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IT has been a tough year so far and the word “unprecedented” has become part of our daily vernacular in 2020.
Unprecedented bushfires, an unprecedented global pandemic, and now unprecedented protests against systemic racism and police violence are occurring worldwide. It is only June and so far we have watched over 17 million hectares of bushland burn across Australia, watched in fear as a new virus has crippled health, social and economic systems around the globe, and now we are hearing, re-living and mourning the story of yet another Black death in custody.
The notion of “being in this together” has become a common catchcry to rally the community through weathering these events. In January, our Prime Minister Scott Morrison told us that “Australia was coming together” in responding to the bushfires. In Victoria, during the COVID-19 pandemic we have been told that “Staying apart, keeps us together”.
Coincidentally, “in this together” was the theme for this year’s National Reconciliation Week which ended earlier this month. Reconciliation Week’s organising committee decided on promoting “togetherness” well before the 2020 rollercoaster we are on even began. Given this common thread of togetherness and in light of the Black Lives Matter protests, it is important for us to reflect – are we truly in this together?
Every year, Reconciliation Week occurs between 27 May and 3 June and is led by Reconciliation Australia. The annual themes are chosen with intention – to act as a conversation starter and to set the tone for the week. In 2019, the theme of truth telling was inspired by the Uluru Statement from the Heart and encouraged all Australians to speak truths about the history of our country and what needed to be done moving forward.
This year’s “in this together” theme was meant to see truth telling transform into actions and spark real change to truly achieve unity. Unfortunately, just like the unexpected disruptions from the COVID-19 crisis, things didn’t seem to go to plan with this year’s theme.
In the same week that we were meant to be “in this together”, major mining company Rio Tinto destroyed a 46 000-year-old significant Aboriginal site in the Western Pilbara region in WA. The site is significant not only to the cultures and connection to land for the Puutu Kunti Kurama and Pinikura peoples, and First Nations people more widely, but a significant historical site that dated back to the ice ages (here, and here).
Rio Tinto boasts an Elevate Reconciliation Action Plan (RAP) (the highest level – for organisations that have a proven track record of embedding effective RAP initiatives in their organisation) and prides itself on employing many First Nations people. Rio Tinto’s chief executive immediately apologised, not for the destruction however, only for the “distress it had caused”. This was the final blow for Reconciliation Australia, who stated that the destruction of this immensely important Aboriginal site was a “breathtaking breach of a respectful relationship” and as such chose to revoke their endorsement of Rio Tinto and suspend the company from the RAP program. This incident highlights the importance of reconciliation programs genuinely incorporating First Nations values and centring Indigenous sovereignty and self-determination.
During this same week, the voices of protesters fighting for George Floyd’s justice and for Black Lives Matter across the US, were amplified worldwide. Many Australians expressed empathy for another US Black death in custody, but were blind to the parallels between this case and the hundreds of Indigenous deaths in custody that have occurred in Australia. The hashtag #cometoAustralia was trending during Reconciliation Week, highlighting the ignorance of the situation in our own backyard. Perhaps in 2020, Australians have begun to realise that Reconciliation Week is much more than morning teas and polite conversations. Cupcakes don’t quite cut it and time for action is now. As Senator Pat Dodson said on Wednesday 10 June:
“For too long there have been nice words and good intentions, but the lack of action and commitment has not seen a reduction in deaths in custody; it’s seen an escalation in the social indicators that diminish First Nations people and diminish us as a nation.”
At the time of the protests in early June, there had been 432 deaths in custody recorded since the Royal Commission into Aboriginal Deaths in Custody concluded in 1991 and zero police convictions. The Australian protests have called for sweeping changes to the incarceration system, including increased accountability for those associated with it, predominantly police. Every state and territory in Australia held protests and marched in collective solidarity for the Black Lives Matter movement. They marched for action on Indigenous deaths in custody while also acknowledging the racism that continues for all people of colour in Australia. Despite this spotlight, there have been five new deaths in custody within the last week, bringing the total to 437.
