A review of PC, M.D. by Sally Satel.

Basic Books, 2000.

This book has a simple theme: Political Correctness has entered the medical profession. The politicisation and radicalisation of health professionals and workers has altered the nature of health care work, and has dangerous repercussions for patients and for society.

The author, a lecturer at the Yale University School of Medicine, and a practicing psychiatrist,  demonstrates that medicine is being undermined by those who want to use the health care profession as another vehicle for consciousness raising and social engineering. Radicals in the medical community are using their profession as a cloak for social activism and political sloganeering. By buying into radical social criticism – be it Marxist, feminist, or postmodernist – they are putting “ideology before patients”. In seeking to bring about political change in the name of health, they are in fact undermining and threatening good medicine.

Increasingly health professionals are becoming advocates for various social justice causes – everything from the conflict in the Middle East to nuclear disarmament. Too often Marxist or feminists critiques are brought to bear on questions of health care. Arguments are made, for example, that racial discrimination causes high blood pressure among blacks.

One of the main dangers of the politicisation of the public health enterprise is that it undermines individual responsibility: “People who practice unsafe sex, stick dirty needles into their veins or fail to take TB medications daily are too often seen as passive victims of malign social forces”.

This is another example of the sweeping disease known as victimisation. More and more people (and social groups) are claiming victim status, with fewer and fewer people taking personal responsibilities for their actions and behaviours. It is much easier to blame the free market or patriarchy or Western culture for our woes than to accept some personal accountability.

Cries of racism and sexism and classism may sound good to some, but they lack in scientific and clinical soundness. The truth is, “uneven access to medical services, disparate knowledge of good health practices and personal attitudes – not discrimination and bias – underlie the vast majority of differences in health outcomes”.

Indeed, lifestyle changes and behavioural modification can result in significant improvements to one’s health. The Centers for Disease Control estimates that at least half of all premature deaths are caused by diseases that have modifiable risk factors. Change the behavior, therefore, and get better health outcomes. She quotes one expert who says, “If you eliminate the factors that we know about, which are largely lifestyle issues – smoking, high blood pressure, high cholesterol, lack of exercise and diabetes – you can eliminate somewhere between 70 and 90 percent of disease in our population”.

One of the more obvious examples of how Political Correctness has had a stranglehold on the medical community is the way we discuss and treat HIV/AIDS. The simple fact is that AIDS has become our first politically protected disease. A disease that is largely based on lifestyle choice has been allowed to spin out of control because of fears of political incorrectness. Indeed, had we treated AIDS like any other contagious disease like tuberculosis or typhoid, it would have been largely contained. This would involve obvious measures like routine testing for infection, contact tracing to identify others, and notification of HIV-positive individuals.

But the militant homosexual community, along with spineless politicians, have insured that this never happened. The results have been devastating. As Satel remarks, “The pursuit of social justice is loosening the public health profession from its scientific and clinical moorings”.

Another example of PC run riot is the growing number of drug addict activists who insist that drug abuse is a human right and the government has a responsibility to make it safer to be an addict. Known as the harm minimisation principle, these groups claim that we need to accept drug use, and to make things easier on drug users. Many of these groups call for the complete legalisation of all drugs. The Lindesmith Center in New York is a leading advocate of harm reduction, arguing that societies must accept drug addiction.

While such groups may pay lip service to the importance of treatment, they seem more interested in allowing the addicts freedom to destroy themselves. Libertarian freedom is held to be the highest good, regardless of the human and social costs.

Thus mandatory treatment programs to help drug addicts have come under heavy fire from harm reductionists. Very few addicts will voluntarily come in – and stay – for treatment. Almost all successful treatment programs need some element of compulsion or coercion. Yet civil libertarians and advocates of political correctness argue that this violates the rights of the addict. Drug addicts are victims of the system, we are told, and mandatory treatment is the wrong way to go. The foolishness of such a position is startling when we compare it to the way we treat other health risks, such as tobacco use. But many do not seem to be bothered by the double standards of PC.

A number of other examples are explored by Satel in this revealing volume. They all demonstrate how the rise in political activism and advocacy, along with the decline in the sense of personal responsibility, are resulting in a less healthy society.

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