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Stop Passing Off Politics as Evidenced-Based Medicine

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As political campaigns have increasingly targeted medical practice issues, there have been a spate of articles and op-eds about the apparent corruption of medicine by politics. The American Medical Association believes it is a significant problem, because it has proposed a solution to keep politics out of medicine. Nevertheless, it seems as though doctors and other healthcare workers have been steamrolled by the political system into surrendering their autonomy and medical decision-making.

I was reminded of this grim reality when Mehmet Oz, MD, said that a woman’s right to an abortion was between herself, her doctor, and her local politicians. It’s bad enough that physicians’ political views and party affiliations affect their treatment decisions, but do we really need politicians meddling in the doctor-patient relationship?

It’s no surprise that medical professionals have been guided by their own political ideology to either combat elected officials or join them — depending on the issue. And therein lies the real problem. We have abandoned science and scientific reasoning to further our personal agendas on “the issues,” leading the medical profession into an internecine war and causing further divisiveness among physicians and the practice guidelines and standards promulgated by them.

For example, Florida has effectively banned physicians from aiding in the “transition” of transgender youth in Florida, creating considerable animus and essentially taking the matter out of the hands of practicing physicians. The Florida Board of Medicine plans to codify into law its own uniquely derived standards for the treatment of gender dysphoria.

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It doesn’t matter that Florida’s standards deviate widely from those of a half-dozen medical societies and organizations. The point is, other than providing comments to the Florida Board of Medicine, practicing physicians will have no real input into the final version of the treatment standards. Instead, those who serve on the Florida Board of Medicine will call the shots — and we can’t ignore the fact that all physicians who are board members are appointed by the governor.

Make no mistake, it is not uncommon to become ideologically blind to science when working for powerful people and even weaker sources of influence. Physicians believed pharmaceutical salespeople did not affect their choice of therapy, but studies proved them wrong.

Do No Harm, a non-profit organization, is a key proponent of Florida’s ban on gender-assisted therapy. In a letter to the Florida Board of Medicine, Stanley Goldfarb, MD, founder and chairman of Do No Harm, accuses the medical establishment of refusing “to side with science.” But whose version of science are we talking about: those in the medical profession who cite favorable outcomes following gender transition therapy, or those who point to its possible harmful and irreversible effects?

The debate reminds me of how two (or more) scientific societies can review the extant medical literature and relevant scientific studies, yet propose vastly different practice guidelines, as was the case with Lyme disease a decade ago. The Attorney General of Connecticut had to intervene to help align the discordant guidelines so that patients could be properly treated. Once again, because of our internal struggles to understand science, its limitations, and applications to medical practice, autonomy and self-determination were stripped from us.

The founder of Do No Harm was troubled by the impact of racial reckoning on medical practice, specifically, he was concerned about claims that systemic racism is responsible for disparities in health outcomes. The issues identified by Do No Harm on their website and in the news are perhaps the most vexing in medical education and practice today: affirmative action admission policies; mandatory anti-racism training; and divisive and possibly race-based discriminatory practices at universities and medical schools that violate academic freedom.

My hope is that we can discuss these (and other) topics without politicians in the exam room. I want to engage in passionate (not over-heated) discussions about social determinants of health, the injection of identity politics into medical research and education, and the validity of implicit bias and whether it contributes to microaggressions. I want to hear more from workers on both sides of the aisle who voiced reasoned opposition to what they perceived as contradictory and unjust COVID-19 policies and later faced recrimination.

I strive to be tolerant of individuals who hold opposing views rather than participate in walk-outs, threaten violence, or snub colleagues by calling them “woke” and other derogatory terms. “It just tells us how terrible our culture is becoming, that we can’t have an honest scientific debate about the things we disagree on,” remarked Georges Benjamin, MD, executive director of the American Public Health Association (APHA). Benjamin recently made that statement after public health expert Leana Wen, MD, was forced to cancel her panel discussion at the APHA annual meeting due to credible threats against her life — and she’s not alone.

Doctors, not politicians, need to pave the way for crucial civil discourse and the resolution of controversial issues that impact healthcare and our patients’ ability to receive it — issues ranging from reproductive health to mental health to environmental health. We should reject predetermined political frameworks for interpreting evidence to explain differences in outcomes. It’s time we learned to differentiate politics from science and quash political initiatives attempting to pass as evidenced-based medical principles.

Arthur Lazarus, MD, MBA, is a member of the Physician Leadership Journal editorial board and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia.

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Uyghur refugee vote by Canada MPs angers China

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OTTAWA –

The Chinese government says a motion MPs passed Wednesday to provide asylum to persecuted Uyghurs amounts to political manipulation by Canada.

MPs including Prime Mister Justin Trudeau unanimously called on Ottawa to design a program that would bring 10,000 people of Turkic origin, including Uyghurs, to Canada from countries other than China.