These protests also coincided with ongoing COVID-19 restrictions on large gatherings which created a lot of tension across the First Nations. With regard to the COVID-19 pandemic, it is important to note that First Nations communities have been instrumental in advocating for and protecting their communities from the threat of COVID-19. First Nations clinicians, public health practitioners and researchers took early and effective action to design culturally safe and appropriate pandemic preparedness and response plans for communities. This involved a suite of responses including legislative changes to limit non-essential travel by visitors to remote communities and identification of Aboriginal and Torres Strait Islander people as a priority group in the COVID-19 response. It included health service planning, working closely with the Aboriginal community controlled health sector to scale up COVID-19 testing, staff training and expansion of telehealth services. It also involved establishing rapid testing in remote communities and expanding testing sites, infrastructure planning to provide space for isolation and quarantine in communities where overcrowding exists, improved epidemiological surveillance of cases among First Nations peoples, and a collection of targeted health promotion and communication materials for First Nations communities.
Globally, public health professionals were criticised for being hypocrites if they supported the Black Lives Matter movement while also promoting public health action on COVID-19. The media have presented the COVID-19 pandemic and the Black Lives Matters protests as competing issues, yet individuals and organisations have been quick to quash these claims, recognising that racism is an underestimated health risk that we need to eradicate. Australia’s leading public health association released a timely statement and some organisations have followed suit, expressing their condemnation of racism and support of the Black Lives Matter movement (here, and here). Thousands of Australians have shown their solidarity through fundraising and messages on social media. However, in spreading these messages, it is critical that non-Indigenous Australians “don’t speak over or for First Nations people” but rather act to amplify Bla(c)k voices by listening and sharing. (Blak is a term commonly used by Indigenous Australians to distinguish from Black American and other Black cultures.) Given the indisputable link between racism and poor health outcomes (as we have discussed before) we hope to see further support and advocacy from many more leading health and medical organisations, such as the Australian Medical Association.
If we are truly going to be “in this together” then we need to have strong non-Indigenous allies who not only speak up on racism and systemic issues, but acknowledge and use the privilege they have to act and make change. This may be as simple as taking steps to learn more about Indigenous deaths in custody and how this relates to health care (here, here, here, and here). A more active approach could involve critiquing statements and advocating for changes to policies that are detrimental to the physical, social, mental and cultural health and wellbeing of First Nations people. Our leaders and politicians need to be accountable for their words and actions and with the wealth of resources and information available, particularly from First Nations scholars, there is no excuse for making comments which do not reflect Australia’s true history. Similarly, there is no excuse for awarding politicians with a Queen’s Birthday honour for (lack of) service to the Indigenous community – millions cut from Indigenous affairs, living in remote communities described as a “lifestyle choice”, an apology to the Stolen Generations deemed unnecessary, and more.
First Nations communities have long been doing the heavy lifting and it is time for non-Indigenous allies to step up. Earlier this year, Reconciliation Australia’s Chief Executive Officer, Karen Mundine, said that:
“Australia’s ability to move forward as a nation relies on individuals, organisations and communities coming together in the spirit of Reconciliation … when we come together to build mutual respect and understanding, we shape a better future for all Australians”
Mutual respect can only be built, of course, through actions and education of oneself as well as others.
The time for nice words and good intentions is over. We are at a critical turning point and we now more than ever need “activist doctors” – doctors who can not only provide evidence-based, high quality care at the bedside, but who strive for health justice, advocate for more equitable health policies and are willing to challenge harmful systemic issues like institutional racism. We need doctors who recognise that implicit racial bias in our health care system can and does cause harm. It is imperative that we work in a way that recognises the ongoing impact of wider systemic issues in our justice, education, health, employment and housing systems on health outcomes. We all need to speak out against racism and this includes within our own profession. We understand speaking out can be challenging but choosing not to is a luxury denied to First Nations people and other minority groups. Without these conversations we cannot and will not move forward.
