Political correctness kills, and here’s medical evidence

The Baltimore Sun, January 7, 2001

By Michael Pakenham

Many reasonable people believe the political correctness phenomenon is at worst a well-intentioned fad. They see it as self-indulgence by under-employed academics and their acolytes—a harmless cult of egotism. In this view, the PC movement’s only really pernicious quality is that it is fundamentally anti-intellectual and, as such, can damage the educational process. But, the theory goes, any responsibly thoughtful citizen will see through its triviality. Therefore the movement is harmless.


Dead wrong.

Now comes a book that demonstrates that PC kills, maims and deranges. No, I am not suggesting that tenured humanities faculties are gathering in stealthy cells and plotting to assassinate threateningly uppity graduate students who insist on reading the classic literary canon.

I am simply reporting the conclusions of an extraordinarily courageous, punctiliously researched, powerful new book: “PC, M.D.: How Political Correctness is Corrupting Medicine” , M.D. (Basic Books, 285 pages, $27).

Dr. Satel is a lecturer at the Yale University School of Medicine, and is a practicing psychiatrist in Washington. She has had wide professional experience in that most difficult area of public health—the discarded mentally ill in the post-deinstitutionalization era. She has written for the New York Times, the New Republic and the Wall Street Journal. Very impressive research and consultation with medical professionals and public-administration authorities went into this book.

She commences by relating that in 1995 as a physician in a San Francisco hospital she became disturbed that her fellow psychiatrists were practicing bad medicine, and began a broader institutional inquiry.

She found two almost entirely different, but mutually collaborative, phenomena: (1) The idea that the job of public health is primarily political and economic, not scientific; and (2) a growing number of people in the medical community who are espousing an aggressively anti-intellectual, science-rejecting New Age philosophy.

The first is based on “the idea that injustice produces disease and political empowerment is the cure.” One example among many: a 1998 session of the American Public Health Association, at which Dr. Satel reports that Sally Zierler of Brown University’s Department of Community Health declared that AIDS is “a biological expression of social inequality.” She then recommended that the way to curb the epidemic is to “limit the power of corporations, cap salaries of CEOs, eliminate corporate subsidies, prohibit corporate contributions to politicians and strengthen labor unions.”

There is, of course, room in any democratic society for revolutionary activists. But Dr. Satel reports that radical doctrine goes deeply into many U.S. public health institutions. These efforts, at best, “create distractions and waste money, (and) at worst they interfere with effective treatment.”

She catalogues both systems and individual cases in which the effects are to limit or contort treatment—worsening disease and leading to unnecessary death.

The second phenomenon grows from a concept that organized medicine is “an oppressor group,” dominated by white males. Its adherents contend that sexism, racism, class and other such determinants are the causes of patients’ psychological distress.

It is a very strong undercurrent in mental health practice and policies, though it reaches well into other aspects of medicine. Dr. Satel traces an important element of its growth to establishment of “The Insane Liberation Front” in 1970 in Portland, Ore. After that came the “Mental Patients Liberation Project” and “Mental Patients Liberation Front” and the “Network Against Psychiatric Assault.”

This may sound, literally, insane—one chapter of the book is titled “Inmates Take Over the Asylum.” But it is being pressed forward earnestly and powerfully.

“These activists call themselves ‘consumer-survivors’ (also ‘psychiatric survivors’),” Dr. Satel reports. “The term ‘consumer’ denotes a user of mental-health services and ‘survivor’ refers to one who has endured psychiatric care. ‘Survivor’ used in the same sense as ‘cancer survivor’ is being used like “Holocaust survivor,’ an individual who has been unjustly imprisoned and even tortured.” They have powerful and increasing influence in governing bodies that control both funds and therapies—and institutions.

They greatly contribute to keeping untreated psychotics on city streets.

In close relation to this, Dr. Satel explores a plethora of doctrines that include such fads as “therapeutic touch,” a putative healing technique involving the concept of human auras and energy fields—though there is not one scintilla of scientific evidence of its existence or effectiveness.

Dr. Satel is thoughtful, indisputably humane—a seriously committed physician. She is conservative in the sense of believing in the effectiveness of well-tested and established institutions. “Postmodernism may be a harmless approach to literary criticism,” she writes, “but in medicine stakes are much higher. A health professional who brings a concept of cultural relativism to her work is a frightening prospect.” She calls the offenders “indoctrinologists”—practitioners of ideological doctrine, rather than medicine.

On one point, she and I disagree. I find postmodernism in literary criticism a pernicious influence. Every time I have taken such texts against the literature they ostensibly examine I have found them to be politically manipulative, intellectually vacant, culturally offensive and abusive of the very concept of art.

But when such blather fatally corrupts health care it is genuinely frightening.

“The good news,” Dr. Satel concludes, “is that the indoctrinologists have yet to be absorbed into the culture of mainstream medicine. In fact, some of their more absurd projects could probably be dismantled over night.” Will they be? Not without great effort, she believes—for though breaking down the more obvious offenses “would be a good first step they will hardly disarm the politically correct troops who, having wreaked havoc in universities, are now ready to march on medicine where they can literally have life and death consequences.”

The stakes in this latest PC battle are, as Dr. Satel writes, extremely high. She makes a compelling case that the time has come for mainstream medicine to fight back.