The Perils of PC Medicine

PC, MD - How Political Correctness is Corrupting Medicine,
by Sally Satel, MD, Basic Books, New York, ©2000, 285 pp, $27, ISBN: 0-465-07182-1

They are not talking about health insurance woes, 15-minute office visits or medical mistakes, but something more sinister. The New England Journal of Medicine claims white men get the best treatment for heart disease. Discrimination causes differences in health between blacks and whites. The patriarchal medical establishment has kept women from participating as research subjects, depriving them of the benefits of medical breakthroughs. (Women actually comprise 62 percent of the 6 million participants in NIH-funded research.) Former psychiatric patients, now "consumer-survivors," condemn the health care system for violating their human rights. They crusade to "limit the powers of psychiatry by making consumers full partners in diagnosis and treatment."

Brown University's Sally Zierler says, "The practice of public health is the process of redesigning society." Assuming social conditions are the primary reason for ill health, she and her colleagues urge the redistribution of wealth to ensure the even distribution of health.

Sally Satel agrees the relationship between health and social status is not trivial, but taking responsibility for one's own health is now virtually ignored. After all, if AIDS is a "biological expression of inequality," as Sally Zierler has put it, we can't hold people accountable for placing themselves at risk for contracting HIV. Doctors like Satel, who expect addicted patients to stop using drugs and to start using condoms - and if all else fails, to use clean needles - are accused of blaming the victim.

PC medicine puts ideology before patients. But injecting social justice into the mission of medicine diverts efforts to find ways of making everyone better off, regardless of race or sex. Satel calls these activists "indoctrinologists," whose prescription for cure is ideology and social reform. Their chief pathogens are capitalism, meritocracy and even the scientific method. Our preoccupation with such headline-grabbing subjects as HMOs, Medicare and uninsured Americans has allowed the indoctrinologists to swoop in under the radar and gain momentum in medical schools, post-graduate programs, editorial boards of prestigious medical journals, and academic and professional societies.

Satel describes how in South Carolina, where a viable fetus is considered a person, child abuse could occur if crack-addicted women had succeeded in their crusade to use cocaine even during the third trimester of pregnancy. This is not unlike gay people in the 1980s, feeling that HIV testing violated their civil rights to donate blood. This introduced HIV to hemophiliacs and cardiac surgery patients; one victim was tax reformer Paul Gann in our community .

As Sally Satel says, the PC prescriptions will be hazardous to our health.

delmeyer@HealthPlanUSA.net