Dr Pies is Professor Emeritus of Psychiatry and Lecturer on Bioethics and Humanities, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts University School of Medicine; and Editor in Chief Emeritus of Psychiatric Times (2007-2010). Dr Pies is the author of several books. A collection of his works can be found on Amazon.
Immoronic: a combination of immorality and moronic. Examples are not hard to find in modern American culture, and they transcend any one political party or ideology.
As an ethicist and physician, I have been struggling to come up with a term that summarizes the potent combination of ignorance and immorality that characterizes certain elements in American society today. My breakthrough came upon reading about former Kentucky governor Matt Bevin’s pardon of a 41-year-old man sentenced to 23 years in prison in 2018 after being convicted of rape, incest, sodomy and other sexual offenses. According to the Washington Post,1 Bevin justified the pardon on the theory that a 9-year-old girl could not have been raped because her hymen was intact. This, despite medical testimony from Dr George Nichols, an expert in evaluating child abuse, who pointed out that inspecting an alleged victim’s hymen cannot prove whether they were sexually assaulted; indeed, most survivors of child sexual abuse do not have any physical damage.
Dr Nichols commented that Bevin “clearly doesn’t know medicine and anatomy” and that “Rape is not proved by hymen penetration.” According to the Post, “Lawmakers on both sides of the political spectrum have called for an independent investigation into Bevin’s flurry of last-minute pardons, citing concerns that some were granted as favors to supporters.”1 The mother of the young girl likened the pardon to a “slap in the face” and was trying to get an emergency protective order-or possibly moving to another part of the country.
How best to describe the combination of ignorance and immorality in the former governor’s action? I have settled on the portmanteau word, immoronic: a combination of immorality and moronic. Examples of the immoronic are not hard to find in modern American culture, and they transcend any one political party or ideology.
It would be a mistake to assume that everyone who traffics in the immoronic is a “moron,” in the colloquial sense of “a very stupid person.” There are certainly people of apparently high intelligence who, nevertheless, propound immoronic views. Consider the case of Robert F. Kennedy, Jr.-the son of Robert F. Kennedy and nephew of President John F. Kennedy. RFK Jr is among the most prominent “antivaxxers” in the United States.
For several years now, this Harvard-educated attorney and adjunct professor of environmental law has been spouting dangerous drivel about a (non-existent) causal link between vaccinations and autism-so much so, that his own family has denounced him. They have noted that, “He has helped to spread dangerous misinformation over social media and is complicit in sowing distrust of the science behind vaccines.”2
Similarly, health care workers who refuse to get the influenza or measles vaccine-thus endangering those they care for-are engaging in immoronic behavior, in my view. Dr Holly Kramer,3 president of the National Kidney Foundation, has pointed out that patients receiving dialysis, for example, are at particular risk of flu complications, owing to their weakened immune systems. “The health care workers need to be vaccinated because dialysis patients are more likely to develop severe influenza and need to be hospitalized and can die from influenza,” Kramer said.
