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The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

No Politics in the Exam Room?

February 21, 2019

by D. Joy Riley MD, MA (Ethics)

One of the many reasons I entered the medical field was because I innocently thought medicine was apolitical. It did not take very long to see—even as a medical student—how very wrong-headed that idea was! So it was with some surprise that I read recently in the Journal of the American Medical Association (JAMA) the article about Leana Wen, MD, entitled, “New Planned Parenthood President: No Politics in the Exam Room.”

Dr. Wen is presented as an attractive, young, intelligent and driven woman in the article and its accompanying photo. Her’s is the story of a poor immigrant ascending the ladder of success in record time. The article is replete with details of her accomplishments. That is not all, as there is also an edited version of an interview with her. Her philosophy and political opinions come through loudly and clearly. In fact, the manipulation of language in the article is positively Orwellian.

In 1946, Eric Arthur Blair, otherwise known as George Orwell, penned an essay that speaks to our time as well as his own: “Politics and the English Language.” He wrote it to counter the “half-conscious belief that language is a natural growth and not an instrument which we shape for our own purposes,” claiming that “it is clear that the decline of a language must ultimately have political and economic causes….”

Orwell’s essay came to mind as I read Dr. Wen’s interview. A comparison of the two is instructive. Indeed, Dr. Wen’s interview should not be read without juxtaposing it with Orwell’s essay. It is Orwell who provides the key for our understanding of not only Dr. Wen’s interview but also the entire JAMA article. What follows is a comparison of quotes from Orwell and Dr. Wen, to be read in the context of traditional Hippocratic medicine.

The traditional Hippocratic Oath included these ethical duties to patients:

  • Use treatment to help the sick, never to injure or wrong them.
  • Give no poison to anyone though asked to do so, nor advise such a plan.
  • Give no pessary to cause abortion.
  • In purity and in holiness to carry out the practitioner’s life and art.

In other words, for millennia, abortion has not been considered “healthcare.”

Quote Set 1
Orwell
“In our time, political speech and writing are largely the defense of the indefensible. Things like the continuance of British rule in India, the Russian purges and deportations, the dropping of the atom bombs on Japan, can indeed be defended, but only by arguments which are too brutal for most people to face, and which do not square with the professed aims of the political parties. Thus political language has to consist largely of euphemism, question-begging and sheer cloudy vagueness. Defenseless villages are bombarded from the air, the inhabitants driven out into the countryside, the cattle machine-gunned, the huts set on fire with incendiary bullets: this is called pacification. Millions of peasants are robbed of their farms and sent trudging along the roads with no more than they can carry: this is called transfer of population or rectification of frontiers. People are imprisoned for years without trial, or shot in the back of the neck or sent to die of scurvy in Arctic lumber camps: this is called elimination of unreliable elements. Such phraseology is needed if one wants to name things without calling up mental pictures of them. Consider for instance some comfortable English professor defending Russian totalitarianism. He cannot say outright, ‘I believe in killing off your opponents when you can get good results by doing so.’”

Dr. Wen
“One of the first things that I did is launch this national awareness campaign. This is Health Care emphasizes that the work that we do at Planned Parenthood, and more broadly the work of reproductive health and women’s health care, is standard medical care.”

In a different interview reported in January 2019, Dr. Wen is quoted as saying, “The last thing I would want is people to get the impression that we are backing off of our core services.” She also said, “What we will always be here to do is provide abortion access as part of the full spectrum of reproductive health care, it’s who we are….”

Meaning
Tearing apart a child in the womb, limb by limb and piece by piece, is healthcare. It is part of women’s healthcare and reproductive healthcare, according to leaders (new and old) of Planned Parenthood. In their most recent annual report, Planned Parenthood reported 332,757 abortions in the U.S. And, according to a number of leaders (political and otherwise), abortion is not only legal but also laudable from conception until, and even beyond, birth.

Quote Set 2
Orwell
“All issues are political issues, and politics itself is a mass of lies, evasions, folly, hatred, and schizophrenia….”

“Political language—and with variations this is true of all political parties, from Conservatives to Anarchists—is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.”

Dr. Wen
“We should not let politics enter the exam room.”

Meaning
Let’s ignore the role politics plays in the exam room.

It should be noted that Planned Parenthood has three national committees involved in federal campaign work: Planned Parenthood Action Fund, Planned Parenthood Action Fund PAC and Planned Parenthood Votes. The last committee listed spent $22 million during the 2016 election. Dr. Wen is employed by Planned Parenthood; there has been no announcement that she is serving without pay by this publicly-funded entity. We should not be deceived. Politics has more than entered the exam room. Politics built the Planned Parenthood exam rooms. Politics sustains Planned Parenthood. If politics were removed from Planned Parenthood, pink hats would be replaced with pink slips.

What can we do? With regard to our own speech and writing, Orwell had some good suggestions for his readers:

  1. Never use a metaphor, simile or other figure of speech that you are used to seeing in print.
  2. Never use a long word where a short one will do.
  3. If it is possible to cut a word out, always cut it out.
  4. Never use the passive where you can use the active.
  5. Never use a foreign phrase, a scientific word or a jargon word if you can think of an everyday English equivalent.
  6. Break any of these rules sooner than say anything outright barbarous.

With regard to our reading, I would add another corrective. If someone winks at the murder of innocents, do not think that truth will escape unscathed. It is always wise to ask ourselves:

  1. What is the person saying?
  2. What is the person not saying?
  3. What do the euphemisms being used actually represent?
  4. What would this look like in plain English?

In plain English: Abortion does not cure disease. Abortion brutally severs a mother from her child—permanently. Abortion brings money to the abortionist and his or her institution. Repeat abortions bring repeat payments to the abortionist and his or her institution. Abortion reduces babies to human tissue. The abortionist provides human tissue for researchers—at a price. This is not Mother Teresa and the Missionaries of Charity. Abortion is a business. Abortion is not healthcare.

D. Joy Riley MD, MA (Ethics)

D. Joy Riley MD, MA (Ethics)

Dr. Riley is executive director of The Tennessee Center for Bioethics & Culture and serves on the ethics committee of a Nashville-area hospital. Board certified in internal medicine, her writing and lecture topics include medical ethics, organ transplantation ethics, stem cell research, genetics, end-of-life issues and assisted reproductive technologies. With Scott B. Rae, she co-authored Outside the Womb: Moral Guidance for Assisted Reproduction, and with C. Ben Mitchell, Christian Bioethics.