Women have more strokes than men, but new European Guidelines remove 'women' bc it omits 'non-binary' & transgendered people.
Women have more strokes than men, but new European Guidelines remove 'women' bc it omits 'non-binary' & transgendered people.
Medicine keeps acting irrationally in the name of political correctness
For people with an irregular heart rhythm called atrial fibrillation, the risk of stroke can be substantive. For a long time, there was a risk score called CHADS-2-VASc that awards points to give you a sense of risk. More points.. more risk.
Over the age of 75… 2 points. Having had a prior stroke… 2 points. Being a woman… 1 point (because women, age-adjusted, have higher stroke risk than men).
Unfortunately that’s no longer PC in Europe. The European Society of Cardiology has decided to remove women as a risk factor because “The inclusion of gender complicates clinical practice both for healthcare professionals and patients. It also omits individuals who identify as non-binary, transgender, or are undergoing sex hormone therapy”
Wow. The only justification I could imagine to remove women from the algorithm is if a) being a woman is not a independent risk factor for stroke (current evidence suggests it is, and the ESC authors don’t dispute it), or b) if women are more likely to experience harms of anti-coagulation (what the score is used to decide).
But the problem with b) more broadly is that the CHADS-2-VASc guidelines merely quantifies risk of stroke, and doesn’t include risk of bleeding (e.g history of falls, etc.) Its not meant to decide whether you need anti-coagulation, but to quantify stroke risk and suggest settings where it might be considered. Here is the original score
Medicine risks becoming co-opted by political movements if we change the practice of medicine to suit political correctness, rather than the best available care based on the data. Inclusion of gender doesn’t complicate clinical practice, it is easy, in fact.
I agree with Professor Gebhard, and worry about the direction medicine is headed. Removing race and gender from medical consideration might easily have effects that harm women and minorities. It is important for evidence to guide these discussions not activism.
They are not erasing gender. They are erasing women.
History echoes. From Science Direct:
During the Weimar Republic more than half of all German physicians became early joiners of the Nazi Party, surpassing the party enrollments of all other professions. From early on, the German Medical Society played the most instrumental role in the Nazi medical program, beginning with the marginalization of Jewish physicians, proceeding to coerced “experimentation,” “euthanization,” and sterilization, and culminating in genocide via the medicalization of mass murder of Jews and others caricatured and demonized by Nazi ideology. Given the medical oath to “do no harm,” many postwar ethical analyses have strained to make sense of these seemingly paradoxical atrocities. Why did physicians act in such a manner?
Yet few have tried to explain the self-selected Nazi enrollment of such an overwhelming proportion of the German Medical Society in the first place. This article lends insight into this paradox by exploring some major vulnerabilities, motives, and rationalizations that may have predisposed German physicians to Nazi membership—professional vulnerabilities among physicians in general (valuing conformity and obedience to authority, valuing the prevention of contamination and fighting against mortality, and possessing a basic interest in biomedical knowledge and research), economic factors and motives (related to physician economic insecurity and incentives for economic advancement), and Nazi ideological and historical rationalizations (beliefs about Social Darwinism, eugenics, and the social organism as sacred). Of particular significance for future research and education is the manner in which the persecution of Jewish physician colleagues was rationalized in the name of medical ethics itself.