In my view, health care workers have no reasonable excuse for refusing the flu shot, if they continue to work in a public health setting. It is also depressing to learn that 37% of American adults don't plan to get flu shots this season, according to a recent poll-probably owing to the fear generated by purveyors of immoronic misinformation.4
Climate change and the immoronic
Then, of course, there are the climate change deniers. Few groups have managed to combine the immoral and the moronic more dangerously than the (mostly right-wing) purveyors of this benighted ideology. It may seem odd to attribute “immorality” to a narrative concerning the earth’s climate, but if befouling the planet’s ecosystems and polluting our air and oceans is not immoral, I am not sure what is. (In addition, the adverse effects of climate change on mental health have been discussed in Psychiatric Times by several psychiatrists).5,6
Yet some very influential climate change deniers insist-despite clear warnings to the contrary from climate science experts-that global warming is a “hoax.”7
In this regard, the “2020 Immoronic Award” must surely go to physicist William Happer, a National Security Council senior director, who famously proclaimed, “The demonization of carbon dioxide is just like the demonization of the poor Jews under Hitler.”8
Immoronic ideas directed against psychiatry and psychiatric patients
Finally, in our own bailiwick of psychiatry, we have the “mental illness deniers,” who get my vote for the most egregious form of immoronic behavior. Those who insist that psychiatric illnesses are “myths” or merely “social constructions” do enormous harm-and show great disrespect-to the millions of people who suffer with schizophrenia, bipolar disorder, and other debilitating conditions.9
Ironically, one subgroup of antipsychiatry critics does not deny the existence of psychiatric illness. No-this group claims there is an “epidemic” of mental illness, fueled by the very medications psychiatrists use to treat psychiatric disorders.10,11 I have taken pains to debunk this claim12 which may frighten vulnerable patients into avoiding or discontinuing potentially life-saving medication. There is compelling evidence, for example, that lithium and clozapine have anti-suicidal effects in bipolar and psychotic disorders, respectively.13,14
The mistrust of science
In my view, there are worrisome societal trends at work that may be contributing to immoronic claims and behavior in this country (and perhaps elsewhere). In our post-modern age, the role of the “expert” has been severely undermined and discredited. Medical specialists who reassure the public that vaccinations do not cause autism are roundly ridiculed and disparaged. Climate scientists who warn of dire consequences from global warning are ignored or slandered.15
Driving the surge of immoronic ideas is a culture drowning in “alternative facts;”16 misleading internet websites; and a general distrust of science itself. A recent survey
that, globally, only 18% of people have a high level of trust in scientists.17 In the US and Canada, the figure is an underwhelming 26%. Shawn Otto, co-founder and producer of the U.S. Presidential Science Debates and author of The War on Science, recently observed “There seems to be an erosion of the standing and understanding of science and engineering among the public. People seem much more inclined to reject facts and evidence today than in the recent past.”18 Otto notes that anti-science positions are now acceptable in public discourse, in Congress, state legislatures and city councils, in popular culture, and in presidential politics.
What needs to be done?
How do we counteract the surge of immoronic claims? First, we need to address deficiencies in our educational system, particularly with respect to science education. As K-12 educator Belle Boggs19 has put it,
“If American citizens are to have any chance of speaking truth to power, they will need to have a better handle on the truth part. They will need to be better educated, and the science classroom will have to be political-not in the partisan sense, but in the sense of the Greek word politikos: of, for, or relating to citizens. The science classroom will need to prepare them for engagement in our democratic society, to make choices that affect their lives and their communities.” 19
More broadly, we need to teach our children at an early age how to sort through and analyze the reams of information-and misinformation-with which they are bombarded every day. In one study by educational psychologist Dr Julie Coiro and colleagues,20 70% of middle school students were found to be ill-equipped to evaluate online information. The study found that these students are more concerned with content relevance than with credibility; rarely attend to source features such as author, venue, or publication type to evaluate reliability and author perspective; and when they do refer to source features, “. . . their judgments are often vague, superficial, and lacking in reasoned justification.”
Finally, in our own field of psychiatry, all of us need to do a better job of public outreach and education, so that the nature and reality of mental illness and the benefits of psychiatric treatment are made widely known. And, yes-we must do so with a full acknowledgment of what we do not know or understand about mental illness, and what we cannot yet successfully treat.
In short, if we are to push back against the surge of the immoronic, we must restore respect for hard-won scientific expertise; provide the public with the tools needed for critical analysis; and remain strong advocates for our profession and our patients.
Editor's note: The term "immoronic" is a neologism coined by the author, so far as he is aware. The views expressed in this article are those of the author and do not necessarily reflect the opinions of Psychiatric Times.
Dr Pies is Professor Emeritus of Psychiatry and Lecturer on Bioethics and Humanities, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts University School of Medicine; and Editor-in-Chief Emeritus of Psychiatric Times (2007-2010).
The author reports no conflicts of interest concerning the subject matter of this article.
