In 2000, the psychiatrist and public-affairs commentator Sally Satel published PC M.D.:How Political Correctness is Corrupting Medicine. She showed how an ethic of political activism was infiltrating the practice of American medicine. Increasingly, she argued, the demands of political correctness were blurring the boundaries between scholarship and political action, subordinating effective treatment to the demand for social reform. One consequence was the rising popularity of the idea that disease is the result not of pathogens but of racism, inequality, or oppression. An official at Brown Universitys Department of Community Health, for example, assured her readers that AIDS is a biological expression of social inequality. At the same time, such indoctrinologists (in Dr. Satels apt coinage) reject standard hygienic practices. She cites the case of a public health nurse who instructed mothers in infant hygiene and was for her pains remembered as a kind of surreptitious agent of the police, insinuating bourgeois ideals into the authentic culture of the working class. No, we are not making this up. Indoctrinologists are not the only voices heard in the medical establishment. But neither are they fringe figures. They now sit at the helm of professional associations and hold impressive posts in schools of public health, Dr. Satel points out. They have changed medical school admission criteria and have infiltrated respected academic journals.
We thought of Dr. Satels sobering book when a friend sent us news of recent changes at The New England Journal of Medicine, one of the most venerable and authoritative organs of the medical establishment. Go back a year or two, and you will find a journal devoted to such topics as Minor Histocompatibility Antigens and Marrow Transplantation (February 1, 1996) or Paraneoplastic Cerebellar Ataxia Due to Autoantibodies against a Glutamate Receptor (January 6, 2000). More and more, however, the indoctrinologists are taking over. There are still plenty of reassuringly technical articles. But there are also more and more articles that replace medical with social issues. The December 16, 2004 issue, for example, carries pieces on Confronting Genocide in Sudan, violence in Colombia, South America, and the left-wing group of physician-activists Médecins sans Frontières and its decision to leave Afghanistan and Iraq lest they become part of the collateral damage in the war on terrorism. (Note the scare quotes, as if the war on terror were merely a pretext for some more insidious activity.)
The rise of indoctrinologists in some of the most prestigious precincts of the American medical establishment is a worrisome trend. As elsewhere, the triumph of political correctness in medicine will result in a lowering of standards and a willingness to barter uncomfortable truths for political expediency. But scientific and technical progress is built not on fictions, no matter how reassuring, but on truth. At best, as Dr. Satel notes, the actions of the indoctrinologists
create distractions and waste money; at worst, they interfere with effective treatment. Although the activists themselves may end up feeling better, gratified to have taken part in the struggle for social justice, they undermine the Hippocratic ideal: the patient comes first.The Gospel of Luke has some good advice: physician, heal thyself.
This article originally appeared in The New Criterion, Volume 23 Number 5, on page 3
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