They passed a motion that acknowledges reports that Uyghurs outside China have been sent back to their country of birth, where they have faced arrest as part of Beijing’s crackdown on Muslim groups.

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Foreign ministry spokeswoman Mao Ning said in Beijing that people in the Xinjiang region live in peaceful harmony, contradicting widespread reports of forced labour and sexual violence.

An English translation by the ministry said Canada should “stop politically manipulating Xinjiang-related issues for ulterior motives,” and Ottawa is “spreading disinformation and misleading the public.”

The non-binding motion said the government should come up with the outline of a resettlement program by May 12 that would begin in 2024 and meet its target within two years.

This report by The Canadian Press was first published Feb. 2, 2023.

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Republicans push to remove Ilhan Omar from foreign affairs panel

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Washington, DC – In one of his first moves since becoming speaker of the United States House of Representatives, Kevin McCarthy is leading an effort to block Congresswoman Ilhan Omar from serving on the chamber’s Foreign Affairs Committee over her past criticism of Israel.

On Wednesday, the Republican majority in the House advanced a resolution to remove Omar from the panel. Democrats opposed the move, accusing McCarthy of bigotry for targeting the politician – a former refugee of Somali descent who is one of only two Muslim women serving in the US Congress.

A few Republicans initially opposed McCarthy’s effort, casting doubt over his ability to pass the resolution against Omar, given the GOP’s narrow majority.

But on Wednesday, all 218 House Republicans present voted to move forward with the measure, as Democrats remained united in support of Omar with 209 votes. A final vote is expected on Thursday as progressives rally around Omar.

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The Congressional Progressive Caucus (CPC) defended Omar, calling her an “esteemed and invaluable” legislator.

“You cannot remove a Member of Congress from a committee simply because you do not agree with their views. This is both ludicrous and dangerous,” CPC Chair Pramila Jayapal said in a statement on Monday.

The resolution

The resolution aimed at Omar, introduced by Ohio Republican Max Miller on Tuesday, cites numerous controversies involving the congresswoman’s criticism of Israel and US foreign policy.

“Congresswoman Omar clearly cannot be an objective decision-maker on the Foreign Affairs Committee given her biases against Israel and against the Jewish people,” Miller said in a statement.

Omar retorted by saying there was nothing “objectively true” about the resolution, adding that “if not being objective is a reason to not serve on committees, no one would be on committees”.

While the Republican resolution accuses Omar of anti-Semitism, it only invokes remarks relating to Israel, not the Jewish people.

For example, the measure calls out the congresswoman for describing Israel as an “apartheid state”, although leading human rights groups – including Amnesty International and Human Rights Watch – have also accused Israel of imposing a system of apartheid on Palestinians.

Early in her congressional career in 2019, Omar faced a firestorm of criticism when she suggested that political donations from pro-Israel lobby groups – including the American Israel Public Affairs Committee (AIPAC) – drive support for Israel in Washington.

Omar later apologised for that remark but Palestinian rights advocates say accusations of anti-Semitism against Israel’s critics aim to stifle the debate around Israeli government policies.

In the past two years, AIPAC and other pro-Israel organisations spent millions of dollars in congressional elections to defeat progressives who support Palestinian human rights, including Michigan’s Andy Levin, a left-leaning, Jewish former House member.

‘Different standards’

Although the Democratic Party is standing behind Omar now, the Republican resolution prominently features previous criticism against the congresswoman by top Democrats.

Lara Friedman, president of the Foundation for Middle East Peace, an advocacy and research group, said Republicans are trying to validate their talking points against Omar by using the statements and actions of Democrats.

“They own this,” she said of Democrats who previously attacked Omar. “They made a decision in the last few years to jump on board and score political points at Ilhan’s expense … And that decision is now the basis for the resolution that is being used to throw her off the committee.”

Friedman added that Omar and her fellow Muslim-American Congresswoman Rashida Tlaib are held to “different standards” when it comes to addressing the Israeli-Palestinian conflict.

Both legislators were the subject of racist attacks by former President Donald Trump who in 2019 tweeted that they, along with other progressive congresswomen of colour, “should go back to the broken and crime-infested places from which they came”.

Omar in particular became a frequent target of Trump’s anti-refugee rhetoric in the lead-up to the 2020 elections. At one rally in 2019, Trump failed to intervene as his supporters chanted “send her back” in reference to Omar.

Friedman said attacks on Omar appeal to the Republican base and play well for the party politically.

“It’s a really handy way to embarrass and corner Democrats because when Democrats vote against this tomorrow, the Republican argument is going to be: ‘I don’t get it. You said all these things [against Omar]. Why are you not holding her accountable?’ Politically, this is just fantastic for them.”

For her part, Omar has remained defiant, calling McCarthy’s effort to remove her from the committee, against initial opposition from his own caucus, “pathetic”.