In Lowitja O’Donoghue’s words: “Together, we can build a remarkable country, the envy of the rest of the world.”
Dr Ngaree Blow is a Yorta-Yorta and Noonuccal, Goreng-Goreng woman living on Wurundjeri country. She is currently working as the Director of First Nations Health for medical education at the University of Melbourne, as well as completing research in the Intergenerational health team at the Murdoch Children’s Research Institute. In 2020 she has been seconded to work with the COVID-19 response team in her capacity as a public health registrar in the Department of Health and Human Resources. In 2019 she was named one of the Australian Financial Review’s “100 Women of Influence”. Ngaree is a board member of the Australian Indigenous Doctors Association and has been involved in many First Nations health, research and education roles.
Dr Alyce Wilson is a Public Health Registrar and Research Fellow at the Burnet Institute working in global maternal and child health and nutrition. She is a medical doctor with additional expertise in public health, obstetrics and gynaecology and nutrition and dietetics. Alyce also works clinically at the Royal Women’s Hospital, Melbourne, and is a lecturer in the Melbourne Medical School at the University of Melbourne. Since February 2020 she has been assisting with the COVID-19 response at the Victorian Department of Health and Human Services.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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Andrew Watkins, much as we venerate The Evidence, we have for a long time known how to craft research to generate the outcome we want: just ask any drug company.
When Michael Gove commented that “people are tired of experts”, it wasn’t just about the hectoring nannying. Evidence itself has now become politicized (as has the peer-review process that oversees it), and we should hardly be surprised: identity groups themselves push for specific e.g. feminist, indigenous, LGBT etc researchers.
Do we really imagine that the findings generated (or at least the ones that see the light of day) are ever going to contradict their narrow agendas?
That medicos are, as you say, so populous at the left-hand end of the continuum; well…. ’nuff said.
Comment from an esteemed elderly physician and pathologist ( who got run out of Berlin a few times )
“Wer kann sich darüber wundern, daß die Demokratie und der Sozialismus nirgends mehr Anhänger fand als unter den Ärzten, daß überall an der äußersten Linken, zum Teil an der Spitze der Bewegung, Ärzte stehen? Die Medizin ist eine soziale Wissenschaft, und die Politik ist weiter nichts als Medizin im Großen.”
“How can anybody be surprised that democracy and socialism have more adherents among doctors than anywhere else, that everywhere at the far left, sometimes at the head of the movement, one finds doctors? Medicine is a social science and politics is nothing other than Medicine writ large.”
Rudolf Virchow (1821-1902)
The idea that we as doctors can separate ourselves from consideration of the social determinants of health and the behaviours contributing to health outcomes is ludicrous. We have no hope of achieving behavioural / cultural change if we just blame the victim and deliver a stern moral lecture. Change is hard, takes time and is imperfect, but doesn’t happen unless one is prepared to engage with the issues, including those of inter-generational disadvantage.
The idea that bodies such as the AMA or various royal colleges should stick to their knitting and look after our self-interest is a hideous betrayal of what medicine is supposed to be about.
It is true that medicine contains a mixture of political views and religious positions, but it is a core professional duty that we keep these out of our consulting rooms and professional lives ( which include policy/advocacy). The positions taken by the AMA and various Colleges on aboriginal health, refugee health/rights , environment etc are increasingly evidence based, which is the rôle and duty of such bodies, to which we owe our privileged position in society and in political advocacy. The contract is that we should do our best for health in the wider sense and stick to the evidence. I have seen few, if any , representations by AMA / Colleges etc on directly medical issues which are not evidence based.
