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As explained in my previous post, plausibility matters. The post was predominantly about biological plausibility – but things can be a little more complex, and it would be foolish to deny the fact that there are two kinds of plausibility; biological and clinical.
Biological plausibility concerns compatibility with established physiology, biochemistry, and pathology. It asks whether a credible pathway exists by which an assumed cause could produce an effect. And it takes into account current knowledge from biology and other natural sciences. Within the Bradford Hill framework, biological plausibility helps distinguish mere statistical associations from actual causes. For more details see my previous post.
Clinical plausibility, by contrast, is based on much softer criteria, such as clinical observation and real-world outcomes. Here, the core question is whether a claimed effect fits observed patient patterns, e.g.:
- temporal relationships,
- dose-response gradients,
- reproducibility across cohorts,
- alignment with known clinical phenotypes.
Supported by case series, observational studies, clinical trials, or epidemiological studies, an intervention can be clinically plausible long before its underlying biology is understood. This has historically been the case for many drugs; an apt example is aspirin which has been used clinically long before a biologically plausible mechanism was discovered..
The two forms of plausibility should be complementary. Ideally, a robust causal claim satisfies both mechanistic logic and clinical observation. Biological plausibility without clinical evidence remains speculative. Clinical plausibility without a known mechanism invites skepticism and further inquiry.
The deficit of biological plausibility is a major indictment of many forms of so-called alternative medicine (SCAM). They often offer no tenable mechanism and fail under rigorous testing. Conversely, demanding full mechanistic clarity before accepting consistent clinical data is likely to hinder progress in healthcare.
In relation to so-called alternative medicine (SCAM), the issue was summarised more than 20 years ago as follows:
In summary, the way to prove the efficacy of most CAM therapies is with well-designed RCTs, and there is no reason to believe that clinical trial designs cannot be developed that allow even complex CAM therapies to be evaluated. The procedures involved can be sophisticated, complex and expensive, however, and this confronts investigators with the challenge of identifying which of the myriad of existing and future CAM therapies merit the effort and expense of definitive RCT evaluation. The challenge should be met as it is in conventional drug discovery, through plausibility-building research. Whenever possible, efforts should be made to establish a credible mechanism of action for a candidate CAM therapy, because this will increase its biological plausibility and reduce the risk of false-negative RCT results. When biological plausibility is lacking, clinical plausibility alone must be the basis for determining whether or not to proceed to the costlier phase of definitive RCTs. The creation of a plausibility-building CAM research strategy will require thought, instruction, funding, and collaboration among conventional clinical investigators and CAM advocates. The advantages are many: fairness, low cost and the creation of rules of engagement for CAM evaluation that foster balanced partnerships between CAM advocates and mainstream clinical scientists.
Ultimately, in my view, not a dogmatic stance but a balanced integration of both biological and clinical plausibility should underpin rational decisions about which medical hypotheses to pursue, adopt, or discard.
Evidence‑based medicine (EBM) was developed to make clinical decisions more reliable by grounding them more solidly in good research. Thus, randomised clinical trials, systematic reviews, and meta-analysis became crucial for healthcare. That development brought undeniable progress, but it also created a problem: if we focus exclusively on such evidence, we might neglect an important question:
IS THE TREATMENT IN QUESTION BIOLOGICALLY PLAUSIBLE?
Put simply, EBM asks “Does it work in this study?” without first asking “Could it reasonably work at all?”
The neglect of biological plausibility can lead to wasted resources, misleading conclusions and, in some cases, the promotion of nonsense. The issue is, of course, particularly relevant in so-called alternative medicine (SCAM) known for its frequent lack of plausibility. A simple example might explain this more clearly: in homeopathy, we see an abundance of poor-quality studies with a positive result. This could easily lead to the overall impression that homeopathy works, while in fact it cannot reasonably work at all.
So, how can we reasonably take account of this complication? It turns out there are several options:
Option 1 Gatekeeping
One way to account for plausibility within EBM is to use it to decide what we test in the first place. Before launching an expensive clinical trial, we can ask for a clear explanation of how the proposed intervention might reasonably work. If no such rationale can be articulated without contradicting science, it is reasonable to conclude that the intervention lacks sufficient plausibility to justify the time, money and ethical burden involved in testing it on patients. In practice, this kind of gatekeeping often happens informally, but making it explicit and mandatory could help keep overtly implausible interventions from consuming scarce resources.
