Why are so many dictators former doctors?
Are we increasingly living under a ‘doctatorship’? The influence of the medical profession over our everyday lives – from personal freedom, to how our children are schooled, to the economy – has soared since the pandemic.
But is this a good thing? Or are democratically elected governments in danger of allowing medics to have undue say over how things are done?
It’s hard to deny that Covid-19 has dramatically increased the influence of medics. When their advice is not taken, medics sometimes resort to the media to pressure our elected politicians to conform to their views, even when they disagree amongst themselves.
Many doctors, of course, have the best intentions at heart. But we should be wary of any group not accountable at the ballot box and while it may sound dramatic, it is worth recalling that doctors and democracy do not always sit amiably side by side. Indeed many tyrants are medically qualified, beginning with the British-trained Syrian eye surgeon President Bashar al-Assad.
Other medical despots include Dr Hastings Banda who brutally ruled Malawi for nearly 40 years, Dr Félix Houphouët Boigny megalomaniac president of Ivory Coast for some 30 years, psychiatrist Radovan Karadzic the ethnic-cleansing Bosnian-Serb leader and the notorious ‘Papa Doc’ Duvalier of Haiti, whose gruesome, tyrannical rule of Haiti as president for life, stretched from 1957 until his death in 1971 after murdering 30,000 people via his Tonton Macoutes mobs. Few from this club had much regard for the Hippocratic oath of ‘do no harm’.
Terrorist leaders too have often trained as doctors before embarking on their murderous rampages. Dr Ayman al-Zawahiri, who masterminded the 11 September World Trade Center massacre, and who succeeded Osama bin Laden as leader of Al-Qaeda, was an Egyptian doctor and surgeon.
Dr George Habash was the 1970s Palestinian terrorist leader of the Popular Front for the Liberation of Palestine, while Dr Abdel Rantisi as Hamas leader conducted the suicide bombings of Israeli civilians in the 1990s.
The historian and novelist Simon Sebag Montefiore, himself the son of a doctor, notes that many of these bloody despots used medical language to justify their gruesome political acts, such as Papa Doc Duvalier’s ‘ nation’s ills demand a doctor’. The Haitian tyrant also liked to say that 'a doctor must take a life to save it.'
Of course, it could be argued that medicine is a traditional prestige route for ambitious middle-class young men in the developing world in a way that law and the humanities might be in developed states. Be that as it may, the correlation between medically trained leaders and authoritarianism is demonstrated in an article in the prestigious medical journal the Lancet from 2017.
Entitled ‘The physician as dictator’ the research was conducted in the wake of atrocities committed by the Assad regime.
It sought to establish in the light of ‘the frequent criticisms of the hierarchical power structure in medicine… whether physicians disproportionately tend to be the leaders of autocracies.’ Deeply researched it analyses some 176 countries over 71 years (1945-2015) identifying the de-facto ruler of every country for each year.
The 1,254 leaders professional backgrounds were investigated as well as the degree of democracy versus autocracy for each leader’s tenure. The article concludes:
“Our results reveal a disturbing correlation that associates leaders who are physicians in the modern era with more autocratic regimes than leaders who are not physicians... considering the trope of the physician-god complex, these sobering data offer an opportunity for crucial self-reflection.
Their recommendation to ‘safeguard against any dictatorial tendencies physicians might harbour’ is a shift away from the authoritarian physician towards more shared decision-making.
Perhaps the Lancet article should be made compulsory reading for members of the doctocracy who, with their new-found Covid powers, are dictating policy across the world with little consideration for the wider implications of their edicts. As Simon Sebag Montefiore remarks, ‘there are cases where the doctor is himself the disease’.