The social justice doctor will see you now
FAIR in Medicine Fellow Dr. Aida Cerundolo writes about the dangers of patients being viewed through a racial lens.
This article was originally published in the Washington Examiner’s Restoring America.
What do forced sterilizations, the Tuskegee experiment, and the Holocaust have in common? They all demonstrate doctors forgetting their commitment to heal humans.
When doctors redirect their priorities to political matters outside the exam room, patient care suffers. That’s why doctors pledging to further social justice initiatives while treating individual humans may be blinded to the risk of harm.
We’ve seen this time and again throughout history. Social Darwinism in the early 20th century, for example, inspired doctors to pursue a genetically fit society through forced sterilizations of the “feeble-minded.” Doctors conducting the Tuskegee experiment to better understand syphilis caused suffering and death by withholding treatment from impoverished black patients. And German doctors motivated by the Nazis’ twisted idea of a better society marked prisoners for death in the mass extermination of Jews.
Why would people trained to heal inflict such pain on their fellow man?
Emboldened by a faith in the latest science and an assumption that certain humans hold less value than others, these doctors overlooked the harm to individuals while zeroing in on a perceived greater good to society. A shift in focus away from the sanctity of every individual is the Achilles' heel of medicine that makes doctors vulnerable to repeating the same mistakes. As Dr. Ashley K. Fernandes explains in " Why Did So Many Doctors Become Nazis? ," “Society is created for the person, not the person for society, and hence the dignity and integrity of the person and her freedom cannot be sacrificed for the sake of society.” Prioritizing the individual is the guardrail that steers medicine away from future carnage.
But it is exactly this shift in focus from the individual to society that social justice advocates demand in the medical field. The American Medical Association carries the social justice torch in its " Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity ," declaring, “Inequities cannot be understood or adequately addressed if we focus only on individuals, their behavior or their biology.” Doctors are told to “confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structured oppression, as well as embed racial justice and advance equity within and across all aspects of health systems.”
Reducing barriers to treatment is necessary to improve healthcare delivery and minimize disparities. But linking immutable characteristics such as skin color with power and privilege in the medical setting rationalizes the distribution of care based on arbitrary factors in the name of a greater good called social justice. This hazards some patients with negatively designated characteristics as being viewed as less valuable than others, potentially impeding the care they need.
The New York State Department of Health prioritized immutable characteristics when recommending that monoclonal antibodies and antivirals to treat COVID-19 be fast-tracked for those of “non-white race or Hispanic/Latino ethnicity” because “longstanding systemic health and social inequities have contributed to an increased risk of severe illness and death from COVID-19.” This approach bypassed patients at risk for severe disease simply because they were born the wrong color.
Despite the illogic of immutable characteristics dictating healthcare, some state medical boards have taken heed of the AMA’s call for mandatory anti-racism lessons and require implicit bias training for doctors to obtain or renew their medical license. Similar courses in medical schools ensure dissemination of the idea that patients be viewed through a racial lens.
The AMA’s strategic plan goes so far as to dissect the white population into even more specific subgroups of oppressors, calling out those who are “wealthy, hetero-, able-bodied, male, Christian, U.S.-born” as keepers of a system that permits their own success at the expense of non-whites and non-Christians. Social power dynamics are described in painstaking detail, while the most important power differential in the exam room — that between the doctor and the patient — is ignored.
Patients must trust that doctors are objective and sincere in their mission to heal, no matter the characteristics of the humans in front of them. Categorizing people as oppressors or oppressed, privileged or deprived, based on skin color, ethnicity, religion, or otherwise, is the start of normalizing their dehumanization, a dangerous practice that has historically resulted in unspeakable horrors. A rejection of labels and a focus on the sanctity of every individual is the only insurance against future barbarity in the name of societal gains.
Dr. Aida Cerundolo is an emergency medicine physician and a FAIR in Medicine Fellow.
People forget that doctors were at the forefront of "the final solution" and belonged to the Nazi party at rates far higher than members of other professions. As soon as we stop seeing our primary responsibility as being to the individual human in front of us, we are going down a very dark path. And yet, every time I pick up a medical journal now, it seems as if at least half the content is about "social justice" or "equity" or "climate change." Perhaps the people who write these articles have good intentions. Perhaps they're just virtue-signalling. But let's do a little thought experiment: If I, as a physician, truly believe that my primary job is to promote racial "equity" (equality of outcome between racial groups) and to help reduce CO2 emissions, how will I treat, say, an elderly white patient with dementia? The logical answer would be to euthanize them. That, I fear, is where we are headed if we don't fight back against this insanity.
Thank you. This trend is highly concerning and often very far from based in principles of biology, let alone medicine. Rather than addressing racism, it paradoxically further embeds it, despite the ponderous literature (much before 2020...) pointing out how "race" is a socially constructed fiction. Looking at someone, guessing their "race", and making a social-justice inflected decision about how to partition care is misguided on so many levels. A truly advanced practice of medicine would be more informed by eg rapid genomic sequencing (precision medicine) in combination with family history rather than how curly someone's hair is, or the precise color of their skin.