Option 2 Prior probability
Plausibility can also be integrated into how we interpret trial results. Some trialists treat a statistically significant result as an infallible signal that the therapy was effective. When a trial result is “statistically significant”, it means the data we observed would be unlikely if the treatment had no effect. Prior probability is another way of expressing plausibility. If a hypothesis is highly plausible given existing scientific knowledge, a positive trial fits into a broader, coherent picture. If a hypothesis is highly implausible, a positive trial is more likely to be a false positive, an artefact of bias, chance, methodological flaws, or fraud. In other words, for low‑plausibility claims, we need stronger and more consistent evidence before accepting them as true. The less plausible a claim is, the more extraordinary the evidence must be.
Option 3 Guidelines
Guideline development offers another opportunity to embed plausibility into EBM. When expert panels prepare recommendations, they typically grade the strength of evidence according to study design, risk of bias, and consistency of results. They might also add a distinct step in which they rate the plausibility of the intervention. This rating could be justified explaining how well the intervention fits with established knowledge. Guideline writers could then let this plausibility rating influence the strength of their recommendations.
Health technology assessments have been moving in this direction for some time. It makes guideline documents more transparent: clinicians could see not only what the trials showed, but also how the intervention was judged to fit into or contradict broader scientific understanding.
Option 4 Causation
Finally, causation frameworks are being used to bring plausibility into EBM. When we decide whether an association is causal, we often rely on criteria such as consistency, temporality and strength of association. Biological plausibility is another of these criteria. Using it systematically means asking whether there is a logical pathway from intervention to outcome that passes through known mechanisms and observed effects. If such a pathway can be sketched in a way that accords with science, plausibility is high. If not, plausibility is low, and we should be more cautious about drawing causal conclusions from statistical associations alone.
EBM has revolutionized healthcare, but evaluating evidence in a vacuum can carry the risk of validating the absurd. To minimise this risk, we might consider integrating biological plausibility into EBM, a possibility that has long been discussed by many experts in the field. This approach is not a rejection of EBM, but a vital safeguard for it which ensures that the evidence aligns with and strengthened by fundamental science and existing knowledge. By demanding extraordinary evidence for extraordinary claims, medicine can better protect its resources, maintain intellectual integrity, and ensure that clinical practice rests on a foundation that is both statistically sound and scientifically reasonable.
Conversion therapy is a form of so-called alternative medicine (SCAM) that attempts to change an individual’s sexual orientation from homosexual or bisexual to heterosexual, or to change their gender identity from transgender or non-binary to cisgender. The practice is built on the false premise that being LGBTQ+ is a mental illness or a developmental flaw that can and should be “cured.” It can range from talk therapy and prayer groups to extreme and physically abusive techniques, such as aversion therapy. Major medical, psychiatric, and psychological organizations worldwide have overwhelmingly rejected conversion therapy. Research consistently shows that it is completely ineffective and causes severe psychological harm, including high rates of depression, anxiety, substance abuse, and suicide. Because of these dangers, dozens of countries have banned or heavily restricted the practice.
Amongst all the many dubious SCAM therapies, conversion therapy must be amongst the most vile, as discussed previously several times, e.g.:
- “Gay exorcism” and conversion therapy by the “Forward In Faith Church International Incorporated” in Scotland
- The ‘Association of Catholic Doctors’ and homeopathic conversion therapy
- Conversion therapy is ‘despicable and degrading’. IT SHOULD BE BANNED EVERYWHERE
Now the Church of England has decided to permit a General Synod event promoting “sexual identity transformation”, i.e. conversion therapy. Entitled “People Change: Sexual Identity Transformation”, the event features Matthew Grech, who claims to have left behind a homosexual lifestyle. Hosted by General Synod member Rebecca Hunt, the meeting highlights speakers who claim to have experienced “positive, beneficial change,” aligning with the Church’s traditional teaching on marriage. Although the Church cancelled an associated exhibition stand, the meeting itself is going ahead despite a 2017 Synod vote overwhelmingly rejecting conversion therapy.
This story unfolded shortly after the UK Government published its draft Conversion Practices Bill, aimed at banning abusive attempts to alter a person’s sexual orientation or gender identity. Humanists UK have long advocated for a comprehensive, loophole-free ban on these discredited and harmful practices, which seek to change, suppress, or “cure” LGBT individuals through coercive counselling, pseudo-psychological interventions, or intense prayer.
