The editors of the NEJM can restore the publication’s reputation as a sober source of important medical information rather than one with ‘soul.’
The New England Journal of Medicine still publishes objective scientific articles. But in the last decade-plus, it is just as notable for its hard left political opinion pieces about issues ranging from climate change, to race relations, to promoting “equity” (as distinguished from equality), to gun control, to supporting transitioning gender-dysphoric minors, and more.
Debra Malina, Ph.D., the first and so far, only “Perspectives” editor — an opinion section where most of the woke political screeds published by the NEJM are placed — is retiring. She has written a swan song piece taking credit for bringing blatant politics to the pages of the NEJM.
Malina writes that when she took the job, she had been hoping to obtain a tenured university position in English literature. Well, that explains a lot, doesn’t it? Then, she brags about politicizing the Perspectives section:
The Perspective section was conceived as a treatment for the systemic condition that an editorial board member (since dubbed the Godfather of the Perspective Section) had diagnosed: “The Journal has lost its soul.” Although I am neither a physician nor a spiritual healer, I like to believe I’ve done my part to remedy that ailment. Over the past 23 years of soul searching, our small but mighty Perspective team has cultivated a broad view of the contexts in which medicine and health care develop, live, function, and contribute and the benefits (to doctors, patients, and society) of physicians understanding these contexts and factoring them into their work.
Having weathered a fair amount of pushback over the wisdom of stretching the Journal’s purview beyond its objective biomedical limits (I was told with some regularity early on that I was going to destroy the reputation of the Journal) and survived to tell the ever-expanding and enriching tale (with Journal reputation still seemingly intact), I hope I am leaving the NEJM audience a tad more well-rounded, savvy, thoughtful, curious, and humane than I found it.
“Stretched” is a polite way to put it. Under her watch, the NEJM became blatantly ideological, which severely undermined its reputation among a broad swath of the public as an objective source of expertise — and based on what medical professionals who contact me when I write about the woke virus that has infected medical journals tell me — from a significant number of doctors, too. In this sense, it has become a “consider the source” source — even as its editors and opinion writers gripe cluelessly about lost public trust in health institutions and the “experts.”
Malina blames everyone but herself and her ilk for the politicization of medicine:
Though I believe that health care is in some ways intrinsically political, the recent intentional and misguided politicization of various health issues has at times challenged the Perspective team to more explicitly stake out medicine’s moral, ethical, and social ground. I have embraced this responsibility, despite the occasional threats of abandonment by readers whose ground looked somewhat different from ours (or our authors’). In this fraught endeavor as in everything else, I have deeply appreciated working with smart, thoughtful, committed, collaborative colleagues able to debate serious topics, sometimes passionately, without losing their sense of humor.
Well, I guess driving a car into a ditch can have its humorous side. But really, physicians, bioethicists, lawyers, and English Ph.Ds. who have pushed Perspectives hard aport, heal thyself!
It wasn’t always like this. One of the most important opinion pieces about medicine ever written was published in the NEJM in 1949. In “Medical Science under Dictatorship,” Leo Alexander, M.D. — the head medical investigator of the Nuremberg Trials — wrote about how eugenics thinking had poisoned German medicine and warned that a creeping utilitarian ethic was infecting American medicine, too:
Gradually, in all civilized countries, medicine has moved away from this position, strangely enough in direct proportion to man’s actual ability to perform feats that would have been plain miracles in days of old. However, with this increased efficiency based on scientific development went a subtle change in attitude. Physicians have become dangerously close to being mere technicians of rehabilitation. This essentially Hegelian rational attitude has led them to make certain distinctions in the handling of acute and chronic diseases. The patient with the latter carries an obvious stigma as the one less likely to be fully rehabilitable for social usefulness. In an increasingly utilitarian society these patients are being looked down upon with increasing definiteness as unwanted ballast. A certain amount of rather open contempt for the people who cannot be rehabilitated with present knowledge has developed. This is probably due to a good deal of unconscious hostility, because these people for whom there seem to be no effective remedies have become a threat to newly acquired delusions of omnipotence.
Would we ever read such a clear-eyed clarion warning in today’s NEJM? Some of the proposals promoted in its pages even outside of the Perspectives section — like advocating for death by organ harvesting where euthanasia is legal — would appall Alexander were he still with us today.
With Malina heading into retirement, the editors of the NEJM can restore the publication’s reputation as a sober and focused source of important medical information rather than one with “soul.” First, the next Perspectives editor should not be an English major or a progressive ideologue. More to the point, I would hope the editors of the NEJM will keep it completely out of politics, or at least public policy controversies that do not have a clear medical or public health nexus. That may not be as much fun as attacking Trump policies, but it is certainly more in keeping with the important public role of a respected medical journal.