If Obama’s nominee for the position of Surgeon General, Vivek Murthy, is not endorsed by the Senate because Senate Democrats from conservative states are too scared to vote for him for fear of losing votes from a population, egged on by the National Rifle Association (NRA), that passionately supports firearms, the first words that come to mind are ‘unfortunate,’ ‘tragic’ and ‘daft,’ although not in that particular order.
Words that do not come to mind are ‘surprising’ or ‘unprecedented.’ This is the natural result of decades of actively encouraging science to mix with politics.
In an ideal world, or I should say reasonable world, noting that perfection is not a pre-requisite to being reasonable, it would scant matter what Murthy thought about firearms.
He would be judged on his (impeccable) credentials, (unmistakable) leadership, and (imaginative) entrepreneurship not to mention his gumption in standing up for what he believes.
It would, of course, be utterly naïve to believe that in the real world his politics do not matter.
I doubt Murthy would have advanced so precociously, let alone been nominated for the position of Surgeon General, if he were a second amendment absolutist, an implacable limited government advocate or had written extensively about the role of free market in healthcare, all things else being equal.
We applaud him for standing up for his convictions not just because of his standing up but for the nature of his convictions.
This is not to suggest that Murthy’s worldview is expedient. There’s no reason to doubt its sincerity. It’s to suggest that a certain weltanschauung is incompatible with progress in academia and beyond.
That’s because despite living in an age of unprecedented reason we have been unable to render unto science what is unto science and render unto politics what is unto politics, a distinction our species has made little progress in making in the last two thousand years.
The NRA have, no doubt, gleefully taken advantage of the mental labor required to make the distinction between science and politics but, to quote Billy Joel, they did not start the fire. It was always burning.
If anyone has a picture of a non-tenured liberal arts professor flaunting a T-shirt sporting the Gladstone flag or “Romney-Ryan 2012” please submit it to Sotheby’s. It’ll fetch millions in the auction. No, pictures of professors wearing “Hope and Change” T shirts are dime a dozen, don’t bother auctioning them.
What business does politics have in the methodological inquiry of physical, biological and social sciences?
If you do not believe that minimum wage may lead to unemployment it tells me nothing about your ability to undertake hypothesis-based research, understand the results of research and apply science efficiently for the greater good (I can predict your voting pattern with some accuracy though, and perhaps where you shop for food).
Academia and science have become fiefdoms, the playground version of “in crowds”. “To join us, you don’t have to be beautiful but just have the correct worldview and wear the right T shirt”.
As if the immunology of the next vaccine that might need to be developed en masse for an epidemic of a mutant virus cares very much whether its developer subscribes to the Keynesian or Hayekian school of Economics.
A counter response to the above is that it is surely not possible to be an effective public health leader and not espouse a political view that heavily favors collectivism, or new liberalism.
Perhaps in ethos. But public health leaders may occasionally have to call upon the market, such as when an urgent need of a new vaccine arises. Its leaders need to be aware of the potential of the market in such circumstances. A staunch anti-capitalist might conceal this awareness in an ideological blind spot.
Public health leaders will be more effective when they acknowledge human nature, the nature that defines the limitations of ambitious public health programs. The jaundiced constrained view of mankind, held by many conservatives, is arguably more realistic than the dreamy utopian view which correlates highly with new liberalism.
This is not to suggest that conservative worldview makes better public health leaders, merely that any form of ideological dogmatism is ultimately counterproductive to the running of programs that require mass co-operation and co-ordination.
A more pertinent question is what exactly is the NRA fearing? Murthy’s view is hardly radical, even less so after the massacre of the school kids in Newton, Connecticut. Legislating gun control is not in the provenance of the Surgeon General of the US. Surely, the NRA with all its hyper lobbying must know that.
The whole episode is frustrating at so many levels. It’s tempting to lay the entire blame at the feet of the NRA. But this episode is merely a symptom of a wider problem: our utter, total, dismal, lethargic failure in keeping politics from crossing the threshold of science and academia.
Murthy is not the only casualty of this admixture, nor will he be the last.
As someone who cares little for either of the US’s political wings or useless labels, I must say this mix is remorselessly dull as well.
Here is a request for the next Surgeon General of the United States. Please place this message on billboards: “Listen up America’s Right and Left: Mixing Politics with Science is Injurious to Public Health.”
Saurabh Jha, MD (@RogueRad) is an Assistant Professor of Radiology at the University of Pennsylvania. His scholarly interests include the value of imaging and dealing with uncertainty in clinical decision making. Jha views most problems in medicine as problems of imperfect information. He trained in the UK and migrated to USA for more predictable weather and a larger yard.
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Legacy, I might, grudgingly, have to agree with you.
I believe that practicing physicians should, for the most part, stay out of politics, particularly issues like; guns, abortion, marijuana, etc. That is not to say that these are not worthy of study by public health issues, but a MD in practice shouldn’t be an advocate for any particular policy on a controversial topic.
I think we kid ourselves if we think that our patients care that much what we think about guns, anyway. To most of them (and frankly to me) it is not a medical issue. “Doc, just shut up and write the prescription” is probably what is going through some of their minds when we lecture them about guns.
Reading through a doc only message board (Sermo) I found some interesting things:
1) There are doctors (don’t know what percent) that don’t believe in the theory of evolution.
2) There are many pro gun docs – particularly in the heartland.
3) There are some docs (although not many pediatricians) that don’t believe in vaccines!
So before we start lecturing patients about guns, perhaps we need to get our “medical facts” straight!
The relevance of SG is a different discussion, and not one I have actively formed an opinion on. But as it stands the post exists.
I don’t care much for political labels. In fact I lament there are not many more liberal arts professors flaunting conservative view points.
The public health consequences of smoking transcend politics, which is more or less my point.
For that matter if Murthy was a neocon, and lost the position because noisy liberals did not like his stance on foreign policy, I would still defend him.
The SG’s only meaningful job is to express views so your dismissal of my concern is completely illogical. If this was a conservative nominee pinched by liberals because of his or her views on sex education in schools would you have leapt to his defense?
It is time to do away with this post because all it does is provide a veneer of independence through which (this or any other) administration can flog political issues while attempting to claim scientific objectivity. The office is a polarizing waste of taxpayers’ resources at a time when we need to find ways to minimize the former and conserve the latter. Getting rid of the entire SG apparatus would save a small amount of money in real dollars but the symbolic value would be huge.
Be that as it may Vik, views on gun control counts as one of the most ridiculous reasons for being pipped at the post.
The position of Surgeon General is an obsolete anachronism and not only did this nomination deserve its end, I’m hopeful the position remains unfilled in this administration and beyond. No occupant since C. Everett Koop has had the guts to take stands unpopular with his or her own political party. The office’s research capacities make no unique contribution that other federal agencies cannot make equally well.
Having no regulatory or enforcement authority, the SG is left only to some element of moral suasion, but in reality the occupants are just political hacks, with all the smarmy, unctuous skills that the Ivy League and other elite academic institutions can impart.
Ummmm…isn’t the surgeon general a political appointment?
And that by itself should invalidate this headline and story.
Hmmmm.