Flexner urged medicine to become social and preventive rather than individual and curative.
The Eugenics Congress welcomed the same message 2 years later.
In 2021 the AAMC and the AMA followed suit.
As in the eugenics movement, an elite group wants to correct all the ills of society while seizing ever-greater control of public discourse and institutional power.
This medical mission-creep has not escaped the notice of academics. Norwegian ethicist Bjorn Hofmann warned of this last year.
1. from targeting experienced phenomena, such as angina, to controlling non-experienced phenomena, such as elevated cholesterol
2. from addressing present pain and suffering to preventing potential future suffering, as with screening for cancer and heart disease
3. from reducing negative wellbeing to promoting positive wellbeing. I quote the preamble to the Constitution of the World Health Organization (Yes, they really do have a Constitution… I think they hold these truths to be self-evident.) "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
Hofmann’s warning:
These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship.
Since Flexner's leading biographer – Thomas Neville Bonner ("Iconoclast") – is no longer with us, I thought someone needed to react to AAMC's rude dismissal of Flexner.
I'm not seeing anything seriously problematic about Flexner's character. But I allow that I may be missing something.
Are Flexner's values "similar to the dangerous agendas of today's AAMC and AMA." I think Flexner would be appalled at the "woke" AAMC and AMA, the significant lowering standards and rigor; and the emphasis on creating "social warrior" physicians instead of attentive clinicians.
If he had faith in licensed physicians, it was for their acquisition of science-based knowledge and clinical skills which he saw as a plus for society. But he could be critical of some medical schools, licensing boards, and the AMA's biased rating system that allowed less than competent physicians to practice, while competent Black physicians were locked out.
You might be referring to something else here, but the fact that Flexner "suppressed scientific dissent" is something I have long heard from "alternative medicine" practitioners – mostly naturopaths and homeopaths. Oh, how they despise Flexner. But for my tastes, mainstream medicine today does little to protect the public from scientifically invalidated practices. Numerous medical schools even have their own "alternative medicine" department.
As for an emphasis on "social engineering," from what I know of Flexner, I've seen nothing about him having an interest in eugenics. And as an educator, he thought individualize instruction best; that approach seems to have carried over into promoting clinical, bedside skills in a day when many physicians were trained exclusively in the lecture hall.
"Ideological litmus tests"? You have me at a disadvantage here. I don't know what you are referring to or how Flexner may have indulged in it.
Thank you for your comments. I have enjoyed your comments and the discussion.
Mar 27, 2023·edited Mar 27, 2023Liked by Robert F. Graboyes
The article's mention of allopathy as a label for the scientific practice of medicine is misguided. "Allopathy" is the label invented in the 19th Century by Samuel Hahnemann, creator of the homeopathy quackery, applying it to the practice of medicine contravening his own. It has nothing to do with today's medicine. Use of the label today is a false flag raised by practitioners of 'alternative medicine' or 'natural medicine', and is also a thinly disguised insult. Part of the irony of some true medical practitioners adopting the term is that by using it themselves, they are contradicting of the very point which Flexner explicitly made in his Report: that a scientific outlook in medical education & practice was antithetical to *both* homeopathy and allopathy.
I was unaware of the WHO "definition", probably because I don't regard it (WHO) as having any authority—definitionally, etymologically or otherwise. I'm not surprised, though, to learn it goes on to say the term denotes what is "sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine." Proponents of "other ways of knowing," had been desperately seeking some way of collectively distinguishing their beliefs & practices from that which accounts for the model practiced by successful medical practitioners. They finally found it, not for their collective selves (eclectics, Flexner called them), but for their competition. They realized the marketing disadvantage they would have in calling what real physicians do with the correct modifier: *scientific* medicine.
Myself, I don't believe any modifier is necessary, much less desirable. WHO notwithstanding, there is no "category of medical practice" other than scientific. There is only *medicine*. There is no other way of knowing what it really is than by science.
Enjoyed your post.
Loved the video.
Now attempting to stop myself from buying a Justin Johnson Signature 3-string Shovel guitar.
https://justinjohnsonstore.com/collections/guitars/products/signature-3-string-shovel-guitar
Flexner urged medicine to become social and preventive rather than individual and curative.