The same cannot be said for their representations on matters relating to the financial interests of members and the overall structure of the healthcare system, which have focused more narrowly on the self-interest of doctors
It appears that there is a substantial minority of dinosaurs, to use Sue Ieraci’s word. I would say that the dinosaurs are the only ones showing common sense and rationality in this discussion. Name-calling is merely going to stiffen our resistance to the emotional, illogical approaches proposed by some, such as affirmative action or positive discrimination. You do not correct an inequality by creating another inequality. For the record, I have supervised and mentored advanced trainees from multiple ethnic, religious and geographical backgrounds, of both genders, and have recruited several to return to my hospital as colleagues after completion of training. Any suggestion of racism against me is grossly offensive and demonstrably false. And I am proud to be called a dinosaur in this discussion; it carries the same connotations as Hilary Clinton’s “deplorables” – and we know how that turned out.
The sad thing is that there is no debate – just self righteous assertion. We have a legacy of mistreatment towards our indigenous citizens and I think all of us will support measures to make amends for the past. However calling me unconsciously racist and full of white privilege does not make me accept unsubstantiated assertions , nor does it make me feel guilty for alleged behaviours and crimes I have not committed ( but, of course, because it is unconscious bias I don’t realise what a bad person I am) . We are duty bound to treat all our patients equally with respect and from my observations most doctors try to do that. We are a profession that prides itself on logic, reason and the careful scrutiny of data. Let us have a proper debate about indigenous incarceration and deaths in custody. Are indigenous persons jailed for crimes that they did not commit or offences that do not warrant jailing? Is the rate of indigenous deaths in custody the same as non-indigenous? What types of crime are they jailed for and are the sentences comparable to non-indigenous or are they statistically different? Lets put all the relevant data on the table so that it can be assessed and analysed. I have worked with some indigenous groups and I know that bad things happen in remote communities with poor education and few job prospects. Drugs and alcohol ravage many of our citizens, not just indigenous and there appears to be the same appalling “equity of outcome” for all addicts. There are social determinants of health, but seeking to induce self loathing in the profession does not address them.
Reading this article and delving into the authors’ back catalogue have done nothing so much as stiffen my resolve to oppose the racialization of our politics and our healthcare.
To all those referring to equity in the comments, what do you actually mean?
Equity of outcome? And across which strata? How many substrata should there be? And how do these substrata intersect?
Identitarianism is rife and dreadfully counterproductive.
Now equity of opportunity is an entirely different thing, and it should be painfully clear for even the most ardent objectors to an article like this, that Indigenous Australians have not had equity of opportunity. There are righteous, just, and essential reforms and measures that should be put in place (and continually revised) until equity of opportunity is achieved. I don’t know how you do this, but I do know that people like the authors of this article are far better placed to comment on this than I. Although difficult to achieve, it is a cause worth fighting for and investing in.
However, it should be self-evident that you can support the above, whilst also rejecting the Marxist, collectivist, radical identitarianism that many people advocating for the above rapidly descend into. Comments like “our more brittle-spirited colleagues” and ” challenge the white male boomers commenting here to reflect on their inner bias” serve only to propagate this unhelpful and counterproductive narrative, and alienate those who might otherwise be allies.
Thank you for a relevant and timely article. Those dinosaurs who seek to separate medical care from “social justice” may have forgotten that socio-economic status is one of the strongest determinants of health status. Doctors have appropriately campaigned against cigarette smoking and in favour of road safety – prevention is part of our core role in promoting health.
True understanding is not about “treating everyone the same”, but recognising the inbuilt disadvantages of growing up black in Australia – where children were removed from families just because of their skin colour, within living memory. Where young people were forced to work as stockmen or domestic workers for no pay – within living memory. Where the colour of your skin sees you banned from swimming pools and other public spaces – all within living memory. Violence, incarceration and substance abuse do not occur in a vacuum.
A wise and insightful doctor understands the social circumstances that shape their patients’ behaviour and lifestyles. Those who don’t understand should seek to learn from the authors – not dismiss them.
I am saddened that some respondents here think of health, and the practice of medicine, in such narrow terms. Are you really refusing to engage with the upstream (eg racism) determinants of health that present in your individual patients? To try and argue that a medical practitioner deals with patients dealing with substance abuse and chronic disease and PTSD as distinct from the societal influences that caused this is selling the practice of medicine short and appears, as others suggested, to be someone practicing medicine in a vacuum.
