The healing profession needs healers: the crisis in medical education.

• Author: Gunn, Albert E.

ABSTRACT: In this article, Dean and professor Albert E. Gunn explains that there is something wrong with the medical profession today. The lack of opposition by physicians to current practices that contravene basic human nature is disturbing. Gunn believes an origin of the problem lies in the process of the selection of medical students. Selection has been biased against the very traits that should make a person a good, caring physician. Gunn recommends looking favorably upon, even recruiting, applicants with a broad education in such subjects as history, philosophy, and literature, rather than just basic, technical science knowledge that they are currently being encouraged to study. Applicants should be recruited who are highly educated and able to think for themselves on important issues. Another bias the author has observed is that against applicants who possess a religiously justified morality. Such applicants are asked to justify and defend such a stance. Gunn believes that the fact that applicants who possess these traits are not considered highly desirable, much less preferred, is the basis of the deterioration of the medical profession, and recruiting such independent-minded, ethical, religiously motivated candidates could be the answer to reviving it.

Recently, Dr. Richard Seed sought support for the cloning of human beings. It was quite a leap from Dolly, the first cloned sheep. The reaction was immediate, and the news anchors analyzed the controversy with utmost seriousness. National Public Radio (NPR), with its trademark strained news-speak, was right on the case. The consensus seemed to be that it was a bad idea. The President was against it. The only question was, why? The arguments against cloning a human being seemed to boil down to: we're not ready for this. And where were the physicians? Did any physician or medical professional society articulate a clear argument against the cloning of human beings? Dr. Seed could not get any physicians to help him, but instead of a reasoned evaluation of what cloning involves and why it is incompatible with man's nature, the medical profession's reaction was the oft-used aphorism: "Be not the first to accept the new nor the last to reject the old." Since in-vitro fertilization has already created life in the test tube, the line between this and cloning was dim. No physician, nor, for that matter, any pundit or newscaster, could provide a cogent argument one way or the other. Technology was seen as moving too fast, but the medical profession was in the high grass on the specifics.

How could it be that the professionals we are most likely to trust are so willing to serve as fellow travelers in redefining human nature down? Why are those whom we depend on to preserve our human nature at the frontline attempting to derogate it? Should they not be somewhere on the line of defense against the ideologues and isms whose concept of the human dimension of existence is so clearly flawed? It is fairly self-evident that people in the media and academia--the knowledge or "new" class--manifest a fundamental skepticism and contempt for religious belief totally out of proportion to that of the society around them. Walker Percy, E. Michael Jones, Amitai Etzione, Paul Johnson, and others have shown that the philosophical fetishes of this new class--from Jean-Paul Sartre to Jean B. L. Foucault--are often elaborate justifications for behavioral and sexual aberration.

Members of the medical profession and others of the educated elite have been in the advance guard of some of the most reprehensible crimes of the twentieth century.(1) Let us leave aside the oft-condemned Dr. Mengele. His activities at the end of his life alone show his utter contempt for human life and support all the accusations against him.(2) Take instead the case of an entire country whose policies and attitudes have become a paradigm of the model modern society, Sweden. The United States is constantly compared unfavorably against what is taken as an exemplary public structure (in birth rates, infant mortality, social support systems, etc., etc.). But now it is revealed that, until recently, Sweden has had a consistent policy of forced lobotomies and sterilization.

It was not until August last year [1997] that the country learnt of the forcible sterilization of about 60,000 people since 1936, under a programme designed to improve the Swedish race by weeding out `undesirable' genetic characteristics such as poor eyesight, mental illness and `sexual and social deviancy.' The discovery that this Nazi-style eugenics experiment was abandoned only in the mid-Seventies has deeply shocked Swedes.(3) The image of a stunned Swede appalled by his country's descent into the netherworld is compelling. By way of contrast, under the United States' regime, the much-admired Justice Holmes would not have been stunned, since he endorsed the same type of Nazi-style eugenics experiment with assurance when he upheld the State of Virginia's compulsory sterilization law over its victim, Carrie Buck.(4) Unlike the shocked Swedes, the United States has not repudiated and denounced such a decision, but the Supreme Court continues to cite it with approval and uses it as a precedent to support new decisions.(5) Moreover, those, like Holmes and others, who supported Nazi-style eugenics experiments are hailed as models for emulation.(6) Canada, also sometimes lauded as having a health system to be emulated, turns out to be sailing in the same boat as Sweden.(7)

Not surprisingly, the barbarities that begin in the medical profession have much wider implications. Physicians are highly regarded by society, and their actions can legitimize the conduct of the society to which they belong. Dr. Leo Alexander, expert witness at the Nurnberg trials and noted for his psychological studies of Nazi war criminals, pointed out that physicians' crimes were the precursors of what came later.(8) The dehumanization of the mentally retarded was a prelude to far worse. This process continues today with the dehumanization of the Tutsi, the Albanian Mohometan, the Arab,(9) and it has given us Rwanda, Kosovo, and Deir Yassin.(10) Fortunately, physicians do not seem to be at the actual forefront in these crimes, but their cooperation with the degradation of the status of some members of the human family (the retarded, those with poor eyesight) may have provided aid and comfort to the actual perpetrators.

The question is why do physicians, ostensibly drawn from a wide cross-section of society, seem to go along with such assaults? Our tried and true conceptions of human nature arose in antiquity, were strengthened in the Middle Ages, and have been accepted until recently. Most purported progressive intellectuals participating in the campaign to overthrow them are of a certain type. They are usually disaffected in some way themselves, victims of some fundamental disjunction with ordinary, normal life. But this does not explain the cooperation of physicians who are often selected for medical school as the cream of the crop of undergraduate students. My experience of nineteen years as the dean of admissions of a medical school has led to some reflections on this question.

Medical School: A Faulty Selection Process

The selection process by which we decide who will become a physician is fundamentally, or rather ideologically, flawed, and has been so for some time. It is skewed toward choosing people who do not or will not think for themselves on many important issues, and who will act, when called on to exercise judgment, as tools of others who have already "wrestled" with the important issues and reached what they consider progressive and compassionate decisions. The healer is replaced by the technician, partly because this simplifies matters, and partly because it enables those who wish to carry predetermined solutions to do so with ease.

This malfunction has come about in several ways. The first is the premedical education that prepares aspirants for medical school. There are many excellent liberal arts programs like those at Baylor University, Christendom, Steubenville, Austin College, the University of Dallas, and Louisiana's Northwestern State University Program for Scholars. A number of these have a value-centered curriculum. But the great majority of members of admissions committees, premedical advisory committees, and even aspiring doctors do not see a strong liberal arts core curriculum as an ideal preparation for medical school. They do not agree that the preparation for...