Adam Kassam is the chief resident in the department of Physical Medicine & Rehabilitation at Western University.
Last week, the Trump administration gave the Centers for Disease Control and Prevention (CDC) a list of terms to be prohibited from budget proposals. That list, provided by White House officials to policy analysts, includes "diversity," "vulnerable," "transgender," "fetus," "entitlement," "evidence-based" and "science-based." The CDC is the national public health agency of the United States, tasked with saving lives and protecting people from health, safety and security threats, except – it seems – if you are classified within the above nomenclature.
This news has been swiftly met with collective outrage from science and health-care officials across the country. Former Surgeon General Dr. Vivek Murthy describes the actions by officials as dangerous and unacceptable, saying the "purpose of science is to search for truth and when science is censored, the truth is censored." Dr. Ashish Jha, director of the Harvard Global Health Institute, said he is worried that this ban will change behaviour at the CDC.
Some speculate that these language restrictions are only meant as a budget strategy to improve the likelihood of a Republican Congress approving funding for various agencies. Furthermore, officials from the Department of Health and Human Services, which oversees the CDC, have stated that the issue of the banned words is a mischaracterization. In reality, however, this administration is attempting to render large segments of the population invisible while preventing health agencies from caring for some of the most at-risk patients in society.
This, of course, comes on the heels of the landmark Alabama Senate election of Democrat Doug Jones. His victory narrows the Republican Senate majority and puts even more pressure on the GOP to deliver legislative victories before the 2018 midterm congressional races, which have the potential to significantly alter the power dynamics in Washington. These upcoming elections will be decided by referendum issues of both a practical and ideological nature. Judging by the results in the deepest of ruby-red states, issues such as health care will be tipping points for candidates.
Therefore, physicians must get involved if they want to protect health care, science and research. While strong official statements from national bodies condemning the behaviour of an administration matter, votes matter more. Our health-care leaders cannot simply denounce the actions of a government: Doctors will need to go door-to-door and stump for political candidates on the ground in a grassroots effort to generate support from the electorate. Health-care institutions should help physicians make this a reality by funding their efforts through the establishment of health-care-driven political super PACs.
Importantly, this ongoing saga in the United States should be seen as a warning for Canadians. Indeed, it was not long ago that the previous federal administration in Ottawa was strongly criticized for muzzling scientists by creating a highly restrictive communications protocol. This, perhaps, was in keeping with a broader political philosophy to reduce transparency in an attempt to control government messaging.
Ultimately, Canada has an opportunity to assert itself as a strong counterweight to the draconian practices of its neighbour to the south. By fostering an environment of open and honest scientific research, while equally promoting the health care of all members of our society, Canada would be viewed as the great defender of science and health care. In a world that is becoming increasingly xenophobic and suspicious of expertise and evidence, Canada may have no other option than to step up to the plate.