OPINION EDITORIAL: WARNINGS FROM THE PAST

In the aftermath of the 2024 Presidential election, our nation finds itself entrenched in a dichotomy of celebration and despair. We have become a society characterized by two diametrically opposing realities, with little hope for convergence. Individuals whom we have long trusted and respected now disseminate what we perceive as false and misleading information are immovable to hear any opposing “truth”.

Supporters of President Trump view his reelection as both a validation of the 2016 election resistance and a chance to enhance our national role and interests. In contrast, opponents of President Trump see his reelection as the onset of democracy’s decline in our nation and a threat to our global standing. In these conflicting perceptions, his reelection represents either the dawn of our nation’s resurgence or the advent of an autocratic theocracy. As a result, we have fragmented into opposing camps, resistant to acknowledging our shared humanity and interests. 

The most damaging consequence of our political tribalism is our growing detachment from objective science. There is an increasing trend of “research” that seeks to promote or justify specific political agendas or ideologies, often at the expense of the fundamental scientific principles necessary for objectivity. This compromise leads to the manipulation of research methodologies and interpretations to achieve predetermined conclusions.

We are abandoning science as a tool for objective inquiry, opting instead to weaponize it in service of political or social self-interests.

Consider any news program that discusses the role, safety, and efficacy of vaccines in our society. Unfortunately, most of the public lacks the requisite skills to accurately interpret research findings and relies on healthcare providers for guidance. When they turn to news programs that cover vaccines, the discussions often devolve into arguments presenting conflicting “facts,” “research,” and “evidence.” There is little to no objective analysis of the data provided, leaving viewers with opposing “opinions” and no clear conclusion to inform their decision-making.

This phenomenon NOW permeates every aspect of health policy.

Healthcare providers are not insulated from this national divide. Some perceive the forthcoming Trump cabinet appointments as a necessary response to governmental overreach, while others view them as a abandonment of evidence-based science and a concession to conspiracy theorists. We anticipate—or dread—potential cabinet appointments, grappling with the role of misinformation, disinformation, and manipulation in shaping health policy in the United States.

Of greatest concern is the increasing tendency to identify with political ideology over professional role. I have observed this shift as individuals increasingly define themselves as “conservative” or “progressive” rather than as a “nurse,” “doctor,” or member of another health profession. We have moved our allegiance from our healthcare identity to our political affiliation.

This growing prioritization of our political identity over our professional role has serious implications for the health and values of our nation. If we forsake our scientific objectivity in favor of political ideologies, we jeopardize not only the health but also the humanity of our society.

In his book “The Nazi Doctors: Medical Killing and the Psychology of Genocide” (1988), Robert Jay Lifton explores the role the healthcare community played in the atrocities of the German Fascist State. I highly recommend this work. Lifton does not focus primarily on the participation of healthcare providers in the concentration camps; rather, he examines how the healthcare profession lent legitimacy to acts of atrocity.

Lifton illustrates how the German healthcare establishment, in the early years of the Nazi regime, normalized the euthanasia of individuals with physical disabilities and the removal of “undesirables” from society. Healthcare organizations promoted the notion that society is akin to the human body. They employed the analogy that a physician does not hesitate to remove cancer from the body. Thus, they propagated the belief that when the state eliminates undesirables, it is no different than a doctor excising cancer.

Physicians, nurses, psychologists, and other healthcare providers compromised their scientific and moral principles to promote their prevailing political ideology. They exploited the trust their communities placed in them to manipulate public perception, ethics, and ideology.  More concerning was the fact that many unconsciously abandoned objective science as they fell into the influence of the Nazi Party.

Lifton’s findings underscore the considerable power healthcare providers have in shaping public perception and beliefs. Consider the fundamental reality that patients often accept the prescriptions we provide without question, even when these medications could pose serious risks to their health. We inform the public about what is beneficial for them and what is harmful. Surprisingly, many people adjust their behaviors in accordance with our guidance. As healthcare providers, we wield a remarkable influence over public perceptions and beliefs, and we possess a substantial capacity to abuse that trust.

