and a documentation of patient-harming frauds in medical research
Preemies gasping for breath
are denied the breathing help they need
The doctors responsible for that trial breached this duty, and many others described below, because they had become prejudiced against oxygen on a non-scientific, metaphorical, and political level.
Dr. William A. Silverman, a now retired neonatologist much involved in the debate about ROP, traced in his 1980 book Retrolental Fibroplasia: A Modern Parable24 how the American proponents of oxygen withholding acquired their sudden and fierce slant against that until then beneficial gas. They got the idea from two British physicians who had not long before used it as an allegory for socialized medicine.
These two had branded the "liberal" use of oxygen a misguided subsidy symbolic of the wasteful and counterproductive profligacy to be expected from a National Health Insurance system, as introduced in England and greatly feared in the United States.
Here is how oxygen became identified with this political threat. A prominent British ophthalmologist had presented in March 1951 his views about the infant's need for "an oxygenated blood supply acquired by its own efforts". Then he elaborated:
In July 1952, this author and a like-minded colleague continued, this time addressing an American audience:
This metaphorical labeling of oxygen as a subsidy made it ideologically intolerable to subsidy opponents.
During those McCarthy-era witch hunting years, it was not necessary for charges of leftist connections to be proven to be believed, so the unfounded insinuations against the until then "life-saving" gas found a ready reception in medical circles from America to Australia27,28.
In a textbook example of what psychologists call "projective identification and action discharge of disturbing internal stimuli", a condition common in political debate where people who feel threatened mistake the symbol for the real thing it represents29, the American medical community reacted to this red-painting of oxygen like a bull to red cloth.
The American Medical Association had just spent $1.5 million in 1949 and $2.25 million in 1950 to defeat President Truman's National Health Insurance proposal. (That amounts to over $16 million in today's money and was at that time the most expensive lobbying effort in American history.) Their advertisements had linked National Health Insurance with socialism and even fabricated Lenin quotes30, and the political fever inflamed by such slander continued to run high years later. According to the Guest of Honor at the 1953 Annual Session of the American Academy of Ophthalmology and Otolaryngology, socialized medicine was "a terrible blow to the art of practice" and a "serious threat"31.
This emotional and political context made it easy for the pediatric leaders to project that threat into the symbol that their colleagues had connected with it. They were under pressure from the agencies providing services to blind people to end the epidemic of preemie blinding. As Dr. Silverman tells it:
Blaming oxygen provided a convenient solution for a profession which had just demonstrated how little the public interest meant to its members.
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