An infection is spreading through American health care—the virulent strain of political correctness known as “wokeness.” In October, the American Medical Association and American Association of Medical Colleges issued its 54-page “Advancing Health Equity: A Guide to Language, Narrative and Concepts” (AHE). This Orwellian assault on the English language is a manual for indoctrinating American medical students into a far-left cult of the woke. I described AHE in a recent article, “The Pall of Politics Descends Upon American Medicine.”
I’m not arguing that the political left is bad and the political right is good. There are ample supplies of lunacy on both sides. However, the left has a stranglehold on the public health field and aspires to hegemony over medicine itself. Hence, they, and not the nuttier elements of the right, are the objects of this essay.
In September, Harold Pollack, a distinguished professor of public health and social work and self-described “emphatic liberal Democrat,” warned that a progressive political monoculture rules America’s public health sector. Pollack argues a contributing factor to COVID vaccine hesitancy is public health’s incapacity to communicate with anyone outside of the political left. (I wrote about this in “Conservatives and Public Health: A Warm Welcome Into a Cold Climate.”)
Public health has a long, illustrious history of stunning accomplishments. Its greatest moment may be the complete elimination of the 3,500-year plague of smallpox. But public health’s Dr. Jekyll has long harbored a Mr. Hyde.
Twentieth-century American public health officials’ zeal for politicized medicine contributed to shameful human rights abuses. After the U.S. Supreme Court’s 1927 ruling in Buck v. Bell, public health became deeply involved in forcible sterilizations of tens of thousands of Americans branded “feebleminded” by the pseudoscience of eugenics. In that case, Carrie Buck’s teenage pregnancy was “proof” that she was genetically feebleminded—despite the fact that the pregnancy resulted from a rape. Others were sterilized because they ran away from abusive homes, were poor, were uneducated, had committed petty crimes, or suffered from physical disabilities.
Public health helped enforce bans on interracial marriage, marriage by disabled Americans, and deportations of immigrants (based on spurious IQ tests). For 40 years, the Centers for Disease Control and U.S. Public Health Service subjected African American men to the horrific Tuskegee Study of Untreated Syphilis.
Some American doctors were complicit in these abuses, but overall, the medical profession’s political heterodoxy and devotion to individual patients offered some protection against public health‘s excesses. But this bulwark may be crumbling.
AHE insists that doctors abandon hundreds of common English words and phrases, substituting convoluted constructions drawn (by AHE’s admission) from critical race theory and intersectionality. Henceforth, sayeth AHE, an individual with, say, a genetic propensity toward diabetes, is not “vulnerable” to the disease. Rather, his susceptibility to the illness is because he is “oppressed,” “made vulnerable,” or “disenfranchised.” Some nefarious force made him susceptible to diabetes. AHE overtly rejects the notion that one’s health results in part from individual choices. Whatever ails you, some oppressor meant for it to happen to you.
Doctors are to memorize long lists of ponderous, politically correct circumlocutions. There are no minorities—only “minoritized” people. The obese are now “people with obesity.” Free clinics must be called something else because “free” is demeaning. Doctors can no longer combat cancer or fight a war on cancer because, Heaven forfend, the words “war” and “combat” imply violence and might send emotionally frail Americans reeling toward the fainting couches housed in their safe spaces.
AHE aims to demonize, demonize, demonize. Doctors must never again say that “Low-income people have the highest level of coronary artery disease in the United States.” Instead, in the manner of parrots, they must say that “People underpaid and forced into poverty as a result of banking policies, real estate developers gentrifying neighborhoods, and corporations weakening the power of labor movements, among others, have the highest level of coronary artery disease in the United States.”
Doctors will henceforth tread a linguistic minefield and be judged immoral when they stumble. The ultimate message of AHE is that the doctor’s primary obligation is to politically re-engineer society rather than to comfort and heal individual patients. The danger of this cannot be overstated.