"Power corrupts" wrote Lord Acton in 1887, "and absolute power corrupts absolutely."  Shakespeare invoked more sympathy for the mighty when he caused Henry IV to bemoan: "uneasy lies the head that wears a crown".  And John F. Kennedy (who should have known) said in his Amherst College speech: “power leads man toward arrogance”.

In modern times there is evidence of another aspect of power, as yet without a pithy quote to catch the public attention: power isolates.  It can be seen in world leaders, benign or otherwise, who become detached from public sentiment.  Mao and Hitler protected their power bases with walls of fear, but those same walls blocked out the truth, along with their enemies.  Perhaps, in their case, truth was an enemy.  More recently, Thatcher lost touch with the mood of the nation.  She achieved much in her early years, yet is now remembered as the caricature into which she evolved.  Too many years of absolute power moved her beyond the reach of effective advice that could have moderated her behaviour.  And Clinton came to believe his own hype.  He really thought that he was a nice guy, that his encounter with Monica Lewinski was what nice guys do, and that when caught out nice guys can be a bit evasive with the truth.  All of which shook the foundations of democracy in the Western World.  Peter Mandelson may have acted within his own scruples, but he had no idea that his acts would outrage others.

Less obvious is the power base of institutions, and yet the same isolation from ‘the man in the street’ can be just as significant.  The medical profession is a prime example.  Time and again, headlines tell us of unthinking, unfeeling, illegal, or otherwise unacceptable acts by doctors and hospitals.  Sometimes the perpetrators are rogues, and unfortunately rogues will be found in all walks of life.  When such cases are brought to light rules and procedures are reviewed (albeit somewhat reluctantly and belatedly on occasion) and the likelihood of recurrence is reduced.

But this week the UK has been shocked by the revelation that tissue is retained by hospitals without the knowledge of patients or their guardians.  During the course of the next few days it became apparent that the taking of organs is also a wide-spread practice, without the knowledge or consent of next-of-kin.  The entire system (from doctor, nurses, and hospitals through to management and finance departments) supported these practices and the onward ‘sale’ to researchers.  In their arrogance and isolation they betrayed the trust and faith bestowed on them.  In fact, had they sought consent it would probably have been granted by many people willing to make a contribution to research. 

The head that wears the crown does not have to be uneasy or arrogant.  And although power isolates, the wise head does not create absolute isolation.