There is no denying that we have all had a very hard few years.

I want to preface what I’m going to write with that acknowledgment. What I want to say needs to be contextualized with the fact that we have collectively experienced an incredible amount of stress and trauma. And we are doing the best we can.

The effects of collective trauma are well documented. We have studies on the crippling PTSD experienced by veterans, the long-term effects of the 9/11 tragedy in the United States, and evidence of ongoing mental suffering in children who lived through school shootings (1). I imagine that the psychological effects of the COVID-19 pandemic will soon join this body of research.

However, some reactions to this pandemic have given me pause. The only reason I can fathom for the dogmatic black-and-white views I have witnessed is that many are thinking and acting from a place of extreme fear.

Reason, cooperation, and critical thinking (that lead to optimal outcomes) seem to have decreased as our terror and confusion have increased.

I’ve started to consider the role of privilege in medical dogmatism. The image below illustrates how I visualize the extreme viewpoints I’ve witnessed from those who put blind faith in conventional medicine, as well as those who put blind faith in “alternative” interventions (or in the strength of their individual health).

In my experience, both extremes tend to be unwavering and vocal, with unexamined biases that may endanger themselves and others. However, the unwritten script of each group is that their views are concretely correct while the “others’” views are abjectly incorrect.

I put others in quotation marks to signify the mental act of “othering”—one group does not view those with differing opinions as other people with valid experiences and the wildly varied and unpredictable views held by individuals, but rather as an entity defined by assumed political affiliation, worldview, level of scientific literacy, or even gender or race. This othering furthers the divide between extremes and contributes to the inaccuracy birthed from a black/white, either/or vantage.

This dogmatism, represented in politics, media, social media, and public policy, leads to more harm. It blocks our ability to see the full picture of what is possible. It colors our perceptions and stands in the way of sorely needed solutions, both in the realms of public and personal health.

And, as previously stated, it is at least partly rooted in privilege. A person, or group of people, who have not been failed, harmed, shamed, or discounted by their doctor or surgeon have experienced an advantage. They have been fully supported by the prevalent medical model and haven’t needed to seek further interventions for unsolved symptoms. And, to be clear, this is fantastic!

However, with this advantage comes a lack of awareness of the experience of being failed or harmed in the conventional model and the feelings of exhaustion and distrust this breeds. For instance, those with mitochondrial disorders see an average of 8.19 clinicians before obtaining an accurate diagnosis (2). Additionally, it is well documented that women and people of color often righteously feel discredited by their medical caregivers (3,4).

how privilege leads to medical dogma

On the other side of this same coin are those who have the privilege of robust health and/or the socioeconomic means to rely on often expensive dietary, supplemental, or lifestyle solutions. Stable health—a body that does not need consistent support from specialized blood tests, medications, or procedures—offers an incredible advantage. Similarly, stable financial standing offers wellness opportunities barred to anyone not able to pay. Again, these are wonderful gifts.

But, along with these gifts comes a lack of awareness of the experience of mandatory medical reliance, or the inability to afford alternative care. Those who are physically vulnerable sometimes rely on the conventional model for their quality of life—they have no other option.

Health dogmatism is fueled by these unconscious biases, combined with the suppositions they encourage. Does mainstream medicine provide life-saving care AND also fail some people, or even harm them? Yes. Both of these things are true.

Ultimately, this privilege intersects with social justice. Are we willing or able to take steps to protect those who aren’t as rich in resources, be they health or money, as we? How can we better understand situations that aren’t our personal experiences? What does it mean to actively care about each other as human beings?

How can we use social justice ideals to pull us out of these binaries?

My hope is that we can respect others’ choices as much as we respect our own and that we can begin to see our way out of dogmatism. I believe we are capable of kind, logical, and rational conversations. Regardless of what people choose, we must recognize the significance of the freedom and empowerment we have each exercised in making autonomous choices along the way—and why collectively supporting our own and each other’s ability to make free choices is at the very heart of a civilized society.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907712/
  2. https://ng.neurology.org/content/nng/4/2/e230.full.pdf
  3. https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care
  4. https://time.com/6074224/gender-medicine-history/