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Revolutionary Medicine

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Revolutionary Medicine EDITORIAL Revolutionary medicine Seiji Yamada, MD, MPH; Arcelita Imasa, MD, Gregory Gabriel Maskarinec, PhD As we are aware that younger people are more socialist principles. The New York Times article likely to be progressive than older people,1 we equates communism with the political systems of address these remarks to young health workers and the Soviet Union and China and notes “no federal health science students. This essay might be official or Democratic candidate advocates construed as something of a missive in the vein of communism.”4 Kropotkin’s “An Appeal to the Young,”2 from This does not, however, exhaust the taxonomy older radicals who accomplished little, to young of socialism. While popular conceptions of the radicals who must accomplish much. We intend political spectrum often range along a single x- our remarks as preliminary, for it will be the axis of left (collectivism) to right (capitalism), young who will re-make the world, and in the consider the addition of a y-axis of ranging from process, they will learn much to teach their individualism (libertarianism, a premium placed descendants. on freedom) to totalitarianism (authoritarianism), as appears here.5 On the left side of this two- The taxonomy of socialism. dimensional grid, individual collectivism = The Harris Poll recently found that four in ten libertarian socialism = anarchism, while Americans, as well as 55% of women aged 18 to totalitarian collectivism = state communism. Of 55, would prefer to live in a socialist country. The note, many anarchists do not concede the term respondents expressed various degrees of support “communism” to the statists, though for specific aspects of socialism. For example, “Communism” (capitalized) is often equated with 76% support universal health care, while 48% Marxism-Leninism-Maoism. agree with “Workers own and control their places What are the implications for medicine? For of employment.”3 This widespread popular the benefit of health workers and health science support for socialism in the U.S. ranges from students, we examine here the ideological bases of agreement with social democratic to democratic different strains of socialism, focusing on the anticapitalist and revolutionary end of the Seiji Yamada, MD, MPH spectrum. http://orcid.org/0000-0002-5258-4488 E-mail: [email protected] Richard Horton on Marx, Luxemburg, and Arcelita Imasa, MD Goldman. E-mail: [email protected] In his “Offline” columns, Richard Horton, the University of Hawaii John A. Burns School of chief editor of The Lancet, has been suggesting Medicine, Department of Family Medicine and Karl Marx,6 Rosa Luxemburg,7 and Emma Community Health, United States. 8 Gregory Gabriel Maskarinec, PhD Goldman as guiding lights of where we need to University of Hawaii, go in medicine. What does Horton mean by this John A. Burns School of Medicine, Departments of choice of forerunners? In his column on Marx, Native Hawaiian Health & Family Medicine and Horton points to the imperative to combat the Community Health, United States corporate takeover of medicine. Horton is thus http://semioweb.msh- calling for an anticapitalist turn in medicine. Marx, paris.fr/AAR/161/introduction.asp?id=161 Luxemburg, and Goldman certainly share a E-mail: [email protected] critique of capitalism. However, their Received: June 2019. revolutionary zeal is another shared characteristic. Accepted: December 2019. Sources on Marx abound. Vicente Navarro’s Conflict of interest: none. Medicine Under Capitalism9 and the writings of Social Medicine (www.socialmedicine.info) -112- Volume 13, Number 3, September December 2020 Howard Waitzkin are useful introductions to man and the value of life has been eliminated; applying Marx to health and medicine. coercion at every step has made effort bitter, Luxemburg engaged in polemical debates labour a punishment, has turned the whole of contra Lenin in the Second International, which existence into a scheme of mutual deceit, and was limited to Marxist-style socialism in the early has revived the lowest and most brutal th instincts of man. A sorry heritage to begin a 20 century. Luxemburg called for a more new life of freedom and brotherhood.10 democratic form of socialism than did Lenin, who While Goldman did not completely disavow may have called for “All power to the soviets violence in defense of the revolution, she came to (workers’ councils)” but actually arrogated all believe that the resort to violence encouraged a power to the Bolshevik Party in the name of the descent into brutality. Her view of the ultimate end “dictatorship of the proletariat.” On the national of revolution was a de-centralized, organic society question, Luxemburg argued that the socialist that valued health, beauty, art, and science. revolution needs to occur internationally and must Real wealth consists in things of utility include the advanced industrial countries, which in and beauty, in things that help to create th early 20 century Europe included Germany and strong, beautiful bodies and surroundings Great Britain. Lenin