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EDITORIAL
Year : 2019  |  Volume : 12  |  Issue : 5  |  Page : 381-382  

Medicine and politics: How to negotiate the minefield?


Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India

Date of Web Publication19-Sep-2019

Correspondence Address:
Amitav Banerjee
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_240_19

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How to cite this article:
Banerjee A. Medicine and politics: How to negotiate the minefield?. Med J DY Patil Vidyapeeth 2019;12:381-2

How to cite this URL:
Banerjee A. Medicine and politics: How to negotiate the minefield?. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2019 Oct 22];12:381-2. Available from: http://www.mjdrdypv.org/text.asp?2019/12/5/381/267088



In 1848, the Prussian government asked the young German pathologist, Rudolf Virchow, to investigate the typhus outbreak in Upper Silesia, presently in Poland.[1] His observations on the epidemic brought about a paradigm shift in understanding human disease at the population level. Beyond the narrow concept of bacteria and infections, as causes of disease in populations, Virchow studied the importance of the social and economic conditions prevailing in Upper Silesia such as poverty, poor civil services, ignorance, illiteracy, and other socioeconomic predicaments. These findings made him realize that if these challenges, all of which called for political action, were addressed, such epidemics would not recur. The remedies for population health were education, employment, a functional government, and investment in agriculture. Virchow summed up famously, “Medicine is a social science and politics is nothing but medicine on a large scale.”[2] Virchow went on to become a political advocate and a crusading social reformer. His reputation as a practitioner of “social medicine” equaled that as a pathologist.[3]

Having established the association between public health and politics the debate is whether medical journals are competent enough to comment on matters political. Is it proper for the BMJ and Lancet to publish amateurish political commentaries?[4] If so, how much space should be devoted to political issues? Should medical journals espouse or criticize a particular political philosophy? These are the minefields medical journals have to negotiate with when they venture into the unfamiliar domain of politics.

The Lancet itself concedes that even in familiar medical domains the choice of content has a racist bias. They are biased toward publishing reports about diseases of affluence as their editorial board comprise members mostly from developed countries.[5] This makes the contents of leading medical journals highly unrepresentative of the health problems, politics included, at the global level.

Against this background, political commentaries published in leading medical journals, which are predominantly from the West, tend to be amateurish, with inadequate insights into diverse points of views.[4]

The principal purpose of medical journals such as Lancet and BMJ is to disseminate medical information. However, because of the association between medicine and politics, there may be instances when it will be difficult to ignore the larger political context which may be part of the “web of causation” of poor health at the population level. In such situations, reputed medical journals should provide a platform for debate on contentious political issues rather than take on the task of preaching on matters political on behalf of entire humanity when the authors of such commentaries are not even representative of the medical profession. The political conformity of both the Lancet and BMJ in their recent commentaries,[6],[7] is amusing to observe, reminiscent of essays by high school students. Both are armchair exercises, lacking insights into the finer nuances of the political situation on the ground. Such half-baked political commentaries, in the long run, will tarnish the reputation of these journals by alienating the readers with better insights and with more nuanced viewpoints on a particular political situation. The BMJ and Lancet need a course correction by encouraging diverse views on complex political situations having impact on health. This will serve them better than publishing highly opinionated commentaries on complex political issues.



 
  References Top

1.
Galea S. Health is Politics on a Grand Scale. Fortune; 20 September, 2018. Available from: https://fortune.com/2018/09/20/health-and-medicine-as-politics/. [Last accessed on 2019 Aug 21].  Back to cited text no. 1
    
2.
Mackenbach JP. Politics is nothing but medicine at a larger scale: Reflections on public health's biggest idea. J Epidemiol Community Health 2009;63:181-4.  Back to cited text no. 2
    
3.
Schultz M. Rudolf Virchow. Emerg Infect Dis 2008;14:1480-81.  Back to cited text no. 3
    
4.
Daniels A. The politics of medicine. Q J Med 2003;96:695-7.  Back to cited text no. 4
    
5.
Horton R. Medical journals: Evidence of bias against the diseases of poverty. Lancet 2003;361:712-3.  Back to cited text no. 5
    
6.
The Lancet. Fear and uncertainty around Kashmir's future. Lancet 2019;394:542.  Back to cited text no. 6
    
7.
Mahase E. Kashmir communication blackout is putting patients at risk, doctors warn. BMJ 2019;366:l5204. Available from: https://doi.org/10.1136/bmj.l5204 [Last accessed on 2019 Aug 30].  Back to cited text no. 7
    




 

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