And to describe public health approaches, that are drawn from our understanding of the social determinants of health, as not the practice of doctors is unfathomable when we are being led by medical public health practitioners on such a grand scale with the global pandemic.
I would like to encourage and challenge those whose instinct it is to dismiss this article, to engage in a discussion and seek to understand why they have such a strong negative response. What is the threat? Why is it so threatening? Where is the harm in exploring some of the ideas presented? What are the opportunities for growth? What could be some potential benefits for you personally? What are the barriers? Is it ego? Is it in opposition to family teachings? Is it fear? We are all human when being called out on our past failings as individuals and as sections of society. My experience is that the situations we react most strongly against are worth examining further and ultimately make us better practitioners.
One respondent accused the AMA of not representing its’ membership by publishing this work and marked it as social and political opinion. I am not a member myself but this accusation implies that, apart from the social and political impacts on patients’ health having no place in an organization that represents medical practitioners politically and socially (the irony!), the needs and indeed leadership of Indigenous doctors be excluded from the AMA’s remit – – I would suggest that the AMA is representing those within its ranks here, inclusive of Indigenous and non-Indigenous doctors. Perhaps this person thought there are no Indigenous doctors in the AMA? Or that social and political issues have no place in patient care?
Failure to learn of our bias or to learn from history, potentially makes us perpetrators of ill-health and so could be framed as a failure in one of the ethical foundations of medical practice itself of ‘do no harm’.
Our knowledge and understanding of health has progressed from colonial days but colonial practices will only change by all of us doing our part just the authors suggested. If we fail to listen, if we fail to consider and support marginal voices then WE continue colonialism and racism and marginalisation in practice, WE perpetuate unconscious bias and WE continue to harm.
We in the healthcare professions are required to be life-long learners – are called to be open to continually reflecting on and developing our practice. This call to learn and to action is an opportunity to impact the health and well-being of our First Nations people and therefore of society as a whole. This is integral to our practice.
Discomfort is also part of learning and self-discovery but is not a reason to avoid such learning. A failure to learn and respond to Australians in all our diversity is failing in the social contract that medical practitioners have – one which calls for health advocacy and ally-ship even when it means facing truths that are personally painful and, at times bewildering and overwhelming, but will ultimately make for a more healthy profession and a society that is seeking to be “in this together”.
I do not agree with this article at all .
I object to how the MJA foist this line of thought continually upon us .
The significant problems In Aboriginal communities cannot be addressed by attention to racism alone . It is only a small part of a bigger problem . The issue of violence of Aboriginal people against other Aboriginal people is huge . The issues of domestic and sexual violence and alcohol and drug abuse in Aboriginal communities must be addressed .Aborigines need to stop being victims and stand up and take individual responsibility for their own lives and fates .They need assistance to get a good education and find a job- just like every other person in Australia . There are many disadvantaged groups in Australia who need assistance – refugees , poor White people and Aboriginal people .The Australian Government and so we as tax payers already spend a fortune each year trying to assist Aborigines .
The BLM is just a Marxist political front to try to prevent the re- election of President Trump . Thank goodness we live in a liberal democracy.
The BLM rallies in Australia that have risked the spread of and hAve indeed spread COViD in Australia are a disgrace.
A whole bunch of angry youth protesting about nothing much in particular .
A clear, well-written opinion piece.
Throughout history, doctors have been instrumental in social justice – the problem these days is that you are instantly accused of ‘virtue-signalling’ and labelled ‘left-wing’, a ‘feminist’ or a ‘bleeding heart’, as evidenced by the previous comments. Dismissive comments, such as ‘what about DV, alcoholism in Indigenous communities’ is the standard tactic in deflecting the focus from the central argument.
To think that there should be a clear boundary between medicine and social advocacy is quite narrow-minded, as doctors we should be striving for health equity and this is as simple as calling out racism within our profession.
