More Wokeness in Medicine Jack Butler
Last year, I wrote for the magazine about the “rampant politicization of health care.” Thanks to greater government involvement in medicine, the ties between academia and the practice of medicine, and other pressures (with George Floyd’s death serving as a special catalyst), medical-school curricula, professional medical associations, and other aspects of the field increasingly reflect and transmit left-wing ideology. Take a look at some med-school curricula:
The Harvard Medical School course “Caring for Patients with Diverse Sexual Orientations, Gender Identities, and Sex Development” promises that “clinical exposure and education will focus on serving gender and sexual minority people across the lifespan, from infants to older adults.” An Indiana University Medical School “Sex and Gender Primer” for first-year students stresses that sex and gender “fall along a continuum, rather than being binary constructs,” and provides instruction on the use of “inclusive terminology.” A June 2020 letter from medical-school faculty at the University of California, San Diego, referred to the deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery and committed to creating “a curriculum which addresses the part we play in righting these systemic injustices” and using “these tragic events to strengthen our resolve.” One survey found that 39 of America’s 50 most prestigious medical schools contained some element of mandatory critical-race-theory training in their curricula.
Unfortunately, more examples of this general trend abound. In City Journal, Ian Kingsbury, director of research at Do No Harm (which specializes in documenting and fighting the politicization in medicine), describes one: The New England Journal of Medicine is denying that there could be any biological basis for the greater risk black women have for preeclampsia, a dangerous pregnancy complication involving high blood pressure.
The higher risk must, instead, be the fault of “the stress imposed by structural and individual racism.” It correctly observes that black females born in the U.S. are likelier to have preeclampsia than black women born elsewhere, and that those in the latter group who have lived here ten years or more are likelier to have it than those who have lived here for fewer years. But these differences have plausible explanations. They’re just not one that the newly politicized medical field wants to hear: genetics and behavior.
The genetic explanation arises from the fact that African immigration to the United States has become more diverse over the years. Kingsbury points to research showing that West African ancestry is “linked to risk variants in a gene called alipoprotein L1 (APOL1) that dramatically increase the likelihood of developing preeclampsia or kidney disease,” believed to be connected to resistance to African sleeping sickness. Because of the slave trade, 50 percent or more of African Americans can trace their ancestry to West Africa. This is less true of modern immigration from Africa to the United States, however, which encompasses more of the continent beyond regions with this unique genetic marker.
As for behavior, the difference in obesity rates between America and sub-Saharan Africa has significant explanatory power. It also could account for outcome differences in recent immigrants vs. those who have been here longer, as data suggest that obesity rates rise for immigrants who remain in the United States over time.
It is not racist to account for genetics and behavior when making medical determinations. An unwillingness to do so is not just indicative of the broader political malady now infecting health care. It also threatens patients — i.e., the ones doctors are supposed to help. Rather than prioritize treating patients, a politicized health-care system would elevate such goals as “dismantling dominant, exploitative systems in the United States, which are largely reliant on anti-Black racism, colonialism, cisheteropatriarchy, white supremacy, and capitalism,” to quote the mission of White Coats for Black Lives, a medical-student activist group. Advancing left-wing ideology isn’t good medicine.
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