After more than fifteen years on college campuses, the voice of political correctness has become numbingly familiar. It’s become so familiar, in fact, that those in the know don’t even call it "political correctness" anymore. The novelty gone and all major opposition silenced, what once impressed many as a dangerous new trend is today so commonplace that it doesn’t even seem to require a name: that’s just how things are. Perhaps this means that the movement has gone stale, maybe even that its practitioners are growing bored of themselves and will soon move on. But in the meantime it’s business as usual at humanities and social science departments across the country: as the old ones fade, new sources of grievance are discovered and added to the shame-faced heap which today passes for the cultural history of the West.

Given the movement’s longevity and apparent success, it comes as no surprise that it should have taken root outside the university over the past decade. How could it be otherwise? That, after all, is where teachers, lawyers, journalists, and politicians come from. In each of these fields, the forced exposure of generations of undergraduates to the picture of Western history as one long outrage perpetrated against gays, women, and ethnic minorities is bearing fruit. Now, the nation’s health care is heading in the same direction.

I first became aware of this trend a couple of years ago. In an article published in the February, 1999, issue of the prestigious New England Journal of Medicine, a group of Georgetown University researchers reported that they had found strong evidence to support the view that black patients were routinely discriminated against by their (mainly white) health care providers. The story was an overnight media sensation. Treating the findings as established fact, the networks and major newspapers assumed a scandalized tone. "Health Care: It’s Better if You’re White" read one typical headline. Before long, the study’s director, basking in his new renown, was to be found in Washington conferring with the Congressional Black Caucus on the health of African-Americans.

There’s always a problem when science makes big news. While I was skeptical of the claim that doctors to any significant degree discriminate against their patients on racial grounds — giving sloppy diagnoses, recommending necessary surgical procedures less often, and so on — I was in no position to make up my own mind on the basis of the available evidence. Like most Americans, I do not turn to the New England Journal of Medicine for light reading. But even if I did, I am probably incapable of conducting the sort of statistical analysis necessary for making sense of the study’s findings. The fact of the matter is, where scientific discovery is concerned, the non-scientist has no choice but to accept what he hears on authority.

The problem is, not all authorities are good ones, a fact which was amply demonstrated in the case of the Georgetown University study. Six months after the study was first released, the New England Journal of Medicine ran a lengthy rebuttal of the Georgetown team’s findings. It now appeared that these findings were based on an intentionally misleading interpretation of the data. In particular, the study encouraged "the mistaken impression that blacks had a 40 percent lower probability of referral than whites, whereas, in fact, the probability of referral for blacks was 7 percent lower." "These exaggerations," the rebuttal’s authors concluded of the Georgetown study, "serve only to fuel anger and undermine the trust between physicians and their patients." As if that weren’t enough, the editors of the New England Journal of Medicine apologized in the same issue for not submitting the original study to a more thorough review before publication. Needless to say, the study’s exposure as a fraud, in contrast to the study itself, got almost no attention from the major media.

According to Sally Satel, a practicing psychiatrist and lecturer at Yale University School of Medicine, the story of the Georgetown study is typical of the increasing politicization of American health care. In their eagerness to reach the politically agreeable conclusion that health disparities between blacks and whites (and these disparities do exist) are a function of racism, the Georgetown study’s directors proved themselves all too willing to sacrifice basic standards of scientific validation. In their eagerness to report the scandalous conclusions which the Georgetown study seemed to authorize, the major media accepted these conclusions as hard fact and in the process failed to ask the sort of questions which might have led to a more balanced view. In Satel’s view, this is in miniature a story which has happened time and again in recent years. Convinced that, in the words of one prominent activist, "the practice of public health is the process of redesigning society", a growing number of doctors, patients’ groups, and public health experts have come to demand that medical science be put in the service of a specifically left wing social agenda. As Satel warns in her new book, P.C., M.D.: How Political Correctness is Corrupting Medicine, the efforts of these "indoctrinologists", if allowed to go unchecked, threaten to do more than just upset the culture of the medical establishment — they will also jeopardize the health of millions of Americans.

To a degree, this is already happening. Over the past few years, a number of widely disparate groups have launched a campaign to prove that social oppression in one form or another is a primary cause of illness. These groups include former psychiatric patients who, referring to themselves as "consumer survivors", blame mental illness on the psychiatric profession itself, nursing associations which, resentful of what they regard as the patriarchal structure of the health care industry, have come to endorse a variety of wholly unscientific New Age therapies, and the field of "multicultural counseling" which, with the support of the major American counseling associations, practices a form of psychotherapy that locates all disorders in the racial oppression experienced by minority patients. In these and other groups, a concern for social justice, born of the civil rights movement a generation ago, has increasingly come to displace more traditional commitments to the health of individual patients.

