Can such an ideology coexist with science‐driven medical education? As one may glean from these tenets of anti‐racist education, which represent the pedagogical application of critical social justice, the answer is a clear “No.” In an essay juxtaposing “liberal” social justice and critical social justice, Michael Mills, co‐founder of the Society for Open Inquiry in Behavioral Science, explained, “When social justice comes up for discussion, the first question that should be posed is: ‘What type of social justice are you referring to — liberal or critical?’” Sadly, the DEI we see in medical schools and beyond aligns with the latter.
These days, medical schools include DEI training as part of the curriculum. DEI even infects continuing‐education classes that physicians must take to maintain certification in a specialty. A recent “maintenance of certification” course for board‐certified general surgeons focused on differentiating microaggressions from macroaggressions — nothing about diagnosing or treating surgical problems. How does this keep a surgeon current on the latest advances in managing surgical diseases?
One of us is a general surgeon. On more than one occasion, he performed emergency, life‐saving surgery on victims of gang‐related gun violence who were sporting swastikas and “white power” and antisemitic‐slogan tattoos. Marinated in the ethos of pre‐DEI medical training, he did not allow the patients’ tattoos or criminal backgrounds to let him lose focus on the sole mission: saving their lives. Law enforcement and the courts addressed the circumstances surrounding the injuries later.
Medical school is the place to learn anatomy and physiology and how to diagnose and treat human diseases and injuries. It is not the place to learn to judge people as oppressors or the oppressed or to prioritize treatment based on a hierarchy of victimhood. It is not supposed to teach doctors to decide who gets a kidney transplant based on whether a patient belongs to a historically disadvantaged group. It betrays the medical profession’s noble mission to consider one patient more righteous and deserving of treatment than another and to prioritize treatment based on anything other than its degree of urgency.
We are not saying that the concepts of diversity, equity, and inclusion per se do not have a place in the field of medicine; these concepts, as commonly understood outside the DEI regime, can be virtues in a free and pluralistic society. However, two significant caveats must be acknowledged.
First, education in DEI efforts need not take valuable time from education in the practice of medicine. In fact, moral and ethical issues regarding physicians and patients are already addressed in the burgeoning and separate field of medical humanities, an interdisciplinary field focused on the confluence of health, medicine, and life experiences from the perspective of humanistic disciplines such as philosophy, history, literature, religion, sociology, and anthropology.
For example, Stanford Medicine’s Presence initiative “champions the human experience in medicine” with the belief that “being present is integral to the art and the science of medicine and predicates the quality of medical care.” Concepts like diversity, equity, and inclusion seem implicit in the medical humanities as they are commonly understood, which strongly suggests that the creation of separate DEI programs is superfluous and a misuse of time and resources.
What’s more, some schools, like the University of Texas’s Institute for Bioethics and Health Humanities, offer separate certificates in medical humanities for interested medical students. The key aspects of these programs are that they are voluntary and separate from education in the actual practice of medicine. Medical humanities as a field may be an important endeavor, but compelling medical‐school students to take substantial time away from medical education to take part in such an endeavor is impractical and unwise.
The second caveat is that even if the field of medical humanities remains separate and distinct, DEI initiatives must still be done in ways that are not divisive and decidedly illiberal. That is, it cannot be undergirded by critical social justice. Unfortunately, some medical‐humanities programs may be doing just that. For example, the Health Humanities Consortium seeks to educate both health professionals and the general public on “the experiences of patients, caregivers, and communities as they are shaped in relation to models of disease, illness, health, and wellness.”
This is a noble endeavor. However, the consortium’s statements on justice, equity, diversity, inclusion, and belonging (JEDIB) smack of critical social justice, as can be gleaned from its strategic plan. Although the exact ways JEDIB is implemented pedagogically is not clear from the website, its emphasis on systemic racism as an uncontestable fact, as well as concepts of lived experience and epistemic justice, should be red flags to anyone familiar with critical social justice ideology.
DEI training’s pernicious effects on clinicians extend beyond treating physical conditions. Its impact on how clinicians treat people with mental‐health problems is bone‐chilling. The American Psychological Association recently released its new Guidelines for Psychological Practice with Boys and Men based on the premise that “traditional masculinity is … on the whole harmful.” It encourages psychotherapists working with boys and men to “address issues of privilege and power related to sexism.”
Writing in the Spectator, noted academic psychiatrist Sally Satel decries the new “social justice therapy” for its “total disregard for the patient’s agency, assuming that social forces are the singularly important determinant of their problems.” Why in the world should anyone seek help from a mental‐health professional who regards them as inherently flawed because of biologically determined characteristics?
One of liberalism’s great insights is that every person is a unique, autonomous individual. Health professionals have an ugly record of betraying that understanding. The German medical profession embraced Nazi racial ideology during the Third Reich when performing euthanasia and live human experiments on members of “racially inferior” groups. Closer to home, American public‐health officials’ implicit belief that members of some racial groups had less individual worth than others was behind the infamous Tuskegee experiment with untreated syphilis.
Viewing patients not as individuals but as members of a group is hazardous not only to individuals’ health but also to society’s health. It can lead to bad outcomes.
