This will not come as news to fans of the Aubrey-Maturin series of historical novels, but there once was a time when surgeons were looked down upon in polite society.
Given their lack of scientific training, they were considered little better than butchers, unskilled hacks who sliced blindly into human flesh, following no ethical creed and honoring no code.
Patrick O'Brian's fictional hero, Stephen Maturin, encountered this perception throughout his 20-book career.
O'Brian's novels highlight British Navy Commander Jack Aubrey's adventures during the Napoleonic era of the early 1800s. Maturin, Aubrey's friend, was a prickly ship's surgeon, natural philosopher and secret agent who patched together sailors ripped apart in horrific naval battles. Rather than a run-of-the-mill slasher, he frequently pointed out that he was a trained physician as well.
Moscow Democratic Sen. Dan Schmidt says the distinction between the two professions stemmed from the precept that physicians should "do no harm."
"Surgeons weren't considered to be physicians because they did harm," he says.
When he was at medical school, Schmidt says, "do no harm" was part of the daily atmosphere. It was an all-encompassing ethic that required doctors to consider the possible harm their actions might cause.
"It started as soon as you got into patient care - even with patient examination, because you were touching people," he says. "You push here and ask 'does it hurt,' so you learn something. You're supposed to balance the potential harm against the benefit. It's a judgment call."
The Idaho Legislature's joint budget committee made a similar judgment call Feb. 15 when it set a spending cap for the 2014 state agency budgets.
Earlier this year, Gov. Butch Otter based his budget recommendation on a forecast of $2.8 billion. That would be a $141 million, 5.3 percent increase over the current fiscal year.
He used most of the increase - $81 million - to boost agency budgets. An additional $20 million was set aside for personal property tax relief, $35 million for savings and the remainder for a small economic-development fund.
Given the current economy, a number of Republicans now say a 5.3 percent growth rate is too optimistic. House Speaker Scott Bedke, for example, says he's more inclined to support something in the 3 percent range. That would reduce available revenue by about $60 million, setting up a potential conflict between tax relief and agency budgets.
Repealing some or all of the personal property tax on business equipment is one of Otter's top priorities this session. However, he has repeatedly said he'll pursue that goal only if lawmakers "do no harm," meaning cities, counties, schools and other local taxing jurisdictions don't suffer.
By setting a spending limit, instead of a revenue number, the budget committee sent a subtle message: Don't expect us to cut agencies to pay for tax relief. The committee essentially said 3 percent revenue growth is needed to pay for the minimum agency needs next year. Only if growth exceeds that amount will there be funds available to pay for tax relief or replenish savings.
That may test the strength of Otter's commitment to "do no harm."
"We've always had a 'starve the beast' mentality around here, so they (Republicans) might be willing to cut revenue at the same time as we're doing deeper budget cuts. That's very sobering," says Rep. Shirley Ringo, D-Moscow.
Adopting a spending cap and simultaneously moving forward with tax relief "would limit what we could do as far as replacement revenue (for local jurisdictions)," Bedke says. "Or if the criteria really is 'do no harm,' it would limit how aggressive we could be in year one" and push tax relief into the future.
Ultimately, the debate forces lawmakers to choose which surgical model they want to follow: Will they act as untrained butchers, blindly hacking away at tax revenues in hopes it will stimulate healthy economic growth? Or will they weigh the long-term costs and benefits and let that guide their decisions?
The outcome may be the same in either case, but only one approach has a proper role in polite society.
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