Here we have an editorial by the very editor of the British journal The Lancet, one of the world’s premier medical journals. I agree with many of his sentiments, but the bloke hasn’t realized that he should keep the journal institutionally and politically neutral. If he has personal views on politics, they should be kept out of the journal. By taking strong stands on various issues here and in previous Lancet issues, editor Richard Horton risks polarizing British medicine.
Why do people insist on using their scientific positions to promulgate opinions on issues that are irrelevant to the venue concerned? In this case, Horton opposes “populism” (apparently the views of more conservative Brits) against “progressivism” (apparently the same thing as American “progressive authoritarianism”, and Horton’s own favored stance).
Click to read, though I put the full editorial below. I also found it archived here. 
The thing is, I agree with most everything Horton says in this first paragraph, but were I editor I wouldn’t use my bully pulpit in a medical magazine to go after my ideological opponents:
Occasionally, someone says something so appalling, so shocking, and so disheartening that you just stop in disbelief. On April 26, 2023, UK Home Secretary Suella Braverman said this: “I think that the people coming here illegally do possess values which are at odds with our country. We are seeing heightened levels of criminality when related to the people who have come on boats related to drug dealing, exploitation, prostitution.” Persistent attacks on migrants escaping war, poverty, and insecurity are now normalised in British politics. Robert Jenrick, Minister of State for Immigration, repeated Braverman’s claims: “Excessive and uncontrolled migration threatens to cannibalise the compassion that marks out the British people. Those crossing [the English Channel] tend to have completely different lifestyles and values to those in the UK.” These remarks come as migrants crossing the Channel are blamed for a “surge in diphtheria cases”. They come as the UK Government continues to pursue efforts to deport refugees to Rwanda. They come as experts argue that the government’s Illegal Migration Bill will not “stop the boats” crossing from France. Children will be at particular risk—detained until 18 years of age, at which point they will be deported. The government seems content to ignore warnings that its authoritarian asylum policies are eroding the UK’s global reputation. Why is this happening?
This is the era of culture wars—politicised conflicts over values, identities, and beliefs. Are British institutions systemically racist? Should the monarchy pay reparations for its historical links to slavery? Are activists terrorising the young with climate doom? Has Brexit been a success? What is the definition of a woman? These debates are not confined to the UK. In the US, social conflicts over abortion—from the 2022 Supreme Court Dobbs decision overruling Roe v Wade to recent legal disputes over access to mifepristone—have once again radicalised Presidential politics. Meanwhile, American universities have become a new battleground for free speech, triggering academics to mount a defence against the “asymmetric warfare” of cancel culture. Writing in The Boston Globe last month, Steven Pinker and Bertha Madras announced the launch of the Council on Academic Freedom at Harvard University to protect free inquiry, intellectual diversity, and civil discourse. The culture wars are not restricted to purely domestic divisions. They extend deep into geopolitics. Perhaps the most consequential area of discord for global health is our relationship with China. As Richard Lester and colleagues at the Massachusetts Institute of Technology wrote in Science recently, a wave of Sinophobia “is clouding the outlook for cross-border academic exchange and collaboration in science and technology”. Racial stereotyping and criminalising academic relations with Chinese scientists and institutions are threats to “the free flow of ideas and people”. In a post-pandemic world, this closing of the public sphere is a danger to our common security and health. But, again, we must ask, why is this happening?
His answer, apparently, is all those pint-swilling, chip-eating British nativist “populists”, afraid of immigrants, are holding back the “progressives”. He also doesn’t seem to realize that he himself is chilling speech by making quasi-official pronouncements in The Lancet, nor does he realize that Pinker and Madras would probably object to this kind of semi-official pronouncement. But wait—there’s more. (Bolding below is mine.)
Antonio Gramsci (1891–1937) was arrested by Mussolini’s police in 1926. Imprisoned, he used his time to fill the pages of 33 notebooks. Gramsci sought to make sense of his experience in the vanguard of Italian politics. One question in particular occupied his thoughts. Why did every effort to bring about revolutionary change in Europe fail? His great insight, one largely forgotten today, was to recognise the way in which the dominant group uses culture to exert its controlling influence. If the ruling power can persuade people to share its social, cultural, and moral values, the motivation for radical political change will wither. The culture wars suggest that it is not the economy, stupid. If populist governments can win over the public to their beliefs, progressives have little chance of electoral success. It was this cultural hegemony, according to Gramsci, that explained the resistance to progressive political change in the aftermath of World War 1. And it is the modern struggle for cultural hegemony that explains today’s bitter disputes over race, sex, and gender. For those who wish to advance a more hopeful, compassionate, and liberal vision of the future, we must recognise that the culture wars are not peripheral matters. They are the ground populists have chosen to fight to protect their power and interests. Gramsci, using the military metaphors of his time, called this struggle a “war of position”. It is a war we must not be afraid to engage in.
