August 13, 2024 - 1:00pm
The medical establishment is unifying behind an emerging ethics standard that would have been virtually unthinkable just several generations ago: doctors and nurses are morally obligated to refuse to provide medical care in non-emergency situations to patients who are racist, sexist, transphobic or hostile to any of the other consecrated intersectional identity groups.
The latest advocate of this brand of medical ethics is the Royal College of Nursing, which recently added “discriminatory behaviour, including racism” to its list of scenarios justifying refusal of treatment or withdrawal of care. While “racism” is not defined — as it typically isn’t in these treatment protocols — the move came in response to the race riots sweeping through the United Kingdom in the wake of the 29 July stabbing that resulted in the deaths of three children.
The riots prompted UK Health Secretary Wes Streeting to state that racist patients “can and should” be denied medical care, reiterating a National Health Service policy adopted in 2020.
A form of this practice is already established in the United States, where hospitals and healthcare organisations are increasingly rejecting patients who refuse to be treated by doctors based on race, sex or sexual orientation. In non-emergency cases, patients must accept the doctor or nurse they are assigned, or potentially find another provider. “Many healthcare systems across the country have similar codes of conduct,” according to Mass General Brigham, a comprehensive healthcare network in Massachusetts. The patient’s refusal doesn’t even have to be articulated explicitly: “Body language and tone of voice are part of the code” at the Milford Regional Medical Center in Massachusetts.
Much lesser known, but just as important, is a parallel development in medical ethics that would allow African American or other patients of colour to request to be racially matched with a provider of the same race, which in effect is a preference not to be treated by a white doctor. This policy is based on the logic that “patient-provider concordance” is ethical in some circumstances — for instance: female patients who prefer female gynaecologists. Accordingly, black patients are historically justified in distrusting the medical profession, which is allegedly corrupted by systemic racism and implicit bias, and they are experientially justified in preferring a doctor who is presumed to be “culturally competent” and consequently, responsive and respectful.
Racially matching black patients with black doctors is now endorsed by the US medical establishment to such an extent that the benefits of the practice were cited last year by US Supreme Court Justice Ketanji Brown Jackson in her dissent in the affirmative action case involving Harvard University, with Justice Jackson noting that diversity in healthcare “saves lives.” In that case, the American Medical Association and 44 other parties breathtakingly declared in their amicus brief: “For high-risk Black newborns, having a Black physician is tantamount to a miracle drug.”
The right to pick one’s doctor, enshrined in the patient-doctor relationship, carries a sacrosanct status in Western society. But that right is clashing with other priorities, such as eradicating racism and eliminating racially disparate outcomes. In the past five years, we’ve seen publicised efforts to prioritise BIPOC patients for Covid vaccines, cardiac care and organ transplants, indicating that the rising generation of medical professionals is receptive to prioritising racial equity and social justice above traditional medical values.
Not everyone is pleased with this turn of events. “What’s next, turning away patients for misgendering?” asked noted journalist Gerald Posner.
Come to think of it, such patient restrictions may not be too far off. Just a few months ago, misgendering was declared by the U.S. Equal Employment Opportunity Commission to be a violation of the U.S. Civil Rights Act.
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SubscribeHatred in the name of anti-hatred. White people are being treated as subhuman.
It would be helpful if on entering a medical facility the patient were supplied with illustrations of the body language and recordings of the tones of voice to avoid.
Though as the Good Book says, physician heal thyself.
It is a worrying time when you are ill and that worry and uncertainty about whether you have been correctly diagnosed might well be perceived as racist if you are white and you ask too many questions of a black doctor or nurse. Authorising subjective body language analysis and tone of voice to determine whether to withhold treatment is positively bizarre and malign.
My son was delivered 25 years ago by a black doctor in a part of the country where there were very few blacks let alone black doctors but it never occurred to me to regard the doctor as anything but a qualified professional. To question his competence on the grounds of the colour of his skin I would have regarded as absurd.
Twenty-five years on I confess the thought might now obtrude as to whether he was a DEI hire who wasn’t up to the job or whether he was infected with the idea that I was a racist because of the colour of my skin and he was entitled to give me less favourable treatment as a result. I should probably suppress the thought as paranoid but it is something that would never have occurred to me before the introduction of all this racist ideology imported from the US.
Well done the racist social justice warriors for making a visit to hospital more fraught than a quarter of a century ago.
