This One's a General

Richard Carmona, hero

By Dave Kopel & Timothy Wheeler

National Review Online. August 14 , 2002 9:30 a.m.

Testosterone is in again. Witness the ascent of Dr. Richard Carmona, the true-to-life hero nominated by President Bush for the post of surgeon general and recently confirmed, unanimously, by the Senate. Our new surgeon general displays the manly virtue of courage that our nation has again learned to admire since we went to war. The confirmation process reflects our rediscovered consensus that real men aren't afraid to use force — even deadly force — when necessary to protect a woman from a violent predator.

Carmona's life story is one of overcoming adversity and excelling in service to others. A high-school dropout from Harlem, he joined the Army and won two Purple Hearts, serving as a medic and a Green Beret. After distinguishing himself as a soldier he resumed his education, becoming a trauma surgeon and earning a postgraduate degree in health policy and administration. Carmona also directed the first trauma care program in southern Arizona.

Along the way, the surgeon-soldier-administrator became an expert on bioterrorism and an advocate for bioterrorism preparedness several years before September 11. So far, shining credentials for a surgeon general.

But Carmona's other high-profile accomplishments stirred a controversy that highlights Americans' ambiguity about the use of force. In 1999 Carmona, a sheriff's deputy and SWAT-team member, encountered a man assaulting a woman. As the Los Angles Times later explained, Carmona had "stumbled onto a killer who was holding a woman hostage. The man, who police later determined had stabbed his father to death and was on his way to kill an old girlfriend, grazed Carmona's head with a bullet before the doctor, also a badge-carrying sheriff's deputy, fired a single shot to kill him."

Carmona had done his job as a sworn peace officer and saved the life of an innocent woman, as well as his own.

But University of Arizona colleague Dr. Charles Putnam denounced Carmona for allegedly violating the physician's duty to do no harm. But in fact, the "do no harm" phrase is a simplification of language from the Hippocratic Oath:

I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked.

This language is, by its terms, confined to the physician's role in treating his patients — not in his role as a father defending a home from a violent invader, or a peace officer defending his community from a murderer.

When the Hippocratic Oath is meant to apply to a physician's non-professional life, the oath specifically says so, for a physician is bound to keep secret he learns "in connection with my professional practice or not in connection with it."

In modern times, most medical ethicists have not delved into issues involving homicidal attacks on medical personnel. Three authors who have, however, are Harvard psychiatry professor Arthur Z. Berg, University of Illinois at Chicago psychiatry and public health professor Carl C. Bell, U-Cal. Davis psychiatry professor Joe Tupin. In their article "Aspects of Violence: Issues in Prevention and Treatment" (published in vol. 86 of the journal New Directions for Mental Health Services, Summer 2000). Advising mental-health workers on dealing with violent patients, Berg and his co-authors explain:

The idea of harming someone is foreign to most mental health workers. Nonviolent methods that do not cause harm are appropriate for management of aggressive patients. But when faced with serious bodily injury or death, those methods may not apply. The clinician must be prepared to do whatever violence is necessary to save himself or herself and other. In these situations, "First do no harm" has no place.

Nevertheless, the verbal attack on Carmona escalated when Dr. James Curran, the Dean of the Rollins School of Public Health at Emory University weighed in. Because of Emory's proximity to the federal Centers for Disease Control, also located Atlanta, its school of public health tends to get a good deal of media attention.

Dean Curran announced that he was not "proud that our surgeon general shoots people." He denounced Carmona as "a cowboy."

Consistent with Dean Curran's aversion to Carmona's use of a firearm, Emory University has long served as a center of antigun propaganda, most notably from Dr. Arthur Kellermann, a tireless producer of dubious antigun factoids. More recently, Emory has become infamous as the home of history professor Michael Bellesiles, author of the now-exposed hoax book Arming America.

Because Dr. Carmona was carrying a gun and knew how to use it, a violent criminal died, and two or more innocent women and men survived. By the moral calculus of most people, this would seem a very good result. Had Dr. Carmona "done no harm" to the harmful predator, then the innocent hostage would have been assaulted and perhaps murdered. The killer might have gone to murder his ex-girlfriend, as well as any peace officers (Carmona included) who attempted to interfere. To be explicit: A dead male violent predator is a better public-health result than several innocent women and men brutalized, severely injured, and possibly murdered.

As Dean Curran's denunciation of the life-saving Dr. Carmona highlights, "public health" is, in some hands, increasingly becoming an instrument of moral intolerance, rather than of genuine public health.

This is why the "public-health" campaign against guns and gun owners tends to ignore or disparage lawful defensive uses of firearms against criminals, or against genocidal governments — even though genocide is surely the worst possible "health outcome."

Rather notably, many of the prime targets of today's "public-health" puritans are same targets which have always been so bothersome to people who insist that everyone live by a single standard of moral purity: tobacco, alcohol, and food. But rather than make the straightforward (and not implausible) moral arguments against smoking, drinking, and gluttony, the "public health" puritans wrap their claims in spurious factoids created by bogus research.

They campaign for smoking prohibition on the ludicrous grounds that inhaling secondhand smoke is more dangerous than smoking cigarettes. They campaign against alcohol by raising scare statistics about "binge drinking" — and rather significantly, their "binge drinkers" include people who drink at levels which leave them stone cold sober. Likewise, the "public-health" puritans rail against gluttony — by producing bogus statistics about "obesity" which define NFL running-backs as "obese."

Of course there are many serious, dedicated public-health workers and scholars who really do protect public health. The genuine health professionals are busy fighting against infectious diseases, monitoring the safety of drinking water, and studying how viruses spread from one population to another.

Yet too often, the "public-health" voices which appear in the newspapers aren't the voices of health advocacy, but the voices of neo-puritanism, masked in public-health rhetoric and waving phony and frightening statistics.

In a sense, Dean Curran's attack on Dr. Carmona serves the useful of purpose of revealing how extreme the Puritans of Public Health Agenda can be. It's not really about reducing how often innocents are harmed by guns; the agenda won't even allow rampaging murderers to be harmed with guns.

Our United States Senate, happily, found nothing immoral in Dr. Carmona's record. Had Dr. Carmona ever performed an abortion, or if he had ever volunteered at a pro-life medical counseling center, you can be sure that at least a few senators would have found the doctor's actions morally disturbing. But saving women by shooting a rampaging murder — there's nothing at all morally disturbing about that — at least according to the 98 United States senators who voted for Dr. Carmona. (Two were absent.)

Dr. Richard Carmona is a physician and educator with demonstrated ability under fire, both metaphorically and literally. He has stood in that dark place where evil threatens, and he has prevailed. What better person could serve as surgeon general for a nation at war?

— Dave Kopel is an NRO contributing editor. Timothy Wheeler is president of Doctors for Responsible Gun Ownership, a project of The Claremont Institute.