I know that I am exposing myself to derision and scorn for discussing fascism in the context of our current administration.1 Why would a pediatrician want to risk such a discussion when it is so much easier just to sit back and accept the change that is afoot? What proof do I have to maintain such an assertion? Well, when these shifts negatively affect children, all children now and in the future, I cannot possibly sit back and accept the changes that are dramatically impacting children and families. To remain silent is to give implicit approval to the purported reforms that are quite the opposite. The crippling cost of inaction mandates a strong response.2
Two recent books have helped crystallize my thoughts and pushed me to action.3,4 Former Secretary of State Madeline Albright reminds us of the counterterrorism mantra needed in today’s vigilant society – “see something, say something.” But then, she further exhorts us to “do something,” that is to push back against the cynicism and the untethered social impropriety and incivility. Rachel Maddow points out the ease of falling victim to big lies (as perpetrated à la Hitler) and the ease with which bad actors can use those lies to their purpose.5 She details the events of the underground fascist movement in the 1930s in the USA. The parallels of that movement to the events of today are striking.
Before I detail my concerns about children and our current plight, I need to add a few more words about my moral imperative. A recent article on medical professionalism emphasizes several things about evolving standards for the practice of medicine, my lifeblood for over 50 years now.6 Medical professionalism demands 1) an understanding of the strength of diversity in society and in the clinical workforce; 2) a strong competency in cultural differences re: beliefs, values and needs; and 3) four key tenets – patient-centered care, ethical practice, social responsibility, and cultural competency. These latter two tenets, social responsibility and cultural competency, are particularly pertinent to dealing with the negative trends attacking “DEI initiatives and woke agendas.”7 I quote Dr. Fayanju below to highlight the changing role of medical professionalism. “Modern medical professionalism emphasizes and requires a broader societal role for physicians that includes advocacy for health equity in order to reduce disparities; taking a global perspective on health and responding to crises like the COVID-19 pandemic; gun violence; and the opioid epidemic with facts and appropriate explanations for sometimes complex or arcane information. It also includes advocating for, and understanding, the impact of human activity on the climate and environment, and recognizing the link between environmental health and public health.” Doctors are no longer just “medical” experts. Our role has expanded to address the health of all people in a global fashion.
So, let me now address the most serious areas of concern that affect our children, our families and our society in our current state that I equate to burgeoning fascism.
- A leader who exalts himself above others – our current president labels himself as a stable genius and demands loyalty above all else. This is a recipe for disaster and takes us down a dark path. The health of our country is dependent on a democracy in which civil disagreements can be discussed openly. Blind fealty based on a written or unspoken oath to one man and perpetrated on the basis of hate and fear does not serve our children.8 It actually serves to turn children against one another and erodes our ability to serve one another.
- A leader who lies indiscriminately – Lies only serve a despot.9,10 They help disseminate hate and fear and linger for years or decades to come. “The election of 2020 was rigged” lie has continued, and the “they are eating cats in Ohio” lie during the 2024 election has only served a divisive purpose. And, they aid to stoke a fire of doubt that pits us vs. them.
- A leader who attacks the strength of the diversity in our society – Serious attempts to dismantle programs that celebrate our diversity and seek to lift all citizens to an equal playing field are rotten to the core.11,12 As noted above, our modern medical professionals should (and must) embrace and address these differences for the betterment of all. The myth of meritocracy, as currently professed, should be squelched.13
- A leader who engages in the demonization of so many – Our current president is quick to label any and all non-citizens as murderers or rapists. Non-immigrant crime is much higher than that attributed to immigrants. Programs to deport non-citizens can be conducted in a humane way with due process. The use of masked “agents” engaging in unlawful seizure without due process is just a telltale example of our slide to fascism. These agents might as well have white robes, pointed hats and burning crosses nearby.
- A leader who jeopardizes the health of our children – To appoint an unqualified head of our health agencies who might singularly dismantle one of the most successful vaccine programs in the world, while leading to increased numbers of disease and preventable deaths, borders on criminal behavior. Perhaps this characterization is too harsh, but a realistic assessment will support my assertion. Cutting back on research programs and environmental protections have a similar effect, disproportionately affecting children now and for decades to come.
- A leader who supports the banning of books – Books are the great tools of a civilized society and to be cherished for our children. When efforts to ban books based on content that some find offensive occurs, we are on a slippery slope to authoritarian messaging. It is ironic that those that fear books will lead to aberrant behaviors see no problem whatsoever with unfettered access to guns. They see any attempt to reasonably regulate guns as ill-conceived, but it is ok to ban books.
- A leader who blurs the lines between church and state – The separation of church and state is quite clear in our constitution so attempts to blur that distinction in education and public policy have the effect of jeopardizing this clear separation. The argument that certain religious groups have been ostracized (evangelical Christians) I find unconvincing and actually antithetical to broadly practicing the golden rule.14 Children need to learn the appropriate separation while freely practicing their faith of choice.
- A leader who seriously attacks the rule of law – Madeline Albright aptly notes that our constitution is the needle-and-thread of democracy. Any defiance of court orders and stonewalling of legal mandates seriously erodes standards that protect children. The thuggery of masked agents, the lack of due process, and then defying the courts are beyond precedent. The removal of appropriate oversight in the Justice Department is frightening as the “law” becomes a tool to gain favor instead of deliver justice for all.
- A leader who ignores humanity across the globe – The current abandonment of our foreign service and aid will lead directly to millions of unfortunate and preventable deaths from starvation and infection.15 Our heartless disregard for others and relinquishing our role to serve others when we can help is beyond appalling. Bill Gates appropriately stated, “the picture of the world’s richest man [Elon Musk] killing the world’s poorest children is not a pretty one.”16
I could go on. I have chosen to pick a few as I seek to maximize the care and nurturing of our children. The safe, stable nurturing relationships (SSNRs) that our children need come from beyond our families when we recognize that it does take a village. The lives of children, the lives of families, and the lives of our communities are inextricably intertwined. It would be convenient to separate the ways of government from the nurturing of our children, but it cannot be done. A misguided leader and government can adversely affect the growth and development of our children. I cannot stand idly by and remain silent. My medical professionalism and personal ethos demand it.
- Definition of fascism – “A populist political philosophy, movement…that exalts nation and often race above the individual, that is associated with a centralized autocratic government headed by a dictatorial leader, and that is characterized by severe economic and social regimentation and by forcible suppression of opposition.”
- https://mychildrenschildren.com/the-crippling-cost-of-inaction/
- Albright M. Fascism: A Warning. Harper Perennial, New York;2018. 288 pp.
- Maddow R. Prequel: An American Fight Against Fascism. Crown, New York; 2023. 382 pp.
- https://mychildrenschildren.com/learning-from-history/
- Fayanju OO, Byyny RL. Professionalism: Yesterday, Today, and What Comes Tomorrow in a Relentlessly Changing World. The Pharos (Spring 2025):2-11.
- https://mychildrenschildren.com/woke-is-good-not-evil/
- (reference to come)
- https://mychildrenschildren.com/lies-and-myths-affecting-childrens-lives/
- https://mychildrenschildren.com/the-cost-of-lies-2/
- https://mychildrenschildren.com/somewhere-2/
- https://mychildrenschildren.com/was-i-wrong-only-in-style/
- https://mychildrenschildren.com/amazing-grace/
- https://mychildrenschildren.com/love-thy-neighbor-3/
- https://mychildrenschildren.com/voices-for-children/
- https://www.nbcnews.com/news/us-news/bill-gates-accuses-elon-musk-killing-poor-children-says-s-giving-away-rcna205566