In 2000, the psychiatrist and public-affairs commentator
Sally Satel published PC
M.D.: How Political Correctness
is Corrupting Medicine. She showed how an ethic of
political activism was infiltrating the practice of American
medicine. Increasingly, she argued, the demands of political
correctness were “blurring the boundaries between
scholarship and political action,” subordinating effective
treatment to the demand for social reform. One consequence
was the rising popularity of the idea that disease is the
result not of pathogens but of “racism,” “inequality,” or

“oppression.” An official at Brown University’s Department
of Community Health, for example, assured her readers
that AIDS is a “biological expression of social
inequality.” At the same time,
such “indoctrinologists” (in
Dr. Satel’s apt coinage) reject standard hygienic practices.
She cites the case of a public health nurse who instructed
mothers in infant hygiene and was for her pains remembered
“as a kind of surreptitious agent of the police, insinuating
bourgeois ideals into the authentic culture of the working
class.” No, we are not making this up. Indoctrinologists are
not the only voices heard in the medical establishment. But
neither are they fringe figures. “They now sit at the helm
of professional associations and hold impressive posts in
schools of public health,” Dr. Satel points out. “They have
changed medical school admission criteria and have
infiltrated respected academic journals.”

We thought of Dr. Satel’s sobering book when a friend sent us
news of recent changes at The New England Journal of
Medicine, one of the most venerable and authoritative
organs of the medical establishment. Go back a year or two,
and you will find a
journal devoted to such topics as
“Minor Histocompatibility Antigens and Marrow
Transplantation” (February 1, 1996) or “Paraneoplastic
Cerebellar Ataxia Due to Autoantibodies against a Glutamate
Receptor” (January 6, 2000). More and more, however, the
indoctrinologists are taking over. There are still plenty of
reassuringly technical articles. But there are also more and
more articles that replace medical with social issues. The
December 16, 2004 issue, for example, carries pieces on
“Confronting Genocide in Sudan,” violence in Colombia, South
America, and the left-wing group of physician-activists
Médecins sans Frontières and its decision to leave
Afghanistan and Iraq lest they become part of “the
collateral damage in the ‘war on terrorism.’” (Note the
scare quotes, as if the war on terror were merely a pretext
for some more insidious activity.)

The rise of indoctrinologists in some of the most prestigious
precincts of the American medical establishment is a
worrisome trend. As elsewhere, the triumph of political
correctness in medicine will result in a lowering of
standards and a willingness to barter uncomfortable truths
for political expediency. But scientific and technical
progress is built not on fictions, no matter how reassuring,
but on truth. At best, as Dr. Satel notes, the actions of
the indoctrinologists

create distractions and waste money;
at worst, they interfere with effective treatment. Although
the activists themselves may end up feeling better,
gratified to have taken part in the struggle for social
justice, they undermine the Hippocratic ideal: the patient
comes first.

The Gospel of Luke has some good advice:
“physician, heal thyself.”