The Eugenics Congress welcomed the same message 2 years later.
In 2021 the AAMC and the AMA followed suit.
As in the eugenics movement, an elite group wants to correct all the ills of society while seizing ever-greater control of public discourse and institutional power.
This medical mission-creep has not escaped the notice of academics. Norwegian ethicist Bjorn Hofmann warned of this last year.
(Managing the Moral Expansion of Medicine, BMC Medical Ethics, September 2022 — https://pubmed.ncbi.nlm.nih.gov/36138414/.)
Hofmann identifies 3 patterns of expansion
1. from targeting experienced phenomena, such as angina, to controlling non-experienced phenomena, such as elevated cholesterol
2. from addressing present pain and suffering to preventing potential future suffering, as with screening for cancer and heart disease
3. from reducing negative wellbeing to promoting positive wellbeing. I quote the preamble to the Constitution of the World Health Organization (Yes, they really do have a Constitution… I think they hold these truths to be self-evident.) "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
Hofmann’s warning:
These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship.
More reading on Flexner reveals a different characterization:
https://www.physicianoutlook.com/articles/abraham-flexner-academic-medicines-favorite-scapeg
Thank you for the kind words about my article.
Since Flexner's leading biographer – Thomas Neville Bonner ("Iconoclast") – is no longer with us, I thought someone needed to react to AAMC's rude dismissal of Flexner.
I'm not seeing anything seriously problematic about Flexner's character. But I allow that I may be missing something.
Are Flexner's values "similar to the dangerous agendas of today's AAMC and AMA." I think Flexner would be appalled at the "woke" AAMC and AMA, the significant lowering standards and rigor; and the emphasis on creating "social warrior" physicians instead of attentive clinicians.
If he had faith in licensed physicians, it was for their acquisition of science-based knowledge and clinical skills which he saw as a plus for society. But he could be critical of some medical schools, licensing boards, and the AMA's biased rating system that allowed less than competent physicians to practice, while competent Black physicians were locked out.
You might be referring to something else here, but the fact that Flexner "suppressed scientific dissent" is something I have long heard from "alternative medicine" practitioners – mostly naturopaths and homeopaths. Oh, how they despise Flexner. But for my tastes, mainstream medicine today does little to protect the public from scientifically invalidated practices. Numerous medical schools even have their own "alternative medicine" department.
As for an emphasis on "social engineering," from what I know of Flexner, I've seen nothing about him having an interest in eugenics. And as an educator, he thought individualize instruction best; that approach seems to have carried over into promoting clinical, bedside skills in a day when many physicians were trained exclusively in the lecture hall.
"Ideological litmus tests"? You have me at a disadvantage here. I don't know what you are referring to or how Flexner may have indulged in it.
Thank you for your comments. I have enjoyed your comments and the discussion.
The article's mention of allopathy as a label for the scientific practice of medicine is misguided. "Allopathy" is the label invented in the 19th Century by Samuel Hahnemann, creator of the homeopathy quackery, applying it to the practice of medicine contravening his own. It has nothing to do with today's medicine. Use of the label today is a false flag raised by practitioners of 'alternative medicine' or 'natural medicine', and is also a thinly disguised insult. Part of the irony of some true medical practitioners adopting the term is that by using it themselves, they are contradicting of the very point which Flexner explicitly made in his Report: that a scientific outlook in medical education & practice was antithetical to *both* homeopathy and allopathy.
I was unaware of the WHO "definition", probably because I don't regard it (WHO) as having any authority—definitionally, etymologically or otherwise. I'm not surprised, though, to learn it goes on to say the term denotes what is "sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine." Proponents of "other ways of knowing," had been desperately seeking some way of collectively distinguishing their beliefs & practices from that which accounts for the model practiced by successful medical practitioners. They finally found it, not for their collective selves (eclectics, Flexner called them), but for their competition. They realized the marketing disadvantage they would have in calling what real physicians do with the correct modifier: *scientific* medicine.
Myself, I don't believe any modifier is necessary, much less desirable. WHO notwithstanding, there is no "category of medical practice" other than scientific. There is only *medicine*. There is no other way of knowing what it really is than by science.