Abstract
Individual autonomy is fragile.
We must ask whether we have been swept up with ‘ a crowd ‘; perhaps trapped within a ' thought window ', carried by mass narrative, or entranced by the certainty of the totalitarised mind.
Loss of the individual to the group can occur on any scale, from ' group-think ' cognitive bias, through the eager madness of a literal crowd, to the modern global reach of propaganda and technocratic totalitarianism.
Milgram electrocution experiments show potential for the mind to be rapidly totalitarised – the hypnotic, focal enthusiasm of ' engaged followers '.
This work was performed at the time Hannah Arendt coined the term ' banality of evil ' and described a new form of criminal, the bureaucrat.
Totalitarianism is an ever present under current in society and the scientific community is not exempt from the dangers. Strictly enforced bed rest for patients is one of the best known medical mass narratives, responsible for the loss of many lives.
Responses to the COVID pandemic years echo the ideologies of history.
Healthy curiosity, dissent from the main stream and open debate are essential to progress in science and must be welcome at all times.
Individuals can advance science.
Narrative is spread by ‘ the crowd ’.
Philosopher Friedrich Nietzsche wrote;
“ In individuals, insanity is rare; but in groups, it is the rule ”. 1
We may ask when we have acted with individual autonomy and when we have been swept along with a group, a crowd or mass narrative; ‘ Freude, schöner Götterfunken ’, at full voice - a chorus, murmuration, or rapture; group-think and crowd thought; the blinkered certainty of the totalitarised mind.
A great threat to progress of science is loss of the individual to ‘ the crowd ’. 2
Gustave Le Bon on “crowd theory” posits that individuals subsumed into a crowd experience psychological change; they shed autonomy to form a collective or totalitarised mind. Blind enthusiasm, fanaticism and mass narrative are related concepts. 3 Similar loss of individualism occurs on scales as small as group-think and as large as a global propaganda campaign.
Political theorist Hannah Arendt describes social fragmentation or the ‘ atomised ’ individual as the vulnerable entity ready to imbibe propaganda. 4
Explored in detail by Mattius Desmet, the psychology of totalitarianism is described as waves of unfettered anxiety and fear that will ‘ latch on ‘ to a new narrative to result in mass formation – thought transformation on a mass scale - the essence of totalitarianism.
It can happen in miniature format in trial by jury; group-think. The most ambitious totalitarian projects of the 20 th century have been the Third Reich (Germany, 1933 – 1945) and Stalinism (Soviet Union, 1920s – 1953). For the 21st thus far, with much of the global population in a mass frenzy over COVID, the highlights have been door-step applause for the NHS (National Health Service, UK) and the call from the Belgium government for the nation to rally as a team of 11 million. Features of the totalitarised mind include sacrifice of personal interest in favor of solidarity with the collective, profound intolerance of dissent, susceptibility to propaganda, and destruction of ethical awareness. The prototypical trait of totalitarianism is experimentation on humans. 5
Milgram electrocution experiments have been widely interpreted as loss of individual autonomy and compliance with authority figures; this includes participation in torture with abdication of responsibility - (‘ just doing my job '). 6 More recently, this research has been expounded as potential for the mind to be rapidly totalitarised – hypnotic focal enthusiasm – by a narrative as simple as participation in research to advance science - ' engaged followers '. 7
Inspiration for Milgram included the capture of SS officer Adolf Eichmann, chief architect of the Holocaust, by Israeli Mossad agents (1960). Subsequently brought to trial in Jerusalem (1961), presumptive expectations that a ‘ monster ’ would appear in the dock were completely deflated; he was a rather dull civil servant.
Hannah Arendt coined ' the banality of evil ’ in her analysis of the trial. 8 She was struck by Eichmann’s demeanor; a shallow bureaucrat motivated by career advancement.
Arendt argued that lack of independent moral thought and blind obedience to authority enabled horrific acts without guilt (banal evil). Bureaucracy allowed individuals to distance themselves from the consequences of their actions. She postulated that Eichmann represented a new type of criminal - the bureaucrat - a challenge to traditional legal frameworks that relied on the guilty mind (mens rea). She predicted in 1958 the intrusive security forces, increased surveillance, informant mindset and censorship of future technocratic totalitarianism. 9 Ultimately, ‘ Eichmann in Jerusalem ’ warns of conformity and failure to exercise moral judgement. Reflections can be found in recent global pandemic management.
Not all totalitarised individuals are caught. Josef Mengele, SS officer and doctor in the Third Reich, conducted macabre experiments on pregnant women and twins at the Auschwitz extermination camp; he tortured children. His mind was totalitarised; his mission, to secure the science behind a perfect twin pregnancy. Mengele would escape justice and ultimately drown off the coast of South America in 1979. 10
Mass narratives in medical science
Totalitarianism is an ever-present undercurrent in society – ready to seize control when conditions allow – cycles of unattached anxiety, eagerness or ebullience that latch on to new narrative. Medical science is no exception.
Bernard Lown (1921 – 2021), worked tirelessly to counter mass medical narrative. Original developer of the defibrillator and cardioverter (1962), he revolutionised resuscitation and rhythm management; he co-founded International Physicians for the Prevention of Nuclear War (Nobel Peace Prize, 1985), and he pioneered mobilisation after myocardial infarction. He is remembered as a visionary physician; he fully understood the absence of controlled clinical trials for coronary artery graft surgery and he rarely referred. Asked about his relatives, he would reply; ‘ one third in Israel, one third in the U.S., one third in ashes – if you don’t learn from history, you are condemned to repeat ’. 12
Conclusion
Nietzsche believed most people never meet their real self; (rather) they become what society seeks; polite, predictable, and popular with peers; a quiet death for the individual; certain embrace by the crowd.
Individuals offer healthy skepticism, curiosity, evidence, open debate; they caution against haste or warp speed.
The essence of totalitarianism is an attempt to reduce the infinite nuance of human language to the absolute certainty of a signpost. Unique individual traits dressed in uniform.
Totalitarianism will remain a threat in science; each wave of propaganda will fizzle out with time, abandoned with the whistle of innocence; but another wave will follow.
Accountability and apology will be hard to find; last seen heading in the direction of Patagonia.
Science is characterised by empathy between the observer and the observed. No one is exempt from the risks of a totalitarised mindset, but each and everyone of us can protect autonomy, embrace creativity, cultivate doubt and uphold the timeless nature of medical ethics.
Footnotes
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.