Opinion
Monday September 17, 2018
page 5
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A call to change the pre-med curriculum Morgan Lucey
Contributing Columnist
I
n every University graduating class, there are hundreds of students who plan to pursue a career in medicine. Medical schools have tough enrollment requirements such as organic chemistry, molecular biology, and physics to start, on top of a wide range of electives and extracurriculars. The work of students who successfully complete all of the requirements should be commended, given the difficulty of these classes on top of the time commitment required for clinical experience and studying for the MCAT. These classes and experiences are integral to a future career as a doctor — biochemistry, for example, provides a foundation for learning how certain drugs affect metabolism and cell func-
tion, which is undoubtedly necessary for doctors. Yet as comprehensive as premedical requirements are in some areas, they are lacking in others that are critical to an effective career in medicine. The past two summers, I have worked at medicinerelated internships, without actually spending time in a hospital or lab. In both of these positions, one thing became clear: There is a lot more to medicine than simply the science of the human body. Doctors face many other problems, ranging from health care inequality due to geographic concerns to determining when it is appropriate to prescribe pain medication in light of the opioid epidemic. The current medical school requirements allow one to understand the science behind these issues, but they do not provide a comprehensive understanding of how our current legal and health care systems constrain the science. Though many universities, ours included, offer
classes that deal with these subjects, none of these courses are required to attend medical school. Similarly, achieving a desirable score on the MCAT does not require knowledge of public health issues. Many pre-med students complete their undergraduate experience without considering the challenges a doctor might face outside of the exam or operating rooms. Global and public health classes should be required for medical school, as opposed to just an afterthought if they fit in one’s schedule (which, with the guaranteed busy schedule of a pre-med student, they probably don’t). These courses allow students to understand the logistics and struggles that their patients may face on a daily basis. For example, the New York Times recently reported on the case of a woman traveling over 100 miles to the nearest hospital to give birth. This was the closest health care facility with an obstetrics/gynecology department, as the hospi-
tal in her own small town had recently closed down due to lack of funding. The trek that the woman was forced to make, without an alternative birthing plan, put both her and her baby’s well-being at risk. If a doctor is aware of the complications that may arise from a woman’s waiting hours with contractions before receiving any medical attention, then the doctor may choose to change the birthing procedure to ensure convenience and safety for the future, perhaps putting patients on bed rest in the hospital close to due dates. Similarly, if given comprehensive knowledge of how insurance policies work, doctors would be able to aid women seeking coverage of proper reproductive health care in today’s tumultuous political climate. These changes deal with our own country, but imagine the difference doctors could make in international programs, such as Doctors Without Borders, if they received education in foreign government’s health care
systems as undergrads. One might argue that more pre-medical requirements will deter students from taking other classes during their undergraduate careers, such as electives and other courses they may be more interested in. However, if students cannot see the value of understanding the public health systems guiding medicine, then medical school may not be the right choice for them. The primary motivating factor behind pursuing a career in medicine should be helping patients. Knowledge of biochemistry or physics is invaluable for directly helping patients alleviate their symptoms, but the ability to help patients navigate the complexity of their health care systems once they leave the examination room is equally important. Morgan Lucey is a rising senior studying neuroscience from Scottsdale, Ariz. She can be reached at mslucey@princeton.edu. This story originally appeared online Aug. 12.
