HMS, Leaving Politics at the Door Harms Our Patients

As the federal government seeks to root out “woke ideology” and “DEI” from medical education, Harvard Medical School appears to have caved to the pressure.

In April, HMS published a mission statement that excised a previous commitment to “nurture a diverse, inclusive community dedicated to alleviating suffering.” As justification, HMS Dean George Q. Daley ’82 explained the change as a “leaner mission statement that speaks very directly to what we do, which is to really advance excellence across our multifaceted mission of education, research and clinical care.”

The phrase regarding diversity was moved to a section on community values, albeit with notable differences. Calls to “speak up” and “empower others to do the same,” which were once noted in community values, have been replaced with a pledge to “provide an environment that values open discourse and the importance of individual voices.” Furthermore, the promises to “foster a culture of inclusion and engagement” and “promote equity and social justice” were dropped.

HMS also “restructured” — or effectively shuttered — its diversity office and hasn’t hosted its yearly multicultural showcase, FABRIC, since 2024. Notably, the performance previously featured students wearing keffiyehs for a Palestinian dabke dance. Just last year, it canceled a panel featuring pediatric patients from Gaza, and only reinstated it after months of public backlash. Time and again, we hear actions like these justified due to “higher-ups” and the “political climate.”

Rather than standing for a vision that seeks justice through meaningful change, the institution now seeks to avoid conflict and survive.

In the past, however, when the political winds were different, HMS seemingly supported diversity and inclusivity efforts. In his April 2021 speech at HMS’s “Stand Against Racism” rally, Daley called for each participant there to be a “pollinator for racial justice and social change.” With respect to institutional action, committees were convened at HMS to “identify where racism lives” and “incorporate anti-racism education” in medical education.

Due to the positive efforts from dedicated faculty and staff, HMS has somewhat incorporated these ideas into their curriculum. Some courses seem to emphasize the impacts of structural racism on health. However, they fail to examine current political forces that create and perpetuate said structural racism. We are limited to frameworks which explain how social and economic forces shape sickness and health. Indeed, these frameworks highlight some structures as producers of disease, like higher risk of exposure to toxic chemicals due to one’s geographic location. But in our experience, explicit inquiry into the actors and political decisions responsible is absent from investigation.

Throughout our medical education we are instructed to understand the ways in which socioeconomic factors affect the health of our patients. But this education fails to hold upstream individuals or forces accountable for its faults. In fact, as we entered our first year, Daley told our class that “we leave our politics at the door when we approach the bedside of a patient.” For HMS and other peer institutions, learning how neoliberal capitalism is designed to reinforce structural inequities in healthcare is apparently too political.

As such, we learn that racist ideology arises out of happenstance, that inequity is human nature, and that we operate in a world in which change is only possible within our current political and economic framework. Our education stymies healthcare leaders’ abilities to imagine equitable health systems under other political realities. We are trained to uphold our current system, research the new drug that can generate a profit, and endlessly ask the question: “Does this or that structure result in health inequities?” Surprise: it always does.

HMS’s choice to remain politically neutral discourages and underprepares its students to tackle pressing health related problems that require political change. Tens of thousands are estimated to die each year due to the absence of a universal healthcare-like system. Census data indicates debt collection agencies hold over $220 billion in unpaid healthcare bills. Workers live in fear of losing their jobs because they would lose their health insurance alongside it. All the while, the costs of housing, childcare, education, and transportation additively cripple working people. The common denominator in these acts of social murder is our profit-driven system.

We are steadfast in our responsibility to be our patients’ allies, rather than disempowered collaborators in a system that is inequitable by design. Doing so requires us to employ critical inquiry not only in the pathophysiology of disease, but also into the financial and political interests of elites who center profits above well-being and justice. Only through this understanding of the upstream political frameworks that govern the distribution of resources, especially health, will we be able to name the system that harms us, organize with people power, and create a new system that is centered on the flourishing of all.

As shapers of the future of healthcare and those who provide it, medical institutions like HMS have the responsibility to lead in this work.

Talat H. Aman and Josef G. Ernst are second-year students at Harvard Medical School.