magine if you will a great and populous nation struggling with internal social and economic division as it works to improve the quality of life for all of its citizens. At the same time, it faces serious external threats to its security from those who would destroy its current way of life.

Unfortunately philosophical differences over right and wrong coupled with the controversial personal behavior of its leader have led to the moralization of politics; this in turn has led to gridlock in the government. Instead of viewing opposition as reasoned disagreement among reasonable people, political factions, intoxicated with the righteousness of their own beliefs, now view political rivals as evil people with evil ideas. If this sounds familiar, it is not without good reason.

Red, White and Blue Becoming Black and Blue?
Although the above statements describe late 16th century Ming China, they would likely remind many of the United States today. The media glibly talk of “Red” and “Blue” states, but the divisions in America are deep, and it is common nowadays to hear people speak of hatred and gridlock when describing national politics. The ASA Political Action Committee (ASAPAC) must work within this environment to further the interests of the ASA membership. In doing so, the ASA leadership receives comments or complaints from time to time from members who have concerns about how the PAC is doing its job. Given the current state of politics in America, this is not entirely unexpected, but ASA members can be assured that the actions of ASAPAC are guided solely by their interests and without regard to partisanship.

The fundamental purpose of ASA is to be the guardian of the art of anesthesiology and to act as a liaison between its members and the public they serve. The government makes the rules under which we practice, and we in turn use our unique expertise to advise it in providing health care to the citizenry. We also work with the government to ensure that its rules do not interfere with our ability to care for our patients, advance the practice of our art, recruit new people or make a fair living. Resources are limited so ASA’s elected leaders prioritize by developing a political agenda to guide our efforts.

Bipartisan Support
The mission of ASAPAC is to support this political agenda; and since we require support from members of both parties, the PAC must work in a nonpartisan fashion. It is true that there is currently a modest edge in PAC support for Republicans, but this is indicative not of PAC partisanship but rather of political reality. Republicans are in a majority of both houses, they control the White House, and they have supported many of our highest-priority issues. Seen through either a blue or a red filter, the actions of ASAPAC could be misconstrued as partisan, but in reality, PAC giving is based largely on helping individual ASA members develop relationships with their elected representatives on the local level and in Washington. In this way, we are able to educate key politicians as to our needs and thus help them to make decisions that conduce to the needs of our members and their patients.

All anesthesiologists benefit from the efforts of those ASA members who so generously donate their time for the good of the profession and the public. Every anesthesiologist can support these efforts by being a member of ASA and contributing to ASAPAC.

Remaining Credible
Another reality of ASAPAC’s political role is the necessity to focus on issues where we have credibility. Some members believe that ASA should advocate on problems that do not bear directly on anesthesiology but that do undeniably have health implications. This must be done with great care and is best avoided entirely where great controversy exists. A political leader hearing ASA’s position on the assault weapons ban might correctly wonder just what special expertise ASA has on that subject. He or she might easily conclude that since we were not experts, our views were really no better than opinions; and in a Washington divided along party lines, people with opinions may find themselves being identified with partisan groups sharing the same opinions. This behavior only tarnishes our image as the nation’s premier resource for issues related to anesthesiology and makes it more difficult to get the bipartisan support we need.

What Will ASAPAC’s Legacy Be?
The polarization of the electorate and the consequent partisan divide in Washington show no sign of abating. In mid-17th century China, political deadlock led to the collapse of the Ming Dynasty and the successful invasion by the Manchu people. Let us hope that we fare better than they did. In the meantime, ASAPAC will continue to eschew partisanship and political controversy while supporting those legislators who support our agenda and whose help we need to accomplish our goals.

Steven D. Goldfien, M.D., is Attending Anesthesiologist, California Pacific Medical Center, San Francisco, California.