This is why medicine is not a liberal profession, but a servile career

From Ballas :

ME: Well, if he refuses, what are the alternatives?
THEM: We'd have to discharge him on oral antibiotics.

ME: Would this work?
THEM: Well, it's not ideal. There's a good chance he'd end up back here in the hospital in a few days.

ME (not punching anyone): if he has someone at home who can help take care of him, etc, he, unfortunately, (squeezing the thumbtacks in my hand) has the right to refuse.
THEM (frustrated, angry): Fine. Whatever. They have to sign an AMA discharge, and know that we're not responsible for what happens.

ME: Unfortunately, (tacks in hand again) his refusal doesn't discharge our obligation to treat. He'll need an outpatient appointment within a day or so.
THEM: No, I'm not doing that. If he doesn't want to follow my prescribed treatment, I'm not going to alter my schedule for him.

ME: Unfortunately, if you were ready to find him incompetent and keep him in the hospital, lawyers won't understand why you didn't follow such a sick person more closely as an outpatient.

That's it!

The doctor's intuition ("them") is that Medicine is their own property, and they are free to dispense it as they see fit. This is the liberal profession view of medicine, making it (along the practice of law, architecture and a few other "intellectual" pursuits) a proper avenue for the interests and efforts of intelligent, educated men - the thing that yielded "la noblesse de robe" in the Empire.

The reality of the matter (as pointed out by "me") is that... well... the doctors have absolutely no rights. None whatsoever. All the rights belong to the patient, and they are unlimited. Does the patient have or have not the right to present himself with a subdural hematoma ? Metatarsal fracture ? It doesn't matter, right ? The patient may present himself with anything in the book. If he so damned well pleases he can even present himself with something not in the book at all! Or maybe sort-of in the book, kinda ? The patient has the sovereign and undisputed right to invent new diseases, and if he does the doctors will crowd around him in awed admiration, like so many teenage ditzes around the one guy that invents motorbikes every year in every highschool. The patient has the right to take his medication, all of it, some of it, none of it, when told to do so or at any other time. There's some effort to limit how much he takes to whatever the doctor says, but this is done from a prone position : the doctor's on his knees begging, essentially, and the patient does as he well damned pleases. And it's his right.

Meanwhile, the doctors have obligations, and - importantly - these are not transactional but factual. They have an obligation to treat, general and universal, from which they can't be discharged by any authority, except retrospectively.

This exactly mirrors the situation in my harem. My slaves have obligations, that are equally factual. "Must keep the pantry stocked" or "must keep pubic hair cleanly shaven" or whatever else - tons and tons of whatever else. They're not transactional, there's not a "if you have the time" or "if you feel like it" or "if you agree it's a good idea" in there. Do it, or else you're screwed.ⁱ

Meanwhile I have rights, and they're neither defined nor relative. They're in fact boundless and absolute. I have the rightⁱⁱ to beat them, for any reason or no reason at all. To any degree.ⁱⁱⁱ I have the right to compel them to do, or not do, I have the right to set up thought processes to replace whatever they're currently employing^iv, I have the right to nominally alter reality^v, and the right to invent new rights or (obviously) redefine existing rights and on it goes, boundlessly^vi.

And since we're on the topic : any situation where rights are involved is exactly this. There can not exist that "balance of rights and obligations" that you daydream. Any practical situation predicated on such nonsense readily resolves to one side or the other, either water or butter. The police, for instance, have the right to beat you up, and the "obligation" to "protect and serve". In practice, whenever you run into them you're their bitch. And yes, stop pretending. Shave that pubic hair instead, and wear the nipple clamps. No, not those. The painful ones, with the bells. Bitch. Conversely, in a different space, you have the "right" to vote, and the obligation to pay taxes. You see where this is going, do you ?

Outside of the inflamed brainbox of henpecked husbands there's not a situation involving rights that's not outright slavery. Make sure you only participate in the Poly Houses you actually wish to participate in. Don't be the stupid dude that pats the wolf thinking it a kitten - the wolf's not a kitten, and whosoever makes the confusion probably needs medication. Antipsychotic medication.

PS. If you're about to go "but it is my nature to do so!", here's a fable for you :

There were two monks who were washing their bowls in the river. Suddenly they both noticed a scorpion that was drowning. One monk immediately scooped it up and set it upon the bank. In the process he was stung. He went back to washing his bowl and again the scorpion fell in. The monk saved the scorpion and was again stung. The other monk asked him,
"Friend, why do you continue to save the scorpion when you know its nature is to sting?"
"Because," the monk replied, "to save it is my nature."

Don't be that guy, seriously. It's beastly. Being a slave is deeply human. Being her master is deeply human. Being a scorpion-related automaton is fit for an arthropod. You don't buy a Pentium IV to run a Z80 emulator on it, do you ? Why then would you use all the power and beauty of the human body to recreate a scorpion counterpart ? Do something worthwhile with all that capital.

Don't be afraid to live your life. Be afraid of living your life as an MD.

1. And screwed in the same exact way, incidentally. What happens to the doctor that egregiously and intentionally fails his obligations ? Why, he will be castigated by the authority, cast out by the other doctors, and no longer be able to call himself a doctor.

   What exactly do you think will happen to the slave that egregiously and intentionally fails her obligations ? Guess, seriously. Castigated by her master, cast out by her sisters, no longer able to call herself a slave ? Ding. [↩]

2. Importantly, this is a right, not a freedom. Of course I have the freedom to do this to her, and to any other woman - but then again so do you. The important difference between rights and freedoms is that rights create relationships, whereas freedoms preexist any human arrangement. It's not that I can beat her that makes her my slave, it's that she submits to this that makes her my slave. This is also why you do not wish to accept the grant of rights from any entity you do not mean to have a relationship with : rights bind you to it. Which is why they're being granted in the first place. [↩]
3. You might not agree that I have the right to kill my own slave by beating her to death, but this is entirely your problem. Neither her (because I say so) nor I (because I say so) are interested in entering a relationship with you, except as predicated on your acceptance of your obligations and of my rights. Prior to entering a relationship, anything you may wish to think on such topics is entirely your problem - and should you wish to enforce it you will need violence. It is immaterial how you justify that violence to yourself, the fact remains that you will have to support your own views in a manner that you yourself claim unethical.

   This logical conundrum is, obviously, why plenty of people have serious problems with the institution of slavery. [↩]

4. This is called education, by the way. [↩]
5. "Then, God be bless'd, it is the blessed sun: but sun it is not, when you say it is not; and the moon changes even as your mind. What you will have it named, even that it is; and so it shall be so for Katharina." [↩]
6. In fact bounded by my own arbitrariety, of course. [↩]