So here we have the editor of The Lancet advocating “radical political change” and demonizing “populists” (he’s not specific about who they are, but apparently sees the ruling powers in Britain as members). At the same time, he proclaims his virtue, for he takes pains to assure readers that he is on the side that wants a “more hopeful, compassionate, and liberal vision of the future,” while his populist enemies apparently want the opposite.
As I said, I’m surely more politically aligned with Horton than with the Tories (I wasn’t in favor of Brexit and deplore British xenophobia). But Horton should adhere to the advice Stanley Fish gave academics in his 2012 book, Save the World on Your Own Time. Would people accept it if a conservative editor of The Lancet used its pages to favor Brexit and demonize immigrants? If not, then they’re saying that editors can proselytize in The Lancet, but only if they proselytize the Right Ideas.
The journal’s policy should be “keep your ideological, moral, and political opinions as private pronouncements, not splash them all over your journal.”
Here are some covers that have come out during Horton’s reign. The first, you may recall, caused quite a bit of pushback, and Horton was forced to issue a notapology.
“Bodies with vaginas?” Wow, how insulting is that? Can you imagine addressing a woman to her face as “a body with a vagina?”
The Lancet cover is real. Horton got a lot of well-deserved grief for it. See https://www.dailymail.co.uk/news/article-10035415/Lancet-editor-apologises-calling-women-bodies-vaginas-medical-journals-cover.html for a typical article.
Well, Horton then mansplained to adult human females – WOMEN – what a ‘woman’ really is, which of course is any man who says he is.
The cover of the issue immediately preceding this abomination was simply ‘Men’s Health.’
Not ‘Bodies with Prostates’ or ‘People who Ejaculate,’ but MEN’S HEALTH.
So why not simply ‘Women’s Health?’
I leave that as an exercise for the readers.
I can’t find the Lancet cover you mentioned. What is the date, volume, and number of the issue?
The discussion of Gramsci, a Communist, is disingenuous. The supposed war of dominant cultures was just a new gloss on the war against Bourgeois Capitalism, since culture is an outgrowth of the structure of the means of production. Why can’t these people be honest and just say they want to change EVERYTHING? The lesson of the 20th century is that the vast majority of the people don’t want to change everything, especially when the war against the dominant culture has a death toll in the hundreds of millions and never did produce those omelettes.
And yet… you could make an argument, worthy of discussion, that the ‘progessives’ are now the dominant group in culture (political ideas, most main stream media, most likely to chill free speech, attitudes of big corporations). Whether this is a good thing or not in principle, culture still *needs* dissenting voices and argument to prevent a collapse into an authoritarian state.
And a science journal should be very wary of expressing its allegiance to one side – or the other.
I agree totally that scientific journals should only publish articles related to the ostensible mission of the journal. Certainly, Horton could have gotten his editorial published in a news outlet sympathetic to his views. It probably would have gotten a wider audience as well.
Horton paraphrases Gramsci by stating this: “His great insight, one largely forgotten today, was to recognise the way in which the dominant group uses culture to exert its controlling influence. If the ruling power can persuade people to share its social, cultural, and moral values, the motivation for radical political change will wither. The culture wars suggest that it is not the economy, stupid. If populist governments can win over the public to their beliefs, progressives have little chance of electoral success.” Regardless of what one thinks of Gramsci, his analysis that cultural issues sway many voters (as opposed to the economic) is as valid today as it was 100 years ago.
In the U.S., at least, this is what the Republicans are banking on: attacking the Democrats, for them synonymous with Progressives, as attempting to destroy the traditional values of American culture. Tucker Carlson is one of many extreme right-wingers that believe waging the culture wars is the way to political power. Carlson’s popularity does not derive from his views on inflation, but rather how the “other” is undermining the culture of “true” Americans (white Christians). Although most Americans state that economic issues are their main concern, it is less clear that they vote on them. In Florida, Ron DeSantis talks about nothing else other than cultural issues. The next year or so will reveal if this strategy works for the Republicans, and, if it does, how long it will take them to end democracy.
Sorry, Historian, but your comment is largely irrelevant to the discussion. You really have to more than make similar comments over and over again, all of which boil down to saying, “Republicans are bad.” Yes, we know this, but could you please be more than a one-note Johnny?
Batya Ungar–Sargon (hardly a conservative or a supporter of the GOP) has often spoken and written about the “class war” within the Democratic Party, which, by racializing everything, has largely abandoned any concern for working people (of any racial group) in favor of endless and empty virtue-signaling about “identity”.
