2021 in review: Medical schools' push for social justice health care

Campus Reform reported this year on medical schools’ embrace of social justice ideas and woke terminology. 

These ideas have gained momentum in higher education and often influence professional associations with links to the academic communities. 

In November, Campus Reform reported on several of America’s leading medical institutions joining an “Anti-Racist Transformation in Medical Education“ program. 

The program’s $377k price tag is funded by the Josiah Macy, Jr. Foundation, which believes that health professional education needs a “strong social mission” and often funds diversity, equity, and inclusion programs. 

Top medical organizations have also shifted to focus on social or so-called health justice. For instance, the American Medical Association (AMA) recently advocated for the removal of sex as a legal designation and referred to racism as a public health threat.

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In August, Campus Reform reported that the AMA publicly stated its intention to “advocate for the removal of sex as a legal designation on the public portion of the birth certificate” in the interest of “protecting individual privacy and preventing discrimination.”

Also in 2021, the AMA partnered with the Association of American Medical Colleges (AAMC) to publish a language guide, Campus Reform reported in November, wherein medical professionals and students are told to remove the words “handicapped,” “morbidly obese,” and “homeless” from their vocabulary.

The AAMC has also concerned itself with dismantling racism and police brutality in America. Its focus on matters of social justice led the organization to create a Center for Health Justice to address health inequities. 

The AAMC states the center will “align and augment the efforts of the nation’s medical schools, teaching hospitals, research institutions, and other local and national organizations to enhance health equity through community collaboration” in the name of health justice.

Similarly, in October, the American Psychological Association wrote an open letter of apology to people of color for “Promoting, Perpetuating, and Failing to Challenge Racism, Racial Discrimination, and Human Hierarchy.” 

One year prior to this apology, students at the University of Pittsburgh School of Medicine created a new Hippocratic oath, which reads, “We start our medical journey amidst the COVID-19 pandemic and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery.”

The social-justice-oriented oath was recited by UPenn students along with the traditional oath, which is a Greek medical text. 

Popular publications, including Scientific American, have endorsed this sentiment. For instance, in a 2018 op-ed, Angira Patel called for “More Physicians to Embrace Advocacy.” 

“As students begin medical school, we must introduce the theory, practice and modeling of physician advocacy at the same time they are learning basic anatomy and physiology,” said Patel. 

While Patel admits “physicians are trained to be objective and apolitical,” she argues that advocacy is not only meant to exist in policy and politics. Rather, physicians should look past scientific objectivity in their work.

Patel, who is an associate professor of pediatrics and medical education, pediatric cardiologist, and director of the McGaw Bioethics Clinical Scholars Program, mentions her own school’s health equity and advocacy curriculum. 

Although personalized Hippocratic oaths have existed for years, they have morphed into non-medical oaths and strayed from the original Greek values. 

A 2004 report published in Academic Medicine says, “Growing attention to and interest in medical oaths and oath taking has led to the use and creation of non-Hippocratic oaths, oftentimes authored by medical students and/or clinical faculty.”

The researchers suggest the adoption of numerous “boutique” oaths may “lead to fragmentation and confusion about the ethical values of the medical profession and, thus, dilute the value of a professionally binding oath.” 

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From language guides to medical oaths, changing objective classes to be subjective alters the purpose and effectiveness of medical education. 

While integrating social and political advocacy roles in professional spheres is increasingly popular, some medical professionals are speaking out against the changes. 

“If the medical profession becomes politicized, even on behalf of ends such as social justice or health care access for all, the world will not thereby be a better place—as the medical profession has no special authority or insight into what is demanded by justice or how far societal resources should support communal health rather than other priorities,” Dr. Thomas Huddle wrote in a paper published by Academic Medicine. 

“It will be a worse place—as mandatory medical engagement with politics will displace real medical work, which is the only contribution of medical professionals, as such, to societal betterment.”

In an interview with Campus Reform, Dr. Huddle said, “Many misconstrued it as an argument against physician advocacy full stop rather than what it was: an argument that advocacy ought not to be construed as a professional obligation, as part of the physician’s task.”

The issue lies not with medical professionals and students expressing social and political ideologies in their personal lives, but rather with it encroaching on their practice and studies, Huddle argues. 

In June, Campus Reform reported that the Journal of the American Medical Association had witnessed two resignations within three months after its staff members were embroiled in controversy for doubting the concept of “structural racism.” 

“The problem (it is a problem in my view) is now much worse, with CRT inspired material increasingly becoming parts of curricula and dissenters finding themselves at professional risk if they raise their voices,” Huddle said. “We in medicine run the risk of discrediting professional authority in its legitimate sphere by pressing it where it does not belong.”

Other professionals, like Dr. Richard Bosshardt, considered leaving medical organizations after noticing a shift in purpose and focus. After 28 years as a Fellow of the American College of Surgeons (ACS), Dr. Bosshardt announced his dissatisfaction with the college. 

When speaking to Campus Reform, Dr. Bosshardt said, “I have been accused of being clueless regarding race issues because I am not black and, worse, some have implied that I am racist because I have challenged the ACS on this issue.”

Campus Reform reached out to every individual and institution named above. This article will be updated accordingly.