1. Farzan AN. Kentucky’s ex-governor pardoned a child rapist because the 9-year-old victim’s hymen was intact. https://www.washingtonpost.com/nation/2019/12/20/matt-bevin-micah-schoettle-child-rapist-hymen-intact-pardon. Accessed January 2, 2020.
2. Epstein K. ‘He is wrong’: Robert F. Kennedy Jr.’s family calls him out for anti-vaccine conspiracy theories. Washington Post. May 8, 2019. washingtonpost.com/health/2019/05/08/he-is-wrong-robert-f-kennedy-jrs-family-calls-him-out-anti-vax-conspiracy-theories. Accessed January 2, 2020.
3. Lazar K. Many health care workers are refusing flu shots, endangering patients, regulators say. Boston Globe. December 20, 2019. https://www.bostonglobe.com/metro/2019/12/20/many-health-care-workers-are-refusing-flu-shots-endangering-patients-regulators-say/7o71o3yYtTEm8Bsoq2zSlJ/story.html. Accessed January 2, 2020.
4. Hellman J. Survey: 37 percent of Americans plan to skip flu vaccine this season. The Hill. December 3, 2019. https://thehill.com/policy/healthcare/472803-survey-37-percent-of-americans-plan-to-skip-flu-vaccine-this-season. Accessed January 2, 2020.
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6. Moffic HS. What Do Climate Change and Physician Burnout Have in Common? Psychiatric Times. January 24, 2017. https://www.psychiatrictimes.com/couch-crisis/what-do-climate-change-and-physician-burnout-have-common. Accessed January 2, 2020.
7. Stanley-Becker I. Trump, pressed on the environment in U.K. visit, says climate change goes ‘both ways.’ Washington Post. June 5, 2019. https://www.washingtonpost.com/world/europe/trump-pressed-on-the-environment-in-uk-visit-says-climate-change-goes-both-ways/2019/06/05/77c8750c-8717-11e9-9d73-e2ba6bbf1b9b_story.html. Accessed January 2, 2020.
8. Lafond N. Trump Physicist Has Compared ‘Demonization’ Of CO2 To ‘Jews Under Hitler.’ Talking Points Memo. May 28, 2019. https://talkingpointsmemo.com/news/trump-physicist-demonization-carbon-dioxide-jews-hitler. Accessed January 2, 2020.
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10. Angell M. The Epidemic of Mental Illness: Why? The New York Review of Books. June 23, 2011.
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14. Pompili M, Baldessarini RJ, Forte A, et al. Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview. Int J Mol Sci. 2016;17:1700.
15. Mann M, Toles T. Deniers club: Meet the people clouding the climate change debate. Washington Post. September 16, 2016. https://www.washingtonpost.com/posteverything/wp/2016/09/16/deniers-club-meet-the-people-clouding-the-climate-change-debate. Accessed January 2, 2020.
16. Pies RW. ‘Alternative facts’: A psychiatrist’s guide to twisted relationships to truth. The Conversation. March 1, 2017. http://theconversation.com/alternative-facts-a-psychiatrists-guide-to-twisted-relationships-to-truth-72469. Accessed January 2, 2020.
17. Wellcome Global Monitor 2019: How does the world feel about science and health?
. Gallup. Accessed January 2, 2020.
18. Examining the Mistrust of Science: Proceedings of a Workshop–in Brief. National Academies Press. 2017. https://www.nap.edu/read/24819/chapter/1. Accessed January 2, 2020.
19. Boggs B. Tell Your Second-Grade Teacher I’m Sorry. Slate. November 24, 2013. http://www.slate.com/articles/health_and_science/education/2013/11/science_education_in_america_why_k_12_students_fall_behind_in_science.html. Accessed January 2, 2020.
20. Coiro J. Teaching Adolescents How to Evaluate the Quality of Online Information. Edutopia. April 7, 2014. https://www.edutopia.org/blog/evaluating-quality-of-online-info-julie-coiro. Accessed January 2, 2020.
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