The Washington Post recently published an article looking at doctors who’ve prescribed quack cures for covid such as ivermectin (an extremely profitable line of bullshit). Very few doctors have paid any penalty for so doing which doesn’t surprise me: doctors have a long history of not policing their own. Nor is it surprising that Republican states want to make it even harder to discipline anti-vaxx doctors; Ron DeSantis is clearly cool letting people die of covid if it convinces anti-vax Republicans that he’s on their side.
What did strike me about the article, though, is that some of the doctors spreading misinformation (masks don’t work! The vaccine is death!) or pushing quack cures go with the First Amendment as a defense: refusing to let them prescribe what lines their pockets (they don’t phrase it that way) violates their right of free speech! It’s “viewpoint discrimination!”
This is a common cry on the right: any criticism of them for being anti-trans, misogynist or whatever is oppression. They have a right to judge trans people, working women, rape victims, etc. because Free Speech but if conservatives get judged in return, that’s not Free Speech, it’s anti-Free Speech. They can punch down (or what they imagine is down) but nobody has the right to punch back up.
(The same is true of the fight over public libraries: I’m sure Moms for Liberty and similar groups would be outraged if liberals started filing to ban books the banners liked (for the record, I do not think “if you ban our books, we’ll ban yours” is a good tactic). Take this WaPo story about conservative Catholics demanding their community library take books out that offend them; Delores Oates, a local politician running for higher office, posted to a Catholic online group that they need supervisors “who care about the well-being of children.” I’m betting if someone pointed out the Catholic Church has done anything but protect children (some pedophilia cases are still being prosecuted) they’d be outraged.)
As for “viewpoint discrimination,” it’s perfectly reasonable to discriminate against some viewpoints, particularly in a scientific/medical setting. Sure, there’s a subjective element in medicine (as the excellent book Untreated says): at what point should someone with pneumonia go into the hospital? Does an injury need surgery or will it recover after rest? When do you send a patient to a specialist? And no, doctors should be free to make their best judgment call even if there’s room for disagreement.
But in the covid case we have doctors spewing bullshit and false facts, either because they’re crackpots or because there’s money in it. Telling doctors not to spread lies about covid, vaccines or ivermectin is entirely appropriate. Patients trust doctors; doctors shouldn’t be allowed to abuse that trust, whether for profit or personal ideology. As I said of Robert F. Kennedy’s anti-vax claims, there’s no scientific controversy here, purely a political one (as witness DeSantis proposing Kennedy as head of the CDC).
There are lots of situations the First Amendment doesn’t apply. Conspiracy to commit a crime (“All I said was, I’d pay him $5,000 to kill my wife. Free speech!”). Slander. Harassment. Shakezula presents a couple of examples. I think regulating medical speech is one more.



