Theodore Dalrymple on Negligence and Unaccountability

Does an overweight patient deserve more resources from the government on account of his condition?

Should Washington D.C. treat mental disorders and addiction as “diseases,” like Parkinson’s, and subsidize treatment accordingly?

As healthcare spending approaches nearly 1/5 of the US economy, we might stop to ask whether the medical profession as a whole is able to think clearly about social and political questions like these.

Theodore Dalrymple is a retired British psychiatrist and fellow at the Manhattan Institute, who has taken upon himself the unenviable task of reading through every weekly issue of the 2018 New England Journal of Medicine. His new book, False Positive: A Year of Error, Omission, and Political Correctness in the New England Journal of Medicine, discovers a persistent bias from the editors of one of the world’s most respected medical journals.

In it, the lay-person is treated to Dalrymple’s wryly humorous writing and impeccable handle on complex sociological issues and statistical analysis, which often confound the esteemed contributors to the Journal. His most remarkable discovery is perhaps the information the authors and researchers fail to mention in their prestigious studies and reviews of the relevant literature.

For example, in assessing the efficacy of a Cholera vaccine in Haiti, the authors diligently note the year the disease arrived, but fail to mention that it was a UN peacekeeping envoy from Nepal that introduced the deadly virus to the island in 2010. This oversight reveals the taboo among elites against criticizing helper organizations like the UN, despite mounting evidence of their incompetence.

Or, take the treatment of addiction — an increasingly important issue in the medical field given the opioid epidemic of the last few decades. The addict is often presented as a patient whose illness relieves him from the blame and cost of treatment. The Journal’s editorial voice never waivers from this politically-correct stance, even though a reasonably smart high schooler can understand that addicts still retain their agency (and culpability) while in the grips of the substance. To suggest otherwise is to dehumanize and infantilize people, especially the lower class.

His innumerable books underline a consistent theme — that the upper classes (including doctors) are all too willing to give the lower classes a free pass for harmful behaviors, and aren’t doing them any favors by doing so.

Theodore joined me for the full hour to discuss the reasons for ever-increasing bureaucratization and socialization of medicine, and how these trends are encouraging unhealthy behaviors at increasing cost to the taxpayer.

Dalrymple — colloquially known as the “skeptical doctor” — is like a responsible adult administering a bitter pill of rationality to the less mature members of his profession, who think they can “make the world a better place” through merely wishing it were so.