“The thought police would get him just the same. He had committed–would have committed, even if he had never set pen to paper–the essential crime that contained all others in itself. Thoughtcrime, they called it. Thoughtcrime was not a thing that could be concealed forever. You might dodge successfully for a while, even for years, but sooner or later they were bound to get you.”
– George Orwell, 1984, Book 1, Chapter 1
This week’s announcement in the Washington Post that the CDC has banned certain words in budget documents elicited outrage throughout the scientific community. Science and innovation is dependent on the ability of researchers to ask novel questions and push the limits of current thinking. Creativity, free expression and stoking controversy are an important part of the research process. In Orwell’s 1984, censorship was the basis of the society and the Thought Police were a feared government agency. It now appears that the current administration has enlisted Orwellian principles in the American scientific community. If this is type of censorship is allowed to grow and expand, all of us will suffer—and patients and advancements in Medicine will suffer the most.
Banning Words and Thoughts
According to the Washington Post report, the following words have been banned in all budget communications at the CDC:
My first reaction to this report was disbelief. REALLY? There is no way this could happen in modern America….We have come so far in the way we address questions in medicine and respond to public health issues. From Zika to flu shots—from issues surrounding the treatment of transgender people to ways in which we can better serve underserved populations—science is blind and researchers should be dedicated to improving patient outcomes irrespective of political rhetoric.
However, after the publication of the repot in the Post, the division of Health and Human Services pushed back quickly and argued that the CDC and HHS remains committed to the use of scientific evidence to guide their recommendations for health policy. Other Federal spokespeople have admitted that the reason for the “banned words” was to help expedite the budgeting process in Congress. By avoiding certain words in budgetary documents, the agency leadership felt that it would be easier to get their budgetary requests through a Republican-controlled Congress.
For me, none of this really holds water. Censorship—either direct or indirect—has no place in a government agency dedicated to science and the advancement and development of public health related policy. As a Duke trained cardiologist, I have always been taught that the BEST way to treat patients is to use the best available scientific evidence from randomized controlled clinical trials (RCTs) in conjunction with clinical judgement to diagnoses and treat my patients. Politics and censorship has never played a role in the way in which I practice medicine.
How Censorship Can Affect Science?
If allowed, censorship can stifle new advancements in Medicine. Imagine a world in which Jonas Salk was not allowed to develop a Polio vaccine—or a world in which researchers were not allowed to develop a treatment for the AIDS virus—hundreds of thousands of people all over the world would suffer and die. Much of our research funding comes from government agencies such as the National Institute of Health (NIH) and public health policy is also set by multiple government agencies including the FDA and the CDC. IF we allow censorship, then the grant approval process and funding of research projects may be politically motivated.
It’s Time for Action
Politics has no place in science. Science is neither Republican or Democrat—science is HUMAN and transcends race, gender and religion. Science is all about passion, compassion, drive and innovation. Science brings people together—politics divide us. While HHS has now pushed back at the Washington Post report, the seeds of censorship in medicine have been planted. As physicians, researchers, scientists and patients we cannot allow this type of behavior to be swept under the carpet. All of us have a responsibility to express our outrage—reach out to your representatives in Congress today. As for me, I will be in Washington DC this week to express mine on behalf of all physician scientists and patients. For my colleagues in Medicine I implore you all: Continue to innovate—continue to ask the hard questions—continue to think independently—Let’s all stay a step ahead of the “Thought Police” in our nation’s capital.