Saturday, May 17, 2014

Social Justice

A Person Of Influence where I work has become increasingly fond of referring to our obligation to social justice in our hospital's ethical decisions. I dislike this on a number of grounds.  First, the preening, in a Matthew 6 manner, is increasingly obvious.  He is justifying the injection of some of his favorite political ideas into the discussion and attempting to secure the high moral ground with this. 

Some of us who are evangelicals develop a particular sensitivity to those tones of self-righteousness, having heard them both in church and out.  Celebrities and politicians engage in these displays for Causes all the time.  It's pretty irritating.  It's even more irritating when you are right in the room with it.

Second, I dislike all modifiers to simple moral words like justice.  Like the authors who needed to point out that they were True Patriots, or Christians who try to grab the inside rail in giving their brands of the faith particular titles*, much mischief gets smuggled in. What's wrong with simple justice, patriotism, or Christianity? If you have to dress it up, I immediately suspect a disguise. Modifiers tend to signal that we are actually going to be ignoring the basic model of justice in favor of something we like better. By focusing our attention on certain aspects of justice, it necessarily shoves others into the background. That is only one step away from allowing injustice at that point, because we have a supposedly higher justice overruling it.

Not that we noticed, of course.

Thirdly, this is especially true of that modifier social when applied to justice. It turns out to mean "fashionable" or "popular" justice. I don't say that to condemn everything that comes to us under the heading of Social Justice.  Well-meaning people, some good things, all that. But it is precisely the type of language we use to deceive ourselves, on the way to deceiving others.

The Person of Influence and one of his public references to social justice got put in his place, providing an example of how "social" justice can be used to disguise injustice.  I don't think he noticed how badly he got schooled, but others did. We were discussing at Schwartz Rounds a patient who had badly injured multiple staff members, some of whom were out for months.  He was inadequately medicated because his father, a physician, was convinced that the boy had shown symptoms of NMS on a previous admission, and refused to allow antipsychotics.  There was in fact no evidence for NMS, and psychiatry is not the physician's specialty.  His belief was in fact bizarre, tied into his denial of his own symptoms.

The discussion centered around the line staff's impression that the father/guardian/physician had the ear of hospital administration to an unhealthy degree.  The appearance was that he had unprecedented access and influence, while staff members of lesser rank continued to be assaulted, put out of work, and in two cases, permanently injured. 

Several physicians in the audience weighed in on the discussion, as they often do. Their comments were indeed valuable and intelligent.  Then the P of I brought up how important it was that we kept social justice in mind in discussing ethical matters.  No one was quite sure what he was referring to in this context, actually.  But it struck a chord in one of the nurses, who sweetly and firmly jumped in: "Yes, I'm glad you said that.  We had several discussions on the unit of whether this situation might have been different if it were a nurse's son, or a mental health worker's son."

Yeah, that actually does come under the heading of "social justice," dunnit? Be careful what you wish for.

There were no further comments, other than a wrap-up by a psychologist.

*Stott's Basic Christianity and Lewis's Mere Christianity are reversals of this - modifiers that accentuate the simplicity and orthodoxy rather than obscure it.

5 comments:

Sam L. said...

Vague modifiers: An early indicator of lying or trying to put something over on you.

Texan99 said...

If all "social justice" meant was being very careful not to put one's thumb on the scale in judging disputes between the rich/powerful and the poor/powerless, I'd say it was a fine thing. It would be an equally powerful tool to reign in the temptation to tip the scale toward the rich as toward the poor.

Instead it increasingly seems to mean the forcible redistribution of wealth by the state, as if perfect uniformity of wealth were the only way to ensure that people concentrate on facts instead of rooting for a team.

Charles Harrell said...

Dang spelling hang-up anyway. That oughta' be rein kinda' like driving a horse not reign like being the king. Or not, with a little pause after reign.

Texan99 said...

Oh, yikes, of all spelling mistakes perhaps one of the ones I hate most: mixing up rein and reign. That's humiliating. I would have bet money I never did that!

a psychiatrist who learned from veterans said...

One perspective, reknitted at times, is that 'the land was here before time.' We have divided it up, for reasons of efficiency in part, utilizing a principle of 'private property.' Nevertheless people in general have some rights to what is produced regardless. That was acknowledged in the Biblical injunction not to completely harvest a wheat field but to allow some for those who would come after the owner's initial taking.