Slavoj Žižek, in his 2014 book Event, perhaps describes the way many (certainly 16 141 241) people feel about our present Brexit moment: “the effect that seems to exceed its causes…an occurrence not grounded in sufficient reasons”. For those who voted to remain, it has been tempting to let emotion take (back) control—shock, sadness, anger, recrimination, blame. A forlorn feeling that maybe xenophobia, intolerance, racism, extreme nationalism, and even violence have emerged as new national values in post-Brexit Britain. The Science Media Centre collected a round-up of rapid reactions from the UK's medical and scientific elite. Venki Ramakrishnan, President of the Royal Society, said, “we must make sure that research, which is the bedrock of a sustainable economy, is not short changed”. Paul Nurse, Director of the Francis Crick Institute, noted that Brexit, “is a poor outcome for British science and so is bad for Britain”. Robert Lechler, President of the Academy of Medical Sciences, called Brexit, “a very disappointing outcome for medical science”. Although understandable, these responses were dispiriting. The “surprising emergence of something new which undermines every stable scheme” (Žižek) surely demanded reflections that were less self-absorbed. The “insufficient” causes and reasons of last week's vote suggest uncomfortable truths. The divisions between old and young, north and south, and England/Wales and Scotland/Northern Ireland threaten the cohesion of not only our four nations but also communities up and down the land. What is the origin of discontent among those who voted to leave the European Union? In one word—unfairness. For those with fewer resources and in the face of unemployment, deindustrialisation, urban decay, rural poverty, and the excesses of globalisation, there was a strong sense that governments and political institutions (such as those of the European Union) had turned their backs on those they purported to serve. Many people feel forgotten at best, ignored at worst—humiliated, alienated, dispossessed, and culturally lost. Brexit was a triumph for direct democracy. It exposed the failure of representative democracy. The chief question now is what does the UK stand for? A clue might be found in Magna Carta, one of the founding documents of our country: “To no one will we sell, to no one will we deny or delay, right or justice.” Brexiteers were protesting that they had indeed been denied “right or justice”. Here is where the UK's medical and science communities have a crucial part to play. Medicine and science embody values of solidarity and society. The purpose of both, through health and knowledge, is to build stronger and more resilient communities, to provide foundations for the fulfilment of hope and aspiration. Our task must be to defend the 800-year-old promise of “right or justice”. That means delivering the right to the very highest attainable standard of health. It means attacking the social, political, and economic determinants of inequality. It means investing in children and young people as the foundation for a sustainable future. It means improving daily living and working conditions throughout the life course. It means restoring as best we can some measure of unity across geographies and generations. This task will not be easy, since the arguments that underpinned the Brexit campaign are inimical to a strong cohesive society. The Brexit dogma thrives on division and conflict. Boris Johnson, a leader of the Leave campaign and a potential future Prime Minister, put it this way in 2013—”some measure of inequality is essential for the spirit of envy…that is, like greed, a valuable spur to economic activity”. Those who led the Brexit campaign seek to build a society based on envy, greed, and inequality. They see these attributes as “essential” prerequisites for national success. Science and medicine urge something very different. The National Health Service is a core social institution that makes equity and altruism central values in our society. The response to Brexit from our scientific and medical leaders should be to widen the circumference of their concerns, not implicitly endorse a philosophy of competitive greed that some Leavers wish to foster. Instead, we should be strengthening our associations across society, encouraging a less selfish and more generous spirit in our public words, and promoting a more constructive internationalism that recognises that there is a slowly emerging world society, one that will depend on our full participation and engagement.
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