A Badge of Discrimination

by Theodore Dalrymple

The Covid-19 epidemic has cruelly exposed the intellectual, moral and financial frivolity of British public administration. Before the epidemic started its deadly campaign against the old, the fat, the hypertensive, the diabetic, the men, the poor, and the black, certain hospitals in London spent time, effort and money on displaying their political rectitude for every bien pensant to see; but just as virtue, when carried to excess, becomes vice, so anti-discrimination becomes discrimination.

I use the word discrimination in its modern political meaning, of course. When I was young—quite a long time ago now—my teachers tried to teach me discrimination, that is to say, the ability to distinguish between the good and the bad in, say, literature or other spheres. They regarded this as perhaps their most important duty as teachers. But the modern political meaning has almost crowded out the older meaning, the semantic shift being an evident symptom of our current obsessions.

In Britain’s highly-centralized, almost Soviet-style healthcare system, the National Health Service, staff are being encouraged all over the country to wear little rainbow-coloured metal badges to show that they are homosexual, bisexual, and transsexual-friendly, and do not discriminate against them. The wearing of these badges is voluntary, but about 3,000 of the staff of Guy’s and St Thomas’ Hospitals, for example, now wear them. The self-congratulatory website of those ancient hospitals—St. Thomas’ is over 800 years old and Guy’s was founded in 1721, now combined into one administrative unit—says:

The badges are just one way to show that Guy’s and St Thomas’ is an open, non-judgmental and inclusive place for people that identify as LGBT+ [which] stands for lesbian, gay, bisexual and transgender). The + simply means we are inclusive of all identities, regardless of how people identify themselves.

This language, which combines the unctuous with the bureaucratic, is typical of the way British hospital administrators express themselves nowadays. And if, as Buffon said, the style is the man himself, we may justly fear for a semi-totalitarian future.

By implication, the badges bully the staff, for if any of them refuse to wear one, their refusal is likely to be taken to mean that their minds are closed, judgmental (in the sense of being censorious, for even the attempt to avoid making judgments is itself based on a judgment), and exclusionary. It is to imply that they would deliberately treat any patients in the above mentioned categories differently and worse from all other patients. Wear the badge or declare yourself to be a bigot.

This is an insult to all those people who worked before the advent of the badges (or who now refuse to wear them) who strove and continue to strive always to treat patients to the best of their ability, irrespective of the many categories into which any individual patient falls. In my experience, the great majority of doctors have always tried to do this.

Let me give an example. Working as I did as a doctor in prison, I met many men who had done terrible things. I treated them, as a matter of course, to the best of my ability. I remember, for example, a man who had strangled three children and then impaled them on railings. Though I did not think he was a good man, and in that sense passed a judgment on him within the privacy of my mind, I treated him for his bronchitis exactly as I would have treated anyone else with bronchitis. I did not find this difficult in the least and do not claim any special merit for having done so, for it is only what all my colleagues in the profession did—as a matter not only of course, but of principle.

A couple of years ago, I read the diary of one of Marshal Pétain’s doctors during the latter’s imprisonment after World War II. The doctor had been a member of the Resistance and had no reason to love Pétain, to say the least: Pétain’s supporters would have had not a second thought about killing him if he had fallen into their power. Yet, as the diary makes clear, the doctor treated Pétain, who by then was demented, with the greatest humanity. Moreover, the doctor refused to publish his diary, despite the financial advantage of doing so, because he thought that publishing it would be to break patient confidentiality. It was only after his death, and more than half a century after Pétain’s, that the diary was published. The doctor’s adherence to his medical ethics was impressive, and he needed no badge to proclaim his virtue.

The irony of the badges is that they are surely discriminatory in the modern political sense, for they select certain categories of people who are specially to be sympathized with. Why not others, then? Why not badges proclaiming sympathy for Moslems, Jews, women, the handicapped, or indeed conservatives, radicals, socialists, fascists, racists, supporters or opponents of capital punishment, climate warriors, the ugly, criminals, sex offenders, embezzlers, or any of the other large, perhaps infinite, number of categories into which people can be placed?

The arguments used to promote the badges were first that a survey showed that one in six of all doctors did not think that a person’s sexual orientation was relevant to their health care, and second that about the same proportion of LGBT+ patients felt that they had been discriminated against on the basis of their sexual orientation. This was the crude reasoning on which the wearing of the badges was based.

But should doctors think that a person’s sexual orientation is relevant to their health care? What is being demanded seems self-contradictory: namely that there should simultaneously be both discrimination and non-discrimination. This impossible demand arises from intellectual carelessness as to when and what categorization is necessarily relevant. A patient’s occupation, for instance, may be relevant to my diagnosis, but not to my determination of whether or not I should treat him as best I can. The deliberate confusion of these two senses by political entrepreneurs leads to endless conflict and the destruction of trust, to the advantage of the entrepreneurs.

That a man feels that he has been unfairly discriminated against on the grounds of a category into which he falls is not in itself proof that he actually has been discriminated against in this way. Surely it requires very little reflection to realize that the question (except in the grossest cases, which of course have been many in history) is far from a straightforward one. Constant rumination and sifting of the entrails on matters of identity and discrimination induces a state of paranoia, mistrust, resentment, and indignation.

A paranoid, mistrustful, resentful, and indignant population is the delight of political entrepreneurs, their bureaucratic dependents, and those who would be dictators of virtue.

First published in the Library of Law and Liberty.