maintained that socialist inspiring to live in. But if man is doomed to revolution can be implemented in a single country, wind cotton around a spool, or dig coal, or even an agrarian one such as Russia. At the outset build roads for thirty years of his life, there of World War I, the Second International died can be no talk of wealth. What he gives to the when German Social Democracy and British world is only gray and hideous things, Labor voted for war credits for their respective reflecting a dull and hideous existence, too weak to live, too cowardly to die. Strange to nations, essentially selling out to the war fever say, there are people who extol this deadening promoted by their capitalist classes. method of centralized production as the Thus, to invoke Luxemburg is to call for more proudest achievement of our age. They fail democratic formations on the path to socialism utterly to realize that if we are to continue in and for international solidarity against capital, and machine subserviency, our slavery is more to critique capital’s drive toward imperial war. complete than was our bondage to the King. Others may cite Lenin’s "Imperialism: the highest They do not want to know that centralization stage of capitalism." With the 20th century and the is not only the death-knell of liberty, but also historical experience of Lenin, Stalin, and Mao of health and beauty, of art and science, all behind us, we look to re-invigorate the drive for these being impossible in a clock-like, mechanical atmosphere.11 socialism that avoids their errors. This is not the “By any means necessary” is a phrase place to engage in a litany of the historic "crimes popularized by Malcolm X. Do the ends justify the of communism" (capital’s apologists do enough means? To achieve the desired society of the for us all) - for the contemporary crimes of future, should we countenance violence? Should capitalism are what we, embedded in global we countenance the dictatorship of the proletariat? capitalism, need to focus and act upon. Should we put our hands in the fate of a central Goldman was an anarchist, and anarchists had authority? Emma Goldman counsels us against been ousted from the First International when doing so. Marx expelled Mikhail Bakunin. Nonetheless, she Therein, perhaps, lies the problem with visited Revolutionary Russia, where she was anarchism. Anarchists tend to believe that humans disillusioned by the Bolshevik takeover. are by nature good, that if humans were freed from Witness the tragic condition of Russia. The methods of State centralization have unjustified authority, that they would naturally paralysed individual initiative and effort; the organize themselves for mutual benefit, tyranny of the dictatorship has cowed the theoretically possible but undocumented in people into slavish submission and all but practice. extinguished the fires of liberty; organized terrorism has depraved and brutalized the Social medicine and revolutionary medicine. masses and stifled every idealistic aspiration; The revolutionary medicine espoused here is institutionalized murder has cheapened grounded in social medicine. As noted by human life, and all sense of the dignity of Social Medicine (www.socialmedicine.info) -113- Volume 13, Number 3, September December 2020 Anderson, Smith, and Sidel, the fundamental the position of the minute hand takes into account precepts of social medicine are that worsening climate security, the clock is largely known for indicating the proximity of the threat of 1. Social and economic conditions profoundly nuclear war. The Bulletin currently cites the U.S. impact health, disease, and the practice of withdrawal from the Iran nuclear agreement and medicine. the Intermediate Nuclear Forces Treaty (INF), the 2. The health of the population is a matter of unresolved North Korea situation, and the turn 15 social concern. toward high-tech, automated weaponry. 3. Society should promote health through both Another, mediating threat to human survival individual and social means.12 is severe inequality – among nations and within nations. For having contributed little historically to In The Second Sickness, Howard Waitzkin the greenhouse gases in the atmosphere – many identifies the forerunners of social medicine to be developing states are most vulnerable to climate Friedrich Engels, Rudolf Virchow, and Salvador catastrophe. Sea-level rise poses a threat to the Allende.13 Social medicine counts among its very existence of small island states and low-lying practitioners Ernesto “Che” Guevara, the Barefoot coastal regions. States in the pathway of tropical Doctors of Revolutionary China, and Cuban cyclones are particularly vulnerable. Those who doctors around the world. The Declaration of experience racial discrimination, and the poor are Alma Ata, i.e. The Declaration on Primary Health particularly vulnerable to severe weather events. Care of the Joint WHO/UNICEF Conference in They live in inadequate dwellings. Their houses Alma-Ata, USSR, 1978, drew on these forerunners are in low-lying areas which experience more as the key to attaining the goal of Health for All by flooding.
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