Racism and discrimination are deeply ingrained in the social, political, and economic structures of our society the world over. For black and brown people, these differences result in unequal access to quality education, healthy food, livable wages, and affordable housing in the suburbs or close to city centres where there are more employment opportunities. This is known as structural racism and speaks to peoples’ conscious and unconscious bias.
It makes no logical sense that medical practitioners, who grew up with biases, as we all have, suddenly possess enlightenment when faced with black and brown patients. Studies in the US and the UK, have indicated that not only do black and brown adults receive substandard quality medical care; failure to diagnose, lack of thorough examinations, and effective medication for illnesses, but black and brown children, have been given less pain medication compared to their white counterparts. The most famous example of this is tennis world champion Serena Williams, who nearly died after doctors initially ignored her request for a CT scan to discover the blood clots in her lungs after she gave birth.
This kind of bias regularly occurs to millions of other black women who aren’t as famous as Williams.
Part of the problem is that many medical standards and techniques still used today are based on untrue beliefs that black and white people have different physiology.
Modern spirometers, used to measure lung capacity, have a “race correction” built into their software to assume that black people have 20% less lung capacity than white people; an untrue theory invented by a pro-slavery doctor in 1851.
Perhaps even more damaging, these kinds of false theories are still taught to students in medical school today, perpetuating the harm against black and brown people, particularly black women in the medical field.
In as much as black and brown people need to trust medical practitioners when receiving medical care, there is a dire need for anti-racism education within this field.
There are horror stories of black and brown women having to virtually deliver babies themselves and clean up after themselves once they have given birth. The amount of pain medication in studies have shown that less pain medication is prescribed to black and brown people than their white counterparts. Perhaps due to the belief that they are “tougher,” their skin isn’t as thin as white peoples skin and that psychologically they are “accustomed” to a “harder” life so can “absorb” pain more. While physically, it is understood that the only difference between a fair and darker skin is the amount of melanin, mentally or psychologically medical practitioners bias may come to the fore. And even unconsciously the darker patient receives less time, a less thorough examination, and is often misdiagnosed.
Would it help if doctors were of colour treating patients of colour? I imagine it would be based on their bias and socialization. If however, they were taught that black people are “tough,” then black medical practitioners who are educated within a racist/ prejudiced system would then go on to treat black and brown people differently too.
To fight racism and discrimination, we all need to recognize, name, and understand these attitudes and actions. We need to be open to identifying and controlling our own implicit biases. We need to be able to manage overt and covert bigotry safely, learn from it, and educate others. Education on race and racism needs to form part of the studies and systems at medical schools need urgent overhauls to create awareness of the possibilities of outdated beliefs of white superiority. If these safeguards were put in place and consciously practised then some people could be saved the horrors of unnecessary pain and suffering and often death due to medical malpractice.
This should not be viewed as a criticism of an underfunded, overburdened system but an opportunity for medical practitioners to uphold the Hippocratic oath they made when they swore to first do no harm.