It is important to clarify that I do not reference Dr. Lifton’s work to equate the Trump Administration with Nazis. His research illustrates the significant influence our industry wields over social norms and acceptability. His research is an indictment of individuals who placed their personal ideology above the health of their patients.

As human beings we will belong to our political tribes.  We are given a constitutional right to advocate our view of what our nation should be.  We will advocate for our political and religious beliefs in many venues.  We do not surrender this right when we accept the responsibility of healthcare provider.

However, Dr. Lifton’s text should act as an indictment of healthcare providers prioritizing political precedences or gain over the ethical principles and science of healthcare.  If we ignore, or abandon, the tenets of science to pursue political aims we harm not only our patients, but our profession as a whole.

If we accept research findings or ascertions of fact solely on the basis of the result aligning with our beliefs, and do not subject all research to critical scrutiny, we became a political agent and not an advocate for our patients. 

Our sacred duty as a healthcare provider, (doctor, nurse, technologist, pharmacist, etc.) is to actively work to advance health science and policy that is built upon the foundation of objective science.  We are advocates for our patients and are obligated to act in THEIR best interest, even when those interests conflict with our own beliefs and ideology.

As the Trump Administration assumes power, parties on both the right and the left, will utilize every means to advance their political agenda.  Partisan and parochial interests will manipulate the passions of the public to achieve their political or fiscal priorities.  These machinations will often be disinterested in public well-being in lieu of personal, or political, profit.

In response to the onslaught of disinformation I have developed a 3 step rules process to guide me in the deliberation of controversies regarding health policies.  I share them with you in the hopes that you might find value in this process is clearing through the noise. 

These rules include:

1. Does it pass the “sniff” test.  If it doesn’t pass the “sniff test”, then it isn’t an issue.
   • If you remove the conspiratorial component of the argument is there a clear, precise and logical argument.
   • Does the argument revolve around an unsubstantiated claim or assertion.  “i.e. People are saying….I have heard….etc.). Is there objective and credible data to support the assertion.  (i.e. peer reviewed or an objective editorial board?)
   • Is the argument based on a falsehood?  As my Grandma used to say “If you have to lie to make a point, you don’t have a point!”
2. Is there an independent foundation to the argument.  In the absence of objective data then move on.
   • Look at the sources and ascertain if they are truly objective authorities in the subject matter. I would use the example of pharmaceutically funded drug research.  I believe we have all learned that such research needs to be evaluated with a high level of scrutiny.  We need to apply that same level of scrutiny to any news story addressing health policy issues as we do to manufacturer research studies.
   • Is the source of the information peer reviewed and objective?  Is there some level of scrutiny prior to publication?Are the sources truly “experts”?  Or is this a panel of individuals misrepresenting their opinion as fact?
   • As an exercise the next news roundtable you watch addressing a health policy subject ask yourself of each panelist: 
     1. What is their qualification to be on this panelIs what they are saying a reflection of objective data, and;
   • Can they truly be unbiased and objective in this matter?
3. Does the argument hold without a “Yeah, but..
   • Is the argument self-contained, or does it require extraneous support.
   • I reference the many health policy arguments that I have been engaged in that quickly divert into multiple disparate issues.  The argument begins discussing one issue, then quickly diverts into multiple unrelated topics. The original subject of issue is somehow attached to an unrelated perceived wrong-doing.  For example the infamous “Yeah, but what about when they….” Response.
   • If a health policy argument or issue cannot be self-contained, then it is likely not an issue. 

In these uncertain times, it is imperative that we, as healthcare providers, prioritize our professional responsibilities over political affiliations. Our commitment to objective science and ethical principles must remain unwavering, even in the face of political pressures. By doing so, we not only safeguard the health and well-being of our patients but also uphold the integrity of our profession. Let us remember that our ultimate duty is to our patients, and it is through this dedication that we can truly make a positive impact on society.