large impersonal concept
of welfare easily lends itself to one 'Big Brother' (or a number of Big Brothers) watching over
you to such an extent that they eventually take over everything that matters in shaping the
individual's life. It will always be in ways which seem good to themselves.
Preventive and Social Medicine may well prove to be the most innocent—or innocent looking—
of all forms of the roads to Totalitarianism.
The question of fluoridation of water supplies is also complicated by the fact that the
areas of more than one local health authority are usually supplied by one water undertaking.
It will be necessary for all the local health authorities supplied by each undertaking to agree
to the procedure before fluoridation is introduced. Alternatively government action by Act of
Parliament may enforce fluoridation universally. A Medical Officer of Health may well find
himself in a situation, such as in the City of London, where the resident population is about
5,000 and the number of children involved is comparatively small. The answer in this case
may be to give fluoride tablets to the small group who will benefit. Some say that mothers
cannot be expected to give tablets to young infants and children over a period of years
regularly. This raises the question of motivation, a very popular one in the modern world of
health education. A woman can be trusted to take contraceptive pills regularly, as she is
motivated by fear of pregnancy, but not to give tablets in an endeavour to prevent caries in her
child's teeth, out of consideration for her child's well-being in this respect.
THE USE OF MASS MEDIA
This brings us to what many consider the most important aspect of the planning of health
programmes. It is true to say that opinions have largely become the facts in health education.
Opinion polls are used to assess so-called needs or as measures to evaluate services provided.
These opinions obtained by postal or personal questionnaires replace the older objective data
of mortality or morbidity statistics of public health. Such sociological enquiries seek to discover
causes of motivation. It is considered that one must seek to alter habits, but influencing
motives often may be at the expense of reason. Exhortation is considered to be ineffective and
the modern advertising techniques by pamphlet or television employ such other devices.
Surely there is a responsibility to ensure that such brain-washing techniques are used
honestly and truthfully in the service of health education, and that the means employed are as
worthy as the ends to be achieved. Methods should not be used which influence action without
the rational consent of the individual and his willing acceptance of the benefit offered. 'Dogooders'
can be a real menace in public health or social work if they intrude upon the sanctity,
right or freedom of the individual against his will. The employment of a mass medium such as
television or the methods of mob psychology to sway people to do what authority considers to
be for their good opens the door to the misuse of their powers, and the eventual elimination of
the freedom of the individual. This is a real danger, especially in the field of mental health.
SOME CRUCIAL CONSIDERATIONS
This whole subject of corporate responsibility in relation to Preventive Medicine involves
all the basic principles of the theory of the State, the extent to which it should interfere and
the age-long uneasy association between corporate action and individual freedom. Not only
so, but it involves also the difficult problem of how far the community may impinge on parental
responsibility—even when it seems for their good. It involves the difficult sphere of the extent
to which suggestive advertising and educative methods may be utilised to alter (against their
will) the people's ways of living.
In the last analysis the Christian doctor is bound to make radical judgments and choices.
He believes and would argue that his experience confirms that Christianity in its ideal form
offers a solution at every tum. If this be God's world, then the summum bonum is God's will
for the State, the community, family, and the individual. The more we are able to approximate
to the overall beneficent plan, and to extend its benefits to all concerned, the more such
problems of individual liberty will be absorbed into the common good. The convinced Christian
is compelled therefore to believe that he is working for the best of Medicine, the State, and
the family, by seeking to conform to the Biblical Revelation.
The corporate action of the State is then seen to be largely negative. It exists for the
restraint of evil and the punishment of the evil-doer so that the individual can live in peace
and responsible freedom. The Magistrate bears the sword for this purpose. He is responsible
for the protection of persons and property in general. The ordinance of marriage preserves the
sanctity of the family. Duties and mutual responsibilities are laid on parents and children,
husbands and wives. The creational ordinances of work and appropriate 'Sabbath Rest' remain
mandatory principles. The moral law indicates the priority of God in the life of the individual,
the sanctity of human life and the right to property. It must be respected, There are other
similar implications. In the Bible the Christian finds revealed to him the principles which are
to guide him. In so far as these can be incorporated into modern living, he believes that the
good of all will be advanced.
58