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Saturday, December 19, 2020

Humans are evolving into sea slugs

The spread of the self-esteem movement into medicine could disrupt its alliance with science

S ome people still believe that political correctness is nothing more than pretending things are true that are really not to spare people's feelings. The plausibility of that belief has been shat­tered by the demand that we now accept and celebrate the pretense—or else.

The latest example can be found in an editorial in The New England Journal of Medicine (thank heaven for little paywalls) that demands that we remove sex from birth certificates so as not to create distress for those who, for whatever reason, believe they are the wrong biological sex. The authors write:

[A]ssigning sex at birth perpetuates a view that sex as defined by a binary variable is natural, essential, and immutable. Participation by the medical profession and the government is often used as evidence supporting this view.

There is no other word for this: it is biology denialism. Sex is binary, natural, essential, and immutable, and pretending otherwise will not change it. Nature does not care whether we believe it or not, any more than it cares whether humans survive or evolve into sea slugs.

Cthulhu's birth certificate
Cthulhu's birth certificate

Pretending things are as we'd like them to be may make people feel better about themselves, but it also means that anyone who disagrees with them is threatening their self-esteem: “erasing” them. Words then become violence, and silence—i.e. lack of praise—also becomes violence. Pointing out that these beliefs are contradictory is also violence. Believing that contradictions violate logic is, per­haps, racist, colonialist, or sexist or maybe all three. We weave a tangled web when we deny reality.

It might be argued that birth certificates are just government documents that no one actually reads, not even those mythical ubiquitous Russian hackers, so why not put false information on them if it makes people happy? If a legal document contains false information it has no value and we should eliminate it altogether. I'd support that—in fact, it can be argued that the entire government, which has grown fat on falsehoods, should be abolished—but the issue is not about government documents. It is about severing the connection between medicine and science. It is a power grab by the self-esteem brigades.

Science and medicine are a powerful combination: human health provides a sense of direction that science needs, and science provides a grounding for medicine in facts. But because medicine faces the public, it is under greater pressure to deny reality to benefit patients' self-esteem.

Everyone talks about a crisis in science, but medicine is in crisis too. Physicians spend much of their patient time typing on their computer instead of listening to the patient. They have a fixed repertoire of questions and tests selected to identify the most serious illnesses. Meanwhile they ignore the complaint you came in with and misdiagnose you on the serious ones. As a result going to a doctor is like going to a sale at Macy's: you go in looking for a lampshade and you end up buying a couch, two TVs and a Barcalounger. You then find that those items are backordered and you still don't have a lampshade.

Making diagnoses on the basis of probability may be a side effect of defensive medicine, but eliminating facts from medicine is not the solution. Throughout history the worst medical scandals—psychosurgery, eugenics, and many others—illustrate what happens when medicine is divorced from scientific fact.

Maybe in the eternal scheme of things it is a small matter: I am convinced that humans are slowly evolving into sea slugs. It may be hard to tell by looking at them, but sea slugs are very happy creatures. They move wherever the tide takes them, they can go to the beach whenever they want, and they feel great much of the time. And increasingly that's all that seems to matter.

dec 19 2020, 5:43 am

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