Yasmine Taeb, legislative and political director at MPower Change Action Fund, a Muslim-American advocacy group, praised Omar’s commitment to a “human rights-centered foreign policy”.

“Rep. Omar speaks truth to power – a rarity in Congress. And House Republican leadership would rather waste time by attacking a progressive Black Muslim woman and pushing a far-right agenda than working on addressing the needs of the American people,” Taeb told Al Jazeera in an email.

Omar has been a vocal proponent of human rights and diplomacy in Congress. While her comments about Israel often make headlines, she criticises other countries too – including those in the Middle East – for human rights violations.

Still, critics accuse her of perpetuating anti-Semitic tropes in her criticism of Israel and even allies have described some of her comments as “sloppy”, if not malicious.

On Thursday, Win Without War, a group that promotes diplomacy in US foreign policy, decried the Republican push against Omar as an attempt to strip the House Foreign Affairs Committee of a “progressive champion and skilled legislator who challenges the political status quo”.

“Rep. Omar has helped raise the bar for progressive foreign policy in Congress. She has steadfastly advocated for cuts to the Pentagon budget, held US allies accountable for human rights abuses, and confronted the racism and Islamophobia present in US foreign policy,” Win Without War executive director Sara Haghdoosti said in a statement.

Committee wars

Congressional committees serve as specialised microcosms of Congress. The panels advance legislation, conduct oversight and hold immense power over the legislative process.

Usually, the party in power appoints the chairs and majority members of committees, while the opposition party names its own legislators to the panels.

But back in 2021, Democrats voted to remove Republican Congresswoman Marjorie Taylor Greene from her assigned committees for past conspiratorial, anti-Semitic and Islamophobic comments.

That same year, the Democratic House majority also formally rebuked Paul Gosar, another far-right Republican, for sharing an animated video that depicted him killing Democratic Congresswoman Alexandria Ocasio-Cortez.

Now, Greene is an outspoken proponent of removing Omar from the Foreign Affairs Committee.

“No one should be on that committee with that stance towards Israel,” Greene said earlier this week. “In my opinion, I think it’s the wrong stance for any member of Congress of the United States – having that type of attitude towards our great ally, Israel.”

After Greene was stripped of her committee assignments, McCarthy had openly promised payback against the Democrats if they became the minority in the House, an event that came to pass in the 2022 midterm elections.

“You’ll regret this. And you may regret this a lot sooner than you think,” McCarthy said at that time.

The newly elected speaker has also blocked Democrats Adam Schiff and Eric Swalwell from joining the intelligence committee. Schiff was the former chair of the panel.

Meanwhile, Republican Congressman George Santos, who is facing calls to step down for lying about his heritage and professional and personal history, “temporarily recused” himself from committee assignments as he is being investigated over his campaign conduct.

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Former interim Conservative leader Candice Bergen steps down as MP

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Member of Parliament and former interim Conservative leader Candice Bergen has resigned her seat in the House of Commons.

Bergen, 58, has represented the Manitoba riding of Portage—Lisgar since 2008. She served as interim leader of the Conservatives and leader of the Opposition from February to September 2022. Prior to that, she served as deputy leader of the Conservatives.

In a video posted to Twitter Wednesday, Bergen said she has submitted a letter of resignation, “ending an incredible and very fulfilling 14 years.”

Bergen thanked her constituents, family, volunteers, staff and political colleagues “on both sides of the aisle, regardless of your political stripe.”

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Bergen announced in September of last year that she would not seek reelection. Pierre Poilievre replaced her as Conservative leader that month.

Bergen did not give a specific reason for her resignation and did not mention any future plans.

“I’m choosing to leave now not because I’m tired or I’ve run out of steam. In fact, it’s the exact opposite,” she said in the video.

“I feel hopeful and re-energized. Hopeful for our strong and united Conservative Party, and our caucus, under the courageous and principled leadership of my friend, Pierre Poilievre.”

Bergen ended her goodbye message on a hopeful note.

“With God’s grace and God’s help, I believe that the best is yet to come. Thank you so much Portage—Lisgar, and thank you Canada.”

The Toronto Star was the first to report the story.

“On behalf of the Conservative Party of Canada, thank you Candice for your leadership, your devotion to our Conservative movement and your service to the people of Portage—Lisgar, and all Canadians,” Poilievre said in a tweet Wednesday.

The news means there will be a byelection in Portage—Lisgar to replace Bergen.

Manitoba Finance Minister Cameron Friesen announced last week that he’d step down as an MLA to seek the federal Conservative nomination in the riding.

The death of MP Jim Carr late last year set up a byelection in another Manitoba riding — Winnipeg South Centre. The Alberta riding of Calgary Heritage and the Ontario riding of Oxford are also up for byelections later this year.

“I thank her for her many years of service,” Prime Minister Justin Trudeau said of Bergen in a media scrum Wednesday.

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