Crucially, data from the National LGBT Survey highlights that faith groups are the primary setting for conversion therapy. Furthermore, the LGBT+ charity Galop has documented numerous cases of faith-based conversion abuse.
Laura Newlyn, Policy and Campaigns Manager at Humanists UK, emphasized that conversion practices cause lasting harm, particularly to young and vulnerable individuals facing intense pressure from religious communities. She rejected the idea that these practices constitute harmless pastoral care or ordinary prayer, stressing that most of the public, including most Christians, support a ban. Humanists UK maintains that any effective legislation must fully cover religious settings and eliminate exemptions for “consent” or religious practices to ensure all LGBT individuals are protected from abuse.
I suppose nobody need eplanations what the Epstein files are, or what crimes they depict, or how often Trump is mentioned in them. What many might not know is that even the United Nations (UN) have commented on these documents
Independent human rights experts, operating under mandates from the UN Human Rights Council, have warned that the Epstein files reveal evidence of a possible global criminal enterprise involving systematic sexual abuse, trafficking, and exploitation of women and girls. Due to the scale, transnational reach, and systematic nature of these atrocities, the experts stated that the documented conduct may meet the legal threshold for crimes against humanity. Under international law, this threshold applies to acts like sexual slavery, torture, and trafficking when committed as part of a widespread or systematic attack against a civilian population.
The disclosure follows the “Epstein Files Transparency Act” of 2025, which led to the US Department of Justice releasing over three million pages, 2,000 videos, and 180,000 images in January 2026. The background involves wealthy financier Jeffrey Epstein, who died by suicide in 2019 while facing minor-recruitment and sexual exploitation charges, and his associate Ghislaine Maxwell, currently serving a 20-year prison sentence.
The experts emphasized that states are legally obligated to investigate these crimes, which were fueled by corruption, supremacy, and extreme misogyny. They called for independent and impartial investigations into all individuals, financial structures, and official entities implicated, asserting that resignations are not a substitute for criminal accountability.
The experts praised the resilience of the survivors but criticized “grave errors” in the release process that exposed sensitive victim information, risking retaliation and stigma. They urged the adoption of victim-centered standard operating procedures for future disclosures and demanded that governments act decisively, declaring that no one is too wealthy or powerful to be above the law.
“Any suggestion that it is time to move on from the ‘Epstein files’ is unacceptable. It represents a failure of responsibility towards victims,” they said. “It is imperative that governments act decisively to hold perpetrators accountable,” the experts said. “No one is too wealthy or too powerful to be above the law.”
Trump and his team have repetedly responded to Epstein-file in general. Trump himself seems keen to disregard the experts, do precisely what they warned against, and move on. As far as I know, there is no statement of Trump or his team commenting directly on the UN experts’ “crimes against humanity” document itself.
The IGeL-Monitor is a German information portal that reviews self-pay medical services offered in doctors’ offices. It summarizes the likely benefit and harm of these services in plain language so patients can make more informed decisions. It is run by the “Medizinischer Dienst Bund” and uses evidence-based assessments rather than advertising or provider opinion.
The IGeL‑Monitor has recently focussed on osteopathy for non‑specific low back pain and judged the evidence as “unclear” stating that the current evidence does not reliably show a benefit, nor does it demonstrate meaningful harm. The reassessment pooled evidence from ten randomised clinical trials including about 1,160 participants. While some trials suggested small improvements in pain or function, the overall certainty of these findings was low due to methodological weaknesses in the primary studies. The reviewers therefore concluded that there is no convincing, high‑quality proof that osteopathic manual therapy provides a clinically relevant advantage over sham or usual care.
A further concern highlighted in the assessment is publication bias: positive trials may be preferentially published. This phenomenon that exaggerates apparent benefits.
No clear pattern of harm from osteopathic treatment was identified. Adverse events were inconsistently and inadequately recorded in the trials. This fact not only limits the confidence about safety, but is also a clear breach of medical ethics.
The IGeL‑Monitor reiterates its previous (2018) position: with current data one cannot reliably endorse osteopathy as an effective out‑of‑pocket intervention for non‑specific low back pain, nor can one identify significant risk. Hence the label “unclear.” For patients considering osteopathy as a self‑paid service, the IGeL‑Monitor recommends being informed about the uncertain benefit and the weak evidence base when weighing potential costs against likely outcomes.
