On medical ideology and the production of docile doctors: The politics of care in an age of authoritarianism

Abstract

The United States is the only high-income nation that does not provide universal healthcare as a fundamental public service to its citizens. Instead, it uses public funds to prop up a for-profit health system that enforces thousands of preventable deaths each year. By fueling public distrust, inequality, and resentment, this has played a major role in the erosion of democracy and the rise of authoritarianism that is now posing direct threats to medical science and clinical care. To understand the persistence of this system despite the harm it causes requires an account of ideology within the U.S. medical profession and medicine's function as an ideological state apparatus and disciplinary training ground for neoliberal subject formation for both doctors and patients. By considering the wide-ranging effects of American medical ideology, its uses of morality, and the depoliticization of health and care it instills, this essay challenges the discourses of “burnout” and “moral injury” as explanations for growing demoralization among U.S. healthcare workers. Against this backdrop, the essay considers American medical training's relation to systems justification, the production of docile bodies and docile doctors, the suppression of dissent, and the political significance of immanent critique within medicine. It concludes with an argument for the construction of a new medical ideology organized around the principles of social medicine conjoined with applied practices of ethical disobedience, solidarity, and entwined clinical and political care.