Ideology, Prejudice, Equity, and Laughter

by Theodore Dalrymple

To a hammer, everything looks like a nail; to a modern ideologist, every difference looks like the result of prejudice.

This ideology reminds me of the tiny ants that have got into my kitchen in my house in the French countryside. They get everywhere, including (this morning) into my computer. The ideology is like that: it gets everywhere and leaves nothing alone. It is, like the ants, very annoying.

An article on the website of the Journal of the American Medical Association, published on July 2, examined the rate at which scientific articles published between 2015 and 2018 in five of the world’s most important medical journals—the Annals of Internal Medicine, the British Medical Journal, the Journal of the American Medical Association, JAMA Internal Medicine and the New England Journal of Medicine—were cited by other workers, according to whether the first or senior authors of the articles were men or women.

The authors examined 5554 articles and found that those with men as first or senior authors were cited about half as many times again as those with women as first or senior authors. They concluded (surprise, surprise) that “These differences may have important consequences for the professional success of women and achieving gender equity in academic medicine.”

Note the weaselly language in which the conclusion is couched. What the authors of the article call in their title the “gender disparity in citations” (the word disparity already connotes anomaly or injustice by comparison with the word differencecauses difference in the career trajectories of men and women in academic medicine.

They say only that it may do so; but once the suggestion is made, of course, it is difficult to get it out of the mind and has a tendency with time to solidify into accepted fact.

Equity

Much more important is the misuse of the word equity, by which the authors obviously mean equality of outcome. Equity, by contrast, means fairness or justice. This is surely an elementary, but highly motivated, mistake.

To illustrate the difference, let us suppose that instead of looking at sex differences, the authors had looked at the IQs of the authors of articles in these journals. They would have discovered (shock, horror!) that the distribution was grossly skewed in favour of those with high intelligence who form at most 5 per cent of the population.

How undemocratic! Equity, in the sense that these authors use it, would demand that the journals published more articles by people of low intelligence, the lack of such publication hampering people of low intelligence from becoming neurosurgeons.

The use of the word equity by the authors rests on the assumption that, if all were fair as it should be, all things desirable and desired (and presumably all things undesirable and undesired also) would be distributed equally between groups.

This is as ludicrous as Rosencrantz’s answer to Hamlet’s request for latest news, “None, my lord, but that the world’s grown honest.” These days, he would reply “None, my lord, but that the world’s grown equitable”—to which Hamlet’s reply would be the same. “Then is doomsday near.”

It is not the job of the editors of JAMA to suppress opinion, but it is surely part of their job to correct gross misuse of language: a misuse that reminds one of Soviet propaganda at its height.

Now it is possible that the differences that the authors found in the numbers of citations of articles by men and women authors is the result of prejudice, but it strikes me as very unlikely. As it happens, I wrote a book a couple of years ago that was a chronicle of the errors, the political correctness, and the medical advances (as I saw them all) that I found in 52 issues of the New England Journal of Medicine.

In not a single instance did it occur to me to select the articles for my commentary according to whether they were written by men or by women; this was simply a criterion that did not occur to me as relevant.

I have also in my career had a side-line in reviewing books: I have probably reviewed about 500 in my time. Again, it has never occurred to me to tailor my review to the sex of the author of the book under review. Nor, when I read the book reviews of others, do I consider the sex of the reviewer, only the content of the review.

It may be that what appeals to me as a man differs from what appeals to a woman, but that is another matter altogether.

Unconscious Bias

It is probable, however, that the authors of the article, and those who think like them, would claim that the mere fact that I did not consciously select the articles for commentary in my book on the basis of the sex of the authors only goes to show how deep is my unconscious bias (assuming that I chose disproportionately more male authors, which is possible—I have made no study of the question).

This resort to unconscious bias as an explanation of my choice would be deeply sinister and totalitarian both in inspiration and consequences. Those who suffer from unconscious bias must be re-educated, and the stronger their resistance to such re-education the greater is their need for it.

I am reminded of the notices that used to appear in grocery stores in poor areas, asking customers not to ask for credit, because “refusal often offends.” One cannot refuse the beliefs of the modern ideologists: refusal not merely often offends, it always does.

The authors of the article were honest enough to admit that their work had limitations. One of those admitted limitations made me smile. “We focused on dichotomized gender categories and were unable to assess citation differences among authors with nondichotomous gender affiliations.”

Of course, the fact that I laughed just goes to show how badly I am in need of re-education. Laughter is itself a sign of an inequitable world, and must be suppressed.

First published in the Epoch Times.