In many cases, the political commitments of health care activists are more than distracting — they are positively harmful. It is a claim to which Satel returns time and again. "Though the activists appear to be waging ‘the good fight’ for better health care through social justice," she writes, "their actions do not prevent disease, treat symptoms or perfect clinical methods. At best, they create distractions and waste money; at worst, they interfere with effective treatment." The drive to force the health care establishment to recognize social oppression as a source of illness is not, in other words, just another dry academic debate pursued by disgruntled scholar-activists. It is also bad science. As such, it constitutes a threat to the well-being of those who have no choice but to put their trust in the health care profession.

Were they not so disturbing for what they say about the direction in which contemporary health care is moving, many of Satel’s anecdotes would be simply funny. Some of the best of these are to be found in Satel’s discussion of post-modern nursing. In an effort to undermine what they regard as the sexually oppressive atmosphere of most hospitals, a number of prominent nursing associations encourage their members to become doctors in their own right through the practice of New Age therapies. One such therapy is "Therapeutic Touch" (or "TT") in which the practitioner waves his hands over the body of the patient in an effort to "adjust the patient’s human energy field". Though TT has recently become a popular subject of instruction at nursing schools, it has never been tested and is not recognized by doctors as a legitimate or effective form of therapy. As a result, nurses practice TT only when the doctors aren’t looking and, as often as not, on unconscious patients. The consequences have been predictably absurd. In one case, "a patient was so startled by the hand-waving of a TT practitioner that he fell out of bed and broke his arm." In another, "a woman with abdominal pain went to a TT nurse who had a private practice. The nurse recommended TT treatments only, and the woman died of complications from a ruptured appendix a few days later."

But, as Satel argues, politically correct medicine has had its most dire consequences in the realm of public policy. The case of South Carolina is in this respect representative. Faced with a growing epidemic of crack cocaine, in the spring of 1989 a number of nurses and doctors convinced the state attorney general to implement a new policy: pregnant mothers whose blood tests revealed that they had used cocaine during their pregnancies could be arrested and charged with child neglect. Though it was no doubt a radical step (too radical for the policy’s many critics), the South Carolina policy was responding to a real crisis. In the space of one year alone, 119 pregnant women had shown up at Charleston’s Medical University’s emergency room with cocaine in their blood. Ten of these miscarried and the remaining 109 were still using cocaine at the time of delivery. Once implemented, the policy seemed to work. In the year or so after it was announced, the number of pregnant women who screened positive for cocaine declined by 75 percent. In part, this may have been a reflection of a slowly abating rate of cocaine use in the ghettos of inner city Charleston. But in part also it was surely a response to the well-advertised new policy.

Despite the policy’s success, civil rights leaders were up in arms. According to them, by criminalizing addiction, the policy victimized mothers (never mind the babies, who were of no interest to the civil rights community). Worse, civil rights attorneys argued in the legal case which inevitably followed, the new policy was a form of racial discrimination. Since most of the affected mothers were black, they charged that the policy unfairly penalized their addiction. An absurd claim, to be sure, since the policy was applicable to white and black mothers alike. But in no time at all, the Federal government had stepped in. Fearing that the law suit would lead to further protests, Federal regulators threatened to discontinue funding of the Medical University if it did not immediately put a halt to the practice of testing mothers for drug abuse. With 60 percent of its budget on the line, the administrators of the Medical University had no choice but to comply. As a result, hundreds of additional crack babies (who any number of studies have shown are severely affected by their mother’s addiction) are today growing up on the streets of Charleston. Perhaps the only people to benefit from the law suit were the civil rights lawyers themselves. Once again, politics had trumped health concerns.

Given the scope of her discussion, it comes as no surprise that P.C., M.D. has made lots of enemies. While the reviews in the conservative press have been enthusiastic, the liberal press (with the strange exception of the New York Times) has had little good to say of Satel’s book. Typically, Satel’s critics have accused her of equivocation: while supplying good reasons to be skeptical of the claims of "indoctrinologists" in the health care establishment, she rarely asserts that their arguments are entirely without truth. But this often-repeated criticism misses the point. Satel’s even-tempered and judicious assessment of the arguments made by those more interested in dealing with social oppression than public health is one of the greatest virtues of her book and a model of scientific rigor. As Satel’s finely discriminating arguments recognize, the truth is never easy and rarely comes all at once. In this respect, she provides a welcome example of how science (and politics) should be done. The medical profession — as well as the rest of us — would do well to follow it.