What a fantastic article. I am absolutely appalled at the mansplaining and denial of white privilege that is going on in the comments. There is no room for beliefs when it comes to racial prejudice. I challenge the white male boomers commenting here to reflect on their inner bias, immense white (and gender) privilege and how both affect their practice. The phrase ‘virtue signalling’ is the new ‘PC’ = a catchcry used by the privileged deniers to silence the voices that need to be heard in order to achieve equity in this country.
Fantastic article, couldn’t agree more. Thank you for publishing such a well written, important article. I will strive to do better for my patients.
Thank you for this well-written article and thank you for striving to improve health outcomes for the vulnerable in society.
Doctors have always been instrumental in advocating for social change – the difference these days is that you’re automatically labelled ‘left-wing’ by our more brittle-spirited colleagues, as evidenced by the comments.
Like several rapacious private medical practices that style themselves as “Institutes”, Reconciliation Australia is a wolf in sheeps’ clothing. RA is a non-government, partisan political organisation with, in contrast to its sweet sounding name, a separatist agenda which amounts to apartheid: government legislated preference in dealing based on skin colour. It appears these authors too have been seduced.
Lowitja O’Donoghue should have paid more attention to the news: we already have “a remarkable country, the envy of the rest of the world.” One of its features is respect for the rule of law, a corollary of which is ‘you do the crime, you do the time’, irrespective of skin colour. One suspects were property theft, bashings or spousal abuse to intrude on the carefully manicured world of these authors, they too might feel that was only fair. To bandy round terms like ‘systemic racism’ without providing even a single example of such a racist statute from that system is a bit…. undergraduate.
And implying that the BLM rallies were justified by that so-far-unconfirmed systemic racism is nothing more than their smug rationalisation that whilst their reasons for breaking isolation rules were wholly noble, your reasons were a crime against humanity. Victoria in particular is now paying the price of their conceit.
One of the focuses now in medical education is ‘social determinants of health.’
What happened to ‘treat the patient, not the disease’??
The mention of drug and alcohol, domestic violence etc- these are all directly related to generational trauma and ingrained racism.
Eg You want to treat a liver cirrhosis, and prevent their child from developing it (preventative medicine) then yes we need to be involved in social justice and advocacy- and we will see the positive health outcomes unfold over the coming decades.
That’s being a doctor.
I absolutely agree with the first four comments. Deaths in custody are a tragedy if preventable, regardless of the skin colour of the victim. However many deaths in custody occur from natural causes, and even deaths during attempts to escape from being arrested or apprehended by police are included in the deaths in custody statistics. The death rate is higher for whites in custody, so what are we supposed to do to reduce the high rate of imprisonment of our indigenous Australians – exempt them from the Criminal Code? And I also am heartily sick of left-wing AMA members using the Federal Presidency to springboard themselves into a political career. If the AMA wishes to make a public stand on a social justice issue, they should at the very least take an opinion poll of their members first.
Thanks Ngaree and Alyce for a thoughtful and compassionate perspective. Now, more than ever is the time for us to listen to the experience and perspectives of those with lived experience different to ourselves.
I completely agree with you that doctors have an important role in standing alongside, and amplifying the voices of those on society’s margins. As doctors, we have a privileged position listening to patient stories, and seeking to makes sense of these stories in their individual, family, and social context. For those of use in public health, this responsibility extends far beyond the individual in front of us – and I am so proud of the doctors we have on the frontlines of COVID, climate health, and Indigenous health.
Your article reminded me of Paul Farmer’s words on health as a human right in his classic book Pathologies of Power: “Human rights violations are not accidents; they are not random in distribution or effect. Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm.”
I am sorry you were subjected to ignorant mansplaining on issues about which you are clearly far more informed. I am also saddened to hear such ignorance and bigotry defended in the name of Medicine. The idea that doctors and medical establishments exist to serve our own self-interest is exactly what triggered Ivan Illich to give up on our proud profession: “Modern medicine is a negation of health. It isn’t organized to serve human health, but only itself, as an institution. It makes more people sick than it heals.”