The new assessment is in agreement with much that I have been saying on this blog. I nevertheless would like to add one important point: back pain is the one condition for which the evidence is relatively sound. There are many other conditions for which osteopathy is being relentlessly promoted as an effective therapy with even less or no reliable evidence at all.
The Church of Scientology has spent decades insisting that psychiatry is a terrorist conspiracy, antidepressants are a gateway to mass murder, and only its own “tech” can save humanity from the menace of Prozac and similar “poisons”. One might imagine this worldview would remain safely quarantined within L. Ron Hubbard’s realm of loons.
But then Robert F. Kennedy Jr. became Secretary of Health and Human Services!
By pure coincidence Kennedy’s “Make America Healthy Again” crusade, unveiled with the MAHA Action Plan to Curb Psychiatric Overprescribing, just happens to target the very same SSRIs that Scientology and its front group CCHR have been demonising for years. Antidepressants are singled out, deprescribing is framed as a patriotic duty, and psychotherapy and lifestyle tweaks are held up as the noble alternative to “overmedicalization.” The American Psychiatric Association calls SSRIs evidence‑based treatment; Kennedy, channelling his inner CCHR lawyer, suggests they’re harder to quit than heroin and may be helping to fuel mass violence.
Enter Wisner Baum, the mass‑tort firm whose senior partners have long, colourful histories with Scientology and its covert operations. This firm has spent years suing antidepressant manufacturers and other psychiatric technologies. And Kennedy has quietly pocketed over $850,000 in fees from them, while keeping a continuing financial interest as HHS Secretary. It is hard to imagine a neater arrangement: a Scientology‑linked law firm sues drug companies; a Scientology‑approved health secretary casts doubt on those same drugs from the cabinet; and fee income flows merrily along.
So, is Kennedy formally a Scientologist?
No, to the best of my knowledge, there is no evidence for that. But perhaps the label becomes somewhat unimportant, when the nation’s top health official is advancing policy that mirrors Scientology’s doctrine and staying financially intertwined with its legal defender. Whether or not he has taken the oath or not (and I am not saying he has), he seems to be doing the work of Xenu, the mysterious extraterrestrial ruler of a galactic confederacy.
An article entitled “Beyond the Appearance of Rigor: Trustworthiness, Integration, and Standardization in Traditional, Complementary, and Integrative Medicine” caught my eye. The name “Traditional, Complementary, and Integrative Medicine” is, I think, impressive as it demonstrates the seemingly infinite ability of SCAM-promoters to come up endlessly with new and ridiculous terms! Please allow me nonetheless to continue calling it so-called alternative medicine (SCAM).
The paper itself might be summarised as follows:
SCAMs struggles to fit into mainstream science. Trustworthiness isn’t just about flashy, individual study results; it requires a reliable system of transparent data and independent replication. However, forcing SCAM into mainstream healthcare via scientific scrutiny, standardisation and integration is a double-edged sword. It strips away the personalized, holistic essence of these therapies. Instead of abandoning science or changing the therapies, researchers need to use creative, flexible scientific methods that document the real-world complexity of SCAM without trying to force it into an artificial mold.
I have heard this argument often, particularly early on when I started applying science to SCAM. SCAM proponents were initially taken by the idea; later, when the results were often not what they expected, they were less impressed and argued that, because science failed to produce positive results, something must be wrong with it and in need of improvement. Specifically, the arguments were:
- SCAM is individualised,
- SCAM is holistic,
- SCAM is complex,
- SCAM is subtle,
- SCAM depends on the skill of the practitioner.
And therefore, SCAM cannot be fitted into the straitjacket of science, particularly not in the one imposed by the randomised clinical trial.
It took many years to convince some SCAM proponents that these notions were erroneous, that science is not always perfect but that no better method for testing exists, that many mainstream interventions (e.g. physiotherapy, psychotherapy) are just as complex, holistic, etc. as is SCAM. Eventually the argument that SCAM defies scientific evaluation disappeared – not totally, but almost.
Now, 30 years later, it is back!
One cannot even blame the SCAM enthusiasts for reviving it. Thirty years of research and very little of SCAM has been proven to work – unless one gives SCAM a huge ‘benefit of the doubt’ and pretends poor science constitutes proof. Even the treatments that SCAM proponents celebrate as evidence-based fall apart once we scratch the surface and discover how poor and irreproducible the evidence mostly is.
