domingo, 29 de enero de 2017

Just because something is nonsense, of course, does not mean that people fail to believe it

Medical correctness

On the creep of P.C. culture into medical scholarship.

by Anthony Daniels

Beware of false prophets,
which come to you in sheep’s clothing,
but inwardly they are ravening wolves.
—Matthew 7:14

In Russia in 1839, Custine wrote that Tsar Nicholas I was both eagle and insect: eagle because he soared over society surveying it with a sharp raptor’s eye from above, and insect because he bored himself into every tiny crack and crevice of society from below. Nothing was either too large or too small for his attention; and sometimes one feels that political correctness is rather like that. For the politically correct, nothing is too large or too small to escape their puritanical attention. As a consequence, we suspect that we are living an authoritarian prelude to a totalitarian future.

Whether medical journals be large or small depends, of course, on the importance that you attach to them. As a doctor I am inclined to accord them more importance than the average citizen might; but what is indisputable is that they are not immune from political correctness, quite the reverse. Reading them, one has the impression of being buttonholed by a terrific bore at a cocktail party, who won’t let you go unless you agree with his assessment of the situation in Somalia.
Political correctness came comparatively late to medical journals.
At first sight, medicine might appear an unpromising subject for political correctness. You are ill, you go to the doctor, he tries to cure you, whoever you might be: what could be more straightforward than that? But in fact medicine is a field ripe for political correctness’s harvester. The arrangement by which health care is delivered is eminently a subject of politics; moreover we live in the golden age of epidemiology, in which the distribution of health and disease is studied more closely even than the distribution of income. Inequalities are usually presented as inequities (they have to be selected carefully, however: I have never seen the superior life expectancy of women, sometimes considerable and present almost everywhere, described as an inequity, even though the right to life is supposedly the most basic of all in the modern catechism of human rights). The decent man abominates unfairness or injustice: therefore the man who abominates unfairness or injustice is decent.

Political correctness—linguistic and semantic reform as the first step to world domination—came comparatively late to medical journals. This is because, where intellectual fashions are concerned, doctors are usually in the rear, rather than the vanguard. Their patients plant their feet on the ground for them, whether they want them planted there or not; for there is nothing quite like contact with a cross-section of humanity for destroying utopian illusions. Of course, there have been politically radical doctors—many of the informants of theBlue Books praised by Marx for the honesty of their exposure of truly appalling conditions were doctors—but their radicalism has been generally of the practical variety in response to the very real and present miseries that they encountered in their work. Their reformism was neither utopian nor a manifestation of the search for transcendent purpose in a post-religious world.

Medical journals have thus gone over to political correctness—admittedly with the zeal of the late convert—comparatively recently. Such correctness, however, is now deeply entrenched. WithThe New England Journal of Medicine for July 16, 2016 in hand, I compared it with the first edition I came across in a pile of old editions in my slightly disordered study: that for September 13, 2007, as it happened, which is not a historical epoch ago. What started as mild has become strident and absurd.

The first article in the earlier NEJM concerned the insufficient use of typhoid vaccination in those parts of the world in which the disease is still prevalent. It was titled “Putting Typhoid Vaccination on the Global Health Agenda.” “The Global Health Agenda”: the very phrase is a masterpiece of suggestio falsi and suppressio veri, which one suspects immediately (and correctly) of having a vast hinterland of saccharine, politically correct, and potentially dictatorial sentiment. In an article titled “Global Health Agenda for the Twenty-First Century,” we find:
Health in its own right is of fundamental importance and, like education, is among the basic capabilities that give value to human life (Sen & Sen 1999). It is an intrinsic right as well as a central input to poverty reduction and socioeconomic development. Health-related human rights are core values within the United Nations and WHO, and are endorsed in numerous international and regional human rights instruments. They are intimately related to and dependent on the provision and realization of other social and economic human rights such as those of food, housing, work and education.
Apart from being execrably written, this is, where it can actually be understood, the most patent nonsense. My rights are not infringed because I fall ill; I have, for example, no right to an unenlarged prostate though I would much prefer to have one; and there can be no right to immortality as there is to freedom from arbitrary arrest.

Just because something is nonsense, of course, does not mean that people fail to believe it, and the notion that health care is a human right is now all but unassailable, and unassailed, in our medical journals (which see every sectional interest but their own). I used to ask medical students whether they could find any good reason for providing medical attention to people other than that they had a right to it: and on the whole they could not, so thoroughly had the notion of rights entered their mind and destroyed their moral imaginations.


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