It seems to me that a doctor’s primary role is to administer to the sick regardless of race, sex, creed etc. In short to be ‘blind’ to all these issues and to accept the relationship in an unconditional manner. To be an activist, as an individual, may be a good thing or not but it inevitably will make it difficult to accept someone who does not agree with your philosophy particularly when the patient is aware of the difference. When doctor groups create position statements on social issues not only are many patients left isolated but are denied any real opportunity to put forward their view i.e. denied freedom of speech. Unfortunately the situation is even worse because patients are vulnerable and as doctors are held in high regard, it is improper for a doctor’s group to take advantage of the situation even if they believe it best. By all means have position statements on medical issues like asthma treatment but if it is a social issue passionate doctors should join a non medical group as many of these issues are very complex and stress the best of brains e.g. Martin Luther King, Nelson Mandela, etc.
Wow. What a telling group of comments on this article. Perhaps you’d all better start listening to your non-white colleagues and patients, instead of yap, yap, yapping about how “doctoring isn’t about social justice”. Seriously? Are you that disengaged from society?
If my reading of this article’s sentiments is correct, 432 deaths in custody need to be matched by an increased number of police convictions? Those at the frontline of criminality will be convicted presumably on grounds of “accountability” while their administrative and political superiors will be exempt. Policing and custodial policy have overlap but also significant differences. Current policies on both have had a long gestation. Simplistic statements such as included in this article, as well as self congratulatory assessments of First People response to Covid-19, will do little to encourage a collaborative sentiment in the greater part of the population.
I would be much more impressed if the authors at least mentioned, much better prioritised the issues of drug and alcohol abuse, domestic violence, child neglect and abuse all of which are much more common within indigenous communities. The violence and murder rate between individuals within these communities is also vastly excessive, but also not (allowed to be) mentioned.
The existing silence is not helping.
To continue silence on these issues is an empty, ineffective form of Virtue Signally, below the standard I expect of individuals in the responsible positions of both authors.
Not expecting those involved to practice the same standards of personal, family, parental and community responsibility is an unspoken, hidden and malignant form of racism, as if saying those in these communities are somehow lesser people and not capable of appropriate standards of behaviour. I don’t believe this.
I agree with Peter Kraus. The AMA has for a long time deviated significantly from its reason for existence by offering opinions on social justice and political issues. Often a justification is given by talking about the public health impact of the social or political issue, thus supposedly making it relevant to the AMA. However, the AMA should not be a public health advocate. It should exist solely for the benefit of its members, who are doctors.
Before offering a public opinion on any issue, the AMA should ask “How will this issue affect doctors professionally?” How will it impact on doctors’: ability to practice, remuneration, legal rights, mental/physical health etc.? If the issue does not affect doctors professionally, the AMA should not be concerned about it. And in deciding if an issue affects doctors professionally, the AMA should not search for tenuous ways to connect issues to doctors professionally, e.g. “This Social Justice issue may adversely affect doctors’ mental health therefore commenting on this issue is within our remit”.
I have long been disappointed with how the AMA has overstepped its brief; I could choose to exit from the AMA but then I will give up supporting the political representation which they give to doctors as a profession, which I believe is essential. I wonder if the AMA would increase its membership by re-focusing its efforts on supporting the profession instead of giving opinions on all manner of other issues.
NO! The AMA and doctors are health care providers. Social justice is important but is a separate issue for individuals, doctors included. The AMA and Colleges have no right to voice political opinions, no matter how sincerely held by those voicing them. Others may feel different. Recent examples are support for same sex “marriage,” thus including people who do not support this redefinition of the fabric of our society.
Of course black lives matter, indeed all lives matter, but there is a lot wrong with the BLM movement and its actions.
Doctors demonstrate a great diversity of political and religious beliefs. Those holding one set of these have no right to hijack the entire profession into supporting one side only.