Yes, I do sympathise with the frustration of SCAM proponents as they gradually realise all this. Many of them know only too well that their most solid evidence can be taken apart by any first-year medical student with rudimentary skills of critical evaluation. Many of them therefore have long moved away from hypothesis testing research and prefer the type of investigation that never generates a negative finding (e.g. surveys, qualitative studies, sociological approaches). Others, including the two authors of the above-mentioned paper, prefer to go full circle and revive the notions we dealt with decades ago claiming we need different standards for SCAM than for the rest of medicine.
Perhaps someone should tell them that double standards are never a good idea?
A recent paper published in the Lancet was entitled “Wellbeing for people and the planet: how to value everyone and everything on a thriving planet beyond 2030“. Here is its abstract:
Humanity is crossing multiple planetary boundaries while facing rising inequality, democratic fragility, and worsening mental health, exposing the incompatibility of unlimited gross domestic product-driven growth with a finite, socially interdependent planet. Only 17% of the Sustainable Development Goal targets are on track, indicating the need for a deeper transformation rather than faster implementation. Synthesising evidence across disciplines, we argue that human beings are evolutionarily wired for cooperation and relational wellbeing, and not perpetual consumption and status competition. This argument underpins a post-2030 shift in a global development paradigm that places multidimensional wellbeing, of people and the planet, at its core. We outline three mutually reinforcing systemic shifts: deliberative democracy that gives communities real power to shape collective futures; economic democracy that redirects finance, enterprise design, and fiscal policy towards equitable, regenerative outcomes; and transformed land and resource governance that recognises ecological limits and the rights of nature. By aligning institutions with the cooperative nature of humans and the Earth’s regenerative capacity, societies can achieve flourishing lives for all within planetary boundaries, offering a scientifically grounded agenda for the decades beyond 2030.
While reading the article, I asked myself: will our current leaders and governments accept shared limits, long time horizons, and fair trade-offs? In practice, men like Donald Trump or Vladimir Putin would probably view this framework through the lens of power, national and personal advantage, as well as political control, rather than collective wellbeing. In addition, sizable sections of the public might simply be too ignorant to comprehend the need for such a strategy. In other words, the proposal may sound morally strong but could be politically unrealistic.
If Trump or Putin were asked to follow the strategy, I fear that several objections would appear immediately.
- First, they would reject the idea that planetary limits should constrain national ambition, especially as they seem to think that economic or military strength or even personal advantage matter more than global cooperation.
- Second, they would treat wellbeing metrics as soft or ideological compared with jobs, growth, security, or sovereignty.
- Third, they would use the language of wellbeing selectively, supporting parts that could further their agendas, while ignoring parts that require sacrifice, redistribution, or international restraint.
Of course, such caveats do not make the paper and its arguments wrong, but they suggest a significant gap between theory and practice. The altruistic strategy is strongest when actors are willing to cooperate and are able to think long term. I am afraid that it is weak in a world where leaders like Trump or Putin can gain by rejecting climate obligations, weakening institutions, or prioritising short-term national interest. In other words, the paper offers a vision for a better governing ethic, but it does not solve the problem of how to make uncooperative or authoritarian leaders comply.
So, my concern is not that the strategy is useless, but that it is unrealistic and far too dependent on political goodwill. A system that works only when leaders are already committed to fairness and restraint cannot be a robust system. What we also need, therefore, is a strategy by which we are able to get such leaders … improving the education of the general public might be a start.
In the US, the dismantling of public health is in full swing. That this development would sooner or later involve chiropractic had to be expected:
- The shady love affair between Robert F. Kennedy Jr. and the Chiropractic Profession
- Robert F. Kennedy Jr. and his harmful ideas about so-called alternative medicine (SCAM)
- The ‘International Chiropractors Association’ Congratulated Robert F. Kennedy, Jr. on His Selection as ‘Secretary of Health and Human Services’
- Eric S Kaplan, the strange chiropractor-friend of Donald Trump
- What does Trump think about so-called alternative medicine (SCAM)?
Thus, the recently launched MAHA Chiropractic Hub cannot come as a surprise. The new Hub is a national lobbying and promotional initiative designed to position chiropractic care as a drug-free, “prevention-first” solution to chronic disease and to reshape US healthcare policy in its favour. Launched as part of the broader “Make America Healthy Again” campaign, the Hub is a coordinated partnership between the MAHA Centre, MAHA Action, and various chiropractic associations, practitioners, and educators. The initiative promotes chiropractic as a root-cause fix for a broken system.