Brett Kavanaugh’s ‘pro-women’ rhetoric is hollow Katherine Fleming
Guest Contributor
S
upreme Court nominee Brett Kavanaugh is trying to convince Democrats that he would not be an anti-women judge. But his opening statement to the confirmation hearings should do little to assuage anyone. Kavanaugh spoke at length about how much he loves his mother, wife, and young daughters. He talked fondly of his daughter’s amazing hugs and the success of the girls’ basketball teams he coaches. I’m happy for Margaret that she just turned 13 and got her braces off. Kavanaugh is clearly a very proud dad and coach. But frankly, what does any of that have to do with evaluating how he would rule on issues concerning the rights of women and girls before the law? What does it tell me about whether my right to make my own reproductive decisions without undue burden or state interference will be protected with Kavanaugh on the bench? Kavanaugh emphasized the value of the strong women and girls in his life, echoing the broader GOP discourse of celebrating individual “strong women” while failing to protect and/ or proving actively hostile
to the rights of women in general. Most people, politicians included, love at least a few women — whether those be their mothers, sisters, wives, girlfriends, aunts, etc. But that tells us very little, if anything, about their political positions vis a vis gender equality. The only thing in this personal vein I can think of that would genuinely help me to evaluate Kavanaugh substantively would be if he stated that because his daughters might someday need abortions, he is committed to upholding Roe v. Wade and Planned Parenthood v. Casey. This isn’t about whether Kavanaugh is personally threatening to women. It is about whether he is politically threatening to women. I believe he is. Kavanaugh wants it both ways. He repeatedly stated in his remarks that his personal beliefs will not influence how he rules because partisanship is not what the judiciary is about. Yet at the same time, he sought to invoke his personal love for strong women and girls and his personal commitment to mentoring female clerks to reassure senators and viewers that he would not be an anti-women’s rights judge. What has Kavanaugh said about substantive issues that disproportionately af-
fect women? Very little, so far. He made abstract statements; his words were slippery and vague enough that they could not be pinned down as any sort of concrete commitment. For instance, he said that his mother taught him, by her own example, that a judge does not decide on abstract principles. Each case is about the people involved, so a judge must put herself or himself in the shoes of those people. But my question is: Where was Kavanaugh’s empathy when a 17-year-old immigrant girl needed an abortion and had already been forced by the Trump administration to delay her abortion by almost a month? Kavanaugh’s decision in her case would have forced this young woman to delay her abortion even longer. (Fortunately, his decision was reversed in a subsequent hearing.) For me, it does not take a large stretch of the imagination to put myself into the shoes of “Jane Doe” in this case. I think about what I would feel in such a situation: overwhelming panic, terror, anger, and desperation. I would be outraged to have my personal reproductive decision dragged before courts and the judging eyes of men like Kavanaugh. In such a situation, I would think of his decision
as unbelievably callous and insensitive to my predicament. So I ask: Can Kavanaugh really put himself into the shoes of plaintiffs like Jane Doe? Also, Kavanaugh knows very well that a Supreme Court case is never just about one case, or one set of people. There are always principles involved — that is why the case made it to the Supreme Court. Decisions must be made with careful consideration of history, present, and future — for instance, careful consideration of the women who have died because abortion was illegal and those who would die if the constitutional right to safe, legal abortion were lost or gutted. Kavanaugh expressed deep reverence for the retired Justice Anthony Kennedy, summarizing Kennedy’s legacy in one word: “liberty.” But what does that mean? Will he uphold that legacy? Because at the core of Kennedy’s legacy of liberty were (some) gay rights and (some) abortion rights. Kavanaugh stated again and again that he is “prolaw” and would interpret the law, not make it for a political purpose. If this is so, then it seems he should be committed to upholding Roe v. Wade because it is (in his own words) “settled
law.” To reverse it at this point in time would be a flagrantly political act. Yet Kavanaugh’s leaked emails undermine even that tepid ‘pro-law’ statement, as he expressed doubt that Roe really is settled law and said that even if it is, precedent can “always” be overruled. Kavanaugh stated that he stands for “equal rights, equal dignity, and equal justice under law.” But does Kavanaugh recognize how important reproductive choice is to that “equal dignity”? It is illustrative to contrast Kavanaugh’s undefined statement about dignity with Ruth Bader Ginsburg’s statement during her own confirmation hearing that the ability to make a decision about whether to bear a child is “something central to a woman’s life, to her dignity.” Neither Kavanaugh’s vague statements of principles nor his statements about his love for the women in his life should give us reassurance that he would bring any commitment to substantive protections for women and girls to the bench with him. Katherine Fleming is a senior concentrator in history from Brookline, Mass. She can be reached at kf leming@ princeton.edu. This story originally appeared online Sept. 7.
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