Best lunacy so far? I vote for the one where patients of all sexes, genders, ages etc. in some NHS areas are to be asked before radiological procedures whether they are pregnant.
Normally when I go for treatment I just get a big tick list, and you tick off that you don’t have AIDS, Yellow Fever, heart problems, pregnancy etc etc
It’s wasteful creating two lists, one for men and one for women.
‘“For high-risk Black newborns, having a Black physician is tantamount to a miracle drug.”’
Statistics are clear that mortality rates for new born black babies are less if they have a black doctor than if they have a white doctor.
‘Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved.’
https://www.pnas.org/doi/10.1073/pnas.1913405117
‘ Results further suggest that these benefits manifest during more challenging births and in hospitals that deliver more Black babies.’
‘Second, these benefits accrue more sharply in more medically complicated cases, insofar as the performance disparity across White and Black physicians increases as the number of newborn comorbidities rises.’
Let’s face it, when there is a very challenging birth, with the baby likely to die, the staff is going to get the white guy to try to handle it, leaving the straightforward cases to the DEI hires.
It is just Simpson’s Paradox, which is often a big effect in aggregated medical statistics.
‘‘ Results further suggest that these benefits manifest during more challenging births and in hospitals that deliver more Black babies.’
Hospitals that deliver more Black babies……’ Do the very best white doctors who could earn a fortune in affluent white areas, tend to choose to work in Chicago South Side, East St. Louis, North Philly, Louisville inner-city hospitals? I suggest not.
You are using logic against people who only speak in terms of emotions and victimhood.
I would suggest, instead of pointing out the logical fallacies as you did so well, we should go with the flow.
As someone who is getting increasingly jaded by the incessant victimhood politics espoused by this group, I am all in favour of making it close to mandatory for blacks to be treated exclusively by black doctors.
Similarly, any women reporting a burglar or fire, get to have teams exclusively comprising of 5ft women turn up to save them.
All self declared non-racists should be assigned a Black dentist on the NHS.
I’m assuming that you don’t have a mother, sister, grandmother, wife or girlfriend.
You are obviously non-mutual
We all have to make sacrifices on the alter of equity no matter what the consequences.
Equity trumps reality even in the case of war in whose name we put women into frontline units
Why would you assume that black applicants to medical school are DEI students? Perhaps they are smart (grades and MCATs) and personable. Why is the superior doctor in an emergency white rather than an ethnic minority? Just asking.
Let’s assume you’re right, and black doctors provide better healthcare to black patients. Why? Is it just because of the colour of the doctor’s skin? If you think so, that’s racism, pure and simple. A more likely explanation is that black doctors are more in tune with the health needs of black patients. So it’s a question of expertise. That is something that can be taught and learned, by doctors of any skin colour.
‘Let’s assume you’re right, and black doctors provide better healthcare to black patients’
The report says ‘ Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved.’
Halved?
If this really were true, and not a statistical artefact, there would be thousands of Lucy Letby style trials each and every year where white doctors were convicted of killing babies through medical negligence.
Reading the paper, I do not see support for your hypothesis that the difficult cases are given to white physicians. They suggest that whoever is on call typically handles the case, and report that the disparity in mortality among Black newborns with white vs Black attending physicians is greater when there are more challenging births – ie: Black doctors attending challenging Black births, versus white doctors also attending challenging Black births. (Not comparing Black doctors with uncomplicated births with white doctors with complicated ones).
The describe effects on mortality are quite puzzling:
Race concordance matters a lot regarding Black newborns, but not white newborns.Race concordance doesn’t matter regarding Black mothers nor white mothers.Increased experience with delivering Black babies doesn’t change thisThe effect doesn’t manifest with Latino births (briefly mentioned)
So what is the mechanism? One of the leading hypotheses – better verbal communication between physicians and patients sharing linguistic or cultural backgrounds, is inconsistent with this, since newborns don’t discuss their care and the concordance effect is not present for maternal mortality where that hypothesis could apply.
Another postulated mechanism would be some difference in procedure which happens to be correlated to race, like if Black doctors systemically had different practices; but then it should show for white newborns as well.
Another would be that Black newborns more frequently have certain problems which Black doctors are more familiar with and catch better; but the study should then find that increased experience with Black deliveries reduces the effect, which was not the case.
The paper mentions vague concepts like “systemic racism” which is not really a testable scientific hypothesis in this situation, so much as an ideological concept. Absent a mechanism, it has an explanatory weight similar to “God so willed it”.