However, medical researchers and public health experts note that the broader claims of chiropractic, particularly those regarding “prevention-first” wellness and treating chronic non-musculoskeletal diseases, lack a credible evidence base. While an optimistic reading of the clinical evidence might support spinal manipulation for short-term relief of acute lower back pain, high-quality scientific data remains weak or non-existent for its efficacy in managing systemic health issues, preventing disease, or acting as a primary care substitute.
Operationally, the Hub seems to organize its strategy around 4 main pillars:
- Public Relations & Branding: Launching a national media campaign to rebrand chiropractic as a credible, prevention-focused discipline, an effort critics argue pushes past the boundaries of evidence-based medicine.
- Legislative Lobbying: Pressing for the Chiropractic Medicare Coverage Modernization Act and the full enforcement of Section 2706 of the Affordable Care Act to expand federal funding and reimbursement.
- Military & Veterans Integration: Promoting chiropractic within Defense Health and Army medical structures for musculoskeletal injuries and pushing the Department of Veterans Affairs (VA) to expand access and reduce wait times.
- Targeted Outreach: Explicitly marketing these non-drug, non-surgical options to vulnerable or specialized demographics, including children, military personnel, veterans, and seniors.
By targeting federal policy and public perception, the Hub seeks to institutionalise chiropractic care across major public health sectors. In the true MAHA tradition, skepticism from the medical and scientific communities regarding the effectiveness and safety of chiropractic is being ignored.
What is next?
You may well ask!
A homeopath to run the FDA, or the flat earth society taking over NASA?
Nothing can surprise me now!
In my view, it gets increasingly hard to ignore parallels between US anti-regulatory health movements and historical eugenics programs like the one enacted by the Nazis during the Third Reich. Evaluating the rhetoric of Robert F. Kennedy Jr. regarding disease, public health infrastructure, and chronic illness, an underlying philosophy emerges of prioritizing a return to idealized “natural health”, while dismantling the medical systems designed to protect the vulnerable. This, I would argue, echoes the tenets of “eugenics” as practiced by the Nazi regime.
To understand this comparison, we must examine the foundational ideology of Nazi eugenics. It was a concept wrapped in the language of public health and hygiene, biological purification, and economic efficiency. The Nazis aimed to eliminate what they deemed to be lebensunwertes Leben (life unworthy of life). German physicians at the time feared that medical science was keeping the weak alive at the expense of the strong, thereby subverting the natural laws of selection. The Nazis viewed chronic illness and disability to be a drain on the collective national body (Volksgesundheit). Their conclusion was that the elimination of the genetically inferior was a biological necessity.
A modern variant of this ideology manifests in rhetoric that views chronic illness not as a collective societal responsibility requiring robust medical intervention, but as a biological failure stemming from a corrupted modern infrastructure. Kennedy’s actions focus on dismantling federal health agencies and drastically alter the regulatory framework governing medicine. In public addresses, he has consistently attacks established medical consensus, stating that public health policies are “ruining our children’s health” and leading to an “epidemic of chronic disease.”
Further alignment with eugenicist thinking lies in the proposed solutions to this perceived crisis. Rather than strengthening protective medical care, the rhetoric frequently leans towards a form of biological determinism that views modern medical interventions, such as vaccines and standard pharmaceuticals, as inherently corrupting influences that prevent the human body from achieving its “natural” state. This brand of anti-science rhetoric effectively abandons the vulnerable, stating that the aggressive opposition to standard medical treatments threatens to reverse decades of progress in child survival and disproportionately harms those with compromised immune systems.
When politicians advocate dismantling public health protections in order to let ‘natural immunity’ or ‘cleansing’ of dependencies determine who survives and who does not survive, they risk endorsing a “survival-of-the-fittest” ideology that overlaps with social Darwinist and eugenic ways of thinking. By declaring chronic illness as something to be purged via the withdrawal of institutional medical support, the rhetoric subtly shifts from a message of health advocacy to one of biological exclusion.
Please don’t get me wrong! I do not for a moment seek to diminish the crimes and atrocities of Nazi eugenics; they remain a singular and unprecedented horror. My purpose, rather, is to highlight that any ideology which calls for the erosion of medical safeguards for the sick rests on a perilous philosophical kinship with the Nazi project of privileging the “healthy” over the “infirm.” By recognising these parallels, we may hope to remain vigilant and help forestall the repetition of such history.
