The Seemingly Unsolvable Dilemma: Racism in the Medical System

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Hi! I’m Ma-Sadio.

(“Many Medical Decision Tools Disadvantage Black Patients”)

Overview

Racism, in general, has always been a significant issue. But what happens when that shifts to the medical system? Racism in the medical system has always been a controversial topic. Like all topics that are heavily debated and covered with a lot of misinformation, it has also become a political one as well. Regardless of positions taken, countless studies, statistics, and figures have proved that medical care differs with different races.

To put this into perspective, black women are four times more likely to die in childbirth than white women. Many people of color (POC) have risked their lives entirely solely based on the inferior treatment they feel they will receive. Because of this, 10% of Asian adults did not see a doctor due to their race in 2018. 21% of Hispanic people did the same. Another issue is that racism in the medical system is taught, and not always visible. Medical students, interns, and residents are taught to quickly identify inflammation, but only for people with white skin, not black or brown skin. Melanoma, an easily treatable disease, is often missed in Black people because physicians cannot tell the difference between it and another diagnosis, simply on the basis of skin color.

With all the questions, misinformation, and lack of medical understanding, we have to ask ourselves the questions of: how has a racist medical system benefited or harmed parties, and how should the situation proceed? What factors limit medical care? And how does race conclusively factor into medical care?


Case Study

Jia Chan is a 42-year old recent immigrant and a new patient at your hospital. Three weeks ago, she had been diagnosed with irritable bowel syndrome after complaining of symptoms of abdominal pain, fever, nausea, diarrhea, and blood in her stool. Jia was prescribed dietary changes. She, however, refused to revisit the hospital afterward, citing mistranslation and racism as her reasons. She also filed a complaint saying that her physician had repeatedly dismissed her symptoms and concluded they were induced by her stress with duties as a busy housewife and demanding mother. However, after a particularly bad pain episode, her husband brought her back in. Her symptoms have worsened, with new additional symptoms of constipation and more pain. No tests have been ordered. Now, her case has been handed to you. How do you handle this situation, and what should you do?

Race is a factor in healthcare and medical care. The glomerular filtration rate (known as the eGFR), is even estimated based on race. There are also many diseases, disorders, and illnesses that are commonly found in certain races. But Jia’s situation is entirely different: she’s declared that she has received lesser care due to her race. This factor has now prevented her from seeing the doctor again. So, recalling the ethical question, how has Jia’s race conclusively factored into her medical care? Her physician had made reference to the ‘tiger parent’ stereotype, a typically Asian stereotype in which a parent demands high levels of success from their children. Jia had a case of diverticulitis, a common inflammatory disease. Her diverticulitis was right-sided, which is typically found only in Asia and is, again, typically overlooked by physicians.

So what would the hospital do in this situation?

The situation depends. There may be grounds for a medical malpractice lawsuit, and grounds for potential compensation, should Mrs. Chan sufficiently prove her treatment was hindered by her race. However, the issue is not the reparations. The problem is that racism was brought into the medical space in the first place.


Main Issues Within Medical Racism

 Those who agree and declare that medical racism exists say that it’s not an anomaly that medical racism has persisted over the centuries, even well into the 21st century. They say it has for a couple of main reasons:

Medical Skepticism

Tuskegee Medical Experiment

The Tuskegee Medical Experiment was an unethical experiment conducted on 600 African-Americans by the United States Government between the years of 1932 and 1972. Under the guise of treating the men for “bad blood” (vernacular for syphilis at the time), it infected 201 men and promised the rest (who were already infected), medical care and more benefits for their families. The experiment was meant to last only 6 months but was extended to 40 years. 28 men died directly as a result, and 59 people, including the wives and children of the participants, were indirectly infected. Eventually, in 1997, then-President Bill Clinton issued a formal apology.

While it took place 49 years ago, the Tuskegee Medical Experiment has continued to have a profound effect on the Black community in the US. Waves of medical skepticism and distrust overtook the community, which has still proven to have a lasting effect. Amidst the vaccine rollout, Black Americans were vaccinated at extremely slow rates. Many cited a distrust in the vaccine itself. 

J. Marion Sims

James Marion Sims is widely regarded as the “Father of Gynecology.” However, the road to this moniker was painful for those who had the misfortune of experiencing it. Throughout his career, Sims performed unethical surgery on Black slaves without anesthesia, a stark contrast to his White patients. He was a racist slaveholder who believed that Black people could not feel pain. Some of his operations attempted to ‘smarten’ African-Americans by drilling into their brain; he believed that his methods were 100% okay. Today, J. Marion Sims is viewed highly, but the trauma, caused by him, carried by the African-American community, has never been forgotten.

Harm Caused to POC

Pain Meds

Black people in the US are often under-prescribed pain meds, creating a racially-induced medical bias on pain. A 2016 study done by the Proceedings of the National Academy of Science of the United States of America concluded that Black and White people are treated differently for pain based on inaccurate and historic stereotypes. Even going as far as to say, that “scholars continue to believe that the black body is biologically and fundamentally different from the white body.” Which is untrue.

Misdiagnoses can also be caused by race, as seen in the previous case study of Jia Chan. Myalgic encephalomyelitis (ME) is described by Mayo Clinic as “a complicated disorder characterized by extreme fatigue that lasts for at least six months and that can’t be fully explained by an underlying medical condition.” The condition is most common amongst women. ME can be diagnosed in any race, but is underdiagnosed in minority communities, as it is seen as a “White woman disease.” Millions of minorities go undiagnosed today due to this untrue medical bias. 

A group of Tuskegee participants received shots.

The Opposition

As with any argument, there are those who disagree. Others declare that medical racism does not exist and that it has dissipated over the centuries. They offer refutes to the antilogy.

Medical Skepticism

The Media’s Role in Mass Panic

Those who disagree with the consensus on racism in the medical system sustain the belief that the mainstream media plays a large role in how alleged racism in the medical system is perceived by the public. Fox News’ Paris Dennard proclaimed that the CDC (Center for Disease Control), was carrying out the bidding of the concurrent administration of President Joe Biden, and had “inserted race” into health problems.

Harm Caused to POC

Those who disagree with the consensus on racism in the medical system sustain another belief that little, if no medical harm, has been caused to POC on the basis of their race. In April 2021, a podcast produced by prestigious medical journal JAMA deemed that no physician was racist.


Conclusion

Like stated in the overview, there are many different sides and opinions to racism in the medical system. However, facts divulge nothing but facts, and a great number of studies have only proved that medical racism exists. Proof of so can be found in studies, stories, case studies, and even interviews from the victims it produces.


Resources

Click for the bibliography here.


Questions

  1. What do you think of racism in the medical system?
  2. How do you think it can be solved? Do you think it’s a solvable problem?
  3. Have you ever experienced racism in the medical system yourself?
1 Comments
Ma-Sadio_561

Ma-Sadio_561

unis, nyc

1 comment

  1. Hi Ma-Sadio, it is undeniable that racism is abhorrently prominent within society including the medical healthcare system, like you stated “facts divulge nothing but facts.” This is a systemic issue that not only affects the minds, but the lives of human beings. The color of one’s skin should under no circumstance define what type of treatment you receive, let alone when it comes to the healthcare system, which we rely on in times of medical and even life-threatening emergency. This is something that has been ongoing for far too long and undeniably needs to change. With this being an issue that has evolved for centuries, yet, never fully eliminated, I wonder how we can truly instigate a change that must first come from the minds of the people who consistently prejudice against others for their identity.

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