In Reply.—Thank you for your letter of support. As we agree on so much, permit me to show you why a physician such as you, dedicated to practicing good medicine, is part of the problem both of us want to correct. When a physician uses phrases like "standard care" and "standardized guidelines," the physician has been duped and subtly tyrannized by the law and the body politic—the legal imperative. This is the consummate success story of authoritarianism: unwittingly, you think as the authorities want you to and act for them.
It has not always been so, but national standards in medicine have evolved into essential legal instruments that the legal imperative enforces. Legal actions are dependent on standards provided by physicians:
Professional negligence or malpractice is a special instance of negligence in which professional standards of care have been developed for persons possessing or claiming to possess special knowledge
SEPKOWITZ S. The Legal Imperative and the Meconium-Stained Newborn-Reply. Am J Dis Child. 1988;142(3):250-251. doi:10.1001/archpedi.1988.02150030016004