Yep…how did the Democrats lose much of their base within the working class? They made race, and sex, the basis for their regular oppression Olympics. The rural, poor whites; especially men, became the “deplorables.”
I can feel the old ‘prick of the Lancet’ joke coming on.
Institutional neutrality was probably the most important norm we had to prevent creeping totalitarianism. Oh well. The Enlightenment was nice while it lasted.
In current British parlance a “populist” is anyone who voted for Brexit, or for Boris … or is a Tory … or is dubious about claims that the UK is rampantly racist … or who can’t see how open borders and unrestricted migration would work … or thinks that men shouldn’t be allowed in women’s sport … or has any of a large number of now-heretical opinions.
The irony is that many people voted for Brexit and Boris because, over periods of time, people like Richard Horton just insulted, derided and demonised them.
To add: The attitude of people like Richard Horton to immigration is inconsistent. The fact is that nearly all those crossing the channel in small boats are not “asylum seekers”, they are people with enough wherewithall to pay people-smugglers £20,000 to get them through the obstacle course of getting into the UK. (I don’t blame them for that, I’d be trying the same if I were them, life is indeed better in the UK than in much of the world.)
If Horton really wanted to welcome and provide a refuge for those “escaping war, poverty, and insecurity”, he’d advocate setting up consultates in poor countries to hand out visas and airline tickets to those in need (much of the current population of Sudan for example). But then he’d get 200 million takers or more, which we obviously can’t take. So there is no solution here. Any government has to maintain the obstacle course and deter migrants. It’s silly to blame them for doing so.
Lancet: “For those who wish to advance a more hopeful, compassionate, and liberal vision of the future, we must recognise that the culture wars are not peripheral matters.”
This discovery was anticipated by Leon Trotsky, in “Culture and Revolution” (1924), which specified the kind of New Man that the Bolshevik vision of the future was creating. He put it this way:
“Man will become immeasurably stronger, wiser and subtler; his body will become more harmonized, his movements more rhythmic, his voice more musical. The forms of life will become dynamically dramatic. The average human type will rise to the heights of an Aristotle, a Goethe, or a Marx.” The actual outcome did not quite reach these heights, but did manage to give us a Putin, a Prigozhin, and the TV presenter Vladimir Solovyov.
“And it is the modern struggle for cultural hegemony that explains today’s bitter disputes over race, sex, and gender. For those who wish to advance a more hopeful, compassionate, and liberal vision of the future, we must recognise that the culture wars are not peripheral matters. They are the ground populists have chosen to fight to protect their power and interests.”
This is, unfortunately, becoming an old story. Authoritarian progressives advance radical positions in institutions across society and then when people push back, we inevitably hear: “The rubes are waging culture war! We told you they were evil!” Yes, Mr. Horton. They are trying “to protect” their interests and their children against your attempts to advance your own ideological interests.
“Progressive” portrayals like that of Mr. Horton are the culture war equivalent of a powerful nation that is a military aggressor abroad, one whose leaders attack and suppress peaceful dissent at home while claiming that they are peace lovers who are simply defending freedom and truth. Any attempt by the attacked to fight back is then used to justify the initial assault and intensify the offensive.
Whatever happened to science (and medicine) journals sticking to science/medicine? Another blot on The Lancet‘s long history. Hopefully this madness will come to an end before too long, but I’m not holding my breath.
“His great insight, one largely forgotten today, was to recognise the way in which the dominant group uses culture to exert its controlling influence.”
Horton doesn’t realize that as editor of the Lancet he IS part of the dominant group that uses culture to exert a controlling influence! He’s even resorted to using the Lancet as his bully pulpit. This sort of hypocritical blindness is partly why the Left has a hard time fighting off the right. Horton comes across as a cultural commissar who wants to impose change from the top down. Who finds that appealing, aside from aspiring commissars?
If there is a surge in diphtheria cases in the UK — the normal number is zero—the editor of The Lancet is certainly within bounds to be commenting on measures being taken to control it (which could well involve quarantining recent arrivals.) That’s about the only thing in the editorial that could have made sense and he missed the opportunity to educate us about a supposedly vanquished disease.
Not every ill in society needs to have a doctor’s opinion proffered about it. We don’t know any more about migrant policy and climate change than anybody else and we disagree as much within ourselves as any other group of random strangers.
As far as I know Horton is now more a media personality (to be graceful, medical communicator) than a doctor (skills are fungible) who has been using “The Lancet” and his numerous newspaper columns for years as his personal blow horn to cudgel and bully others. His editorial is simply admitting that his track record is no accident.
Here is another criticism of Horton:
https://unherd.com/thepost/richard-horton-is-destroying-the-lancets-with-politics/