I am very much in favor of reducing Black birth mortality, but this paper has no explanations of the mechanisms involved. They authors are aware of that, and call for more research. They call for more diversity in physicians as a stop gap, but in a birthing center with only one doctor at a time, that is not a full solution – so they too want to find the real cause so it can perhaps be mitigated with better training for all doctors.
Somebody needs to observe the Black and white (and other racial/ethnic groups) doctors to see if there are differences in behavior. There’s a lot of questions which statistical analyses of records cannot address.
I don’t have much issue with the paper (bringing up systemic racism is kind of pro forma today, probably couldn’t get published without it). I would likely have some issue with how activists might use this to reinforce the oppression narrative and to “prove” that systemic racism exists.
Oh, I would have wanted to see some reference to any changes over time, as that too might give a clue – it the disparity increasing or decreasing?
Thanks for an interesting non-ideological discussion of what seems to be a curious phenomenon.
If a black person says they want a black doctor, but there are no black doctors available, can then the assigned white doctor refuse to treat the black person because the black person is racist (in wanting a black doctor)?
Fascinating scenario and I would say “yes”. The patient is clearly articulating racist behaviour and as such the white doctor SHOULD be within his or her rights to refuse to treat the patient.
Black people can’t be racist, didn’t you know? Especially the ones who sold other black people as slaves to the American whites who fought a war to eradicate slavery.
It is the sad but logical endpoint of 20 year Social Re Engineering Experiment by our Progressive State – and the inevitable expression of our new Equality credos; if you ascribe elevated/privileged legal and now moral status to minority ‘Victim’ Groups, you have automatically defined the white majority en bloc as the requisite ‘Oppressors’ (it makes no sense without bad guys) – and by definition raycist or sexist Oppressors too. All this stems from the Equality Act of 2010. No one could have foreseen that it carried the virus of Critical Race Theory. The Two Tier Police – damned as structurally racist by the Left for decades – has simply collapsed to the Rainbow Flaggers and now lines up on the streets alongside masked community ‘allies’. They have fallen. The NHS as the last symbol of both Bevanite Socialism and the Multicultural State, will inevitably succumb too. Life in a hardcore progressive/identitarian State..Chapter One.
Is this not a violation of the Hippocratic Oath for doctors ?
When will this madness ever stop ? It appears that in parts of the USA, black patients can demand treatment by black doctors. But Wes Streeting would deny treatment to any “racist” white person asking for a white doctor.
This is all simply creating and propagating racism where none originally existed.
Still, we’re officially in “two tier Britain” now, so this must be right …
At least in the US the states are considered the primary law making unit so health care systems are implemented more locally. This can be usurped if states are accepting all kinds of strings attached grants and etc but there is at least some mechanism to prevent federal bureacrats from imposing draconian universal rules and behavioral nudging.
In a Universal Health system there is so much centralization that it becomes more difficult.
The problem Wes will have is that the most enthusiastic racists aren’t white.
Well, it didn’t take long for the shine to come off Wes Streeting, did it? What a fool he must be not to see the tsunami of unintended consequences that will flow from this.
Wes Streeting is a former Stonewall employee. This stuff runs in his blood.
Ultimate fascism
From an article in the Daily Mail:
If this is true, it will not be long before black patients demand to be treated by white doctors.
Ha ha. Of course! It’s obvious. To qualify under the DEI regime the white doctors will have to be so spectacularly good that no-one will want to be treated by anyone else.
Remind me: who was it who said: ‘everything woke turns to shit’?
I suspect that is the preference anyway
What if the only neurologist on duty is white. Will the black patient have a stroke while waiting for a black neurologist ?
The Authoritarian Left gets its tentacles everywhere. And in suitably Bolshevik style, Labour got less than 25% of the vote to win all that parliamentary power.
It is astonishingly racist and stupid for AMA and other medical associations to state that newborn black babies have a better survival rate when treated by black doctors vs. white. If this is true at all, it probably means the most skilled, experienced, educated doctor available is summoned to handle these dire, challenging births, the outcomes of which are always uncertain. The doctor called, may well be, in most cases, white. Insipid DEI fanatics can’t imagine such a scenario. They denigrate and mock the sincere effort of good doctors striving to save lives.
Is this a spoof piece originally intended for April 1st?
I want to post something on this subject. But I am fearful that the British police will knock on my door and arrest me for expressing my views.