Like Tara, I too, am going to give my take on the article "On Racial Profiling" by Sally Satel. This is a really thought-provoking article, especially for those considering a career in the health professions. It caused me to reevaluate my own perspective on the role of race in medicine.
While I am in no way an advocate of racial profiling in the strictest sense (I am ardently against it), I believe that including race in any patient's history/physical as part of making an educated diagnosis is critical. Based on the article I think it's rather clear that race isn't being used as the only factor in diagnoses. Doctors still take into account the symptoms presented by patients (proximate causes) and couple these symptoms with overarching correlates - like race, gender, ethnicity. Nobody (or very few at that) is saying that because of a person's race he/she has certain conditions. The science available to say that is speculative at best. Empirical evidence, however, does show that certain conditions do cluster and occur more frequently among certain populations - i.e. sickle cell anemia in African Americans, Tay-Sachs in Ashkenazi Jews - and thus one could make an educated argument establishing a strong correlation between conditions (many of which have a genetic component) and a person's race.
As Tara points out, to adopt a race-blind or gender-blind approach would be ill-conceived. Doctors are looking for all available puzzle pieces, and if race happens to narrow down the number of possible diagnoses and thus means the patient is subject to fewer unnecessary tests then I believe that race-consciousness is beneficial in medicine. Dr. Satel and others like her are not saying that a person's race should affect the quality of care that doctors afford to their patients; rather she is contending that race may play a role in the effectiveness of certain treatments.
"Racial profiling" in the context of medicine does not imply the creation of two-classes of patients - one receiving better care than the care - it simply points towards more specialized medicine. To understand this better, consider: If a doctor sees an African American patient with heart problems and is choosing between prescribing BiDil and Enalapril, wouldn't the doctor be remiss to take into account the preponderance of studies that shows the relative efficacy of BiDil vs. Enalapril (which by the way might lead to serious complications)? I know I would certainly hope my doctor would. Likewise, when it comes to dosing, isn't it wiser for a doctor to begin with a lower dose of anesthetics for an Asian American patient undergoing surgery due to the increased risk of apnea than to be negligetn and ignorant and simply treat the patient like everyone one? While discrimination and prejudice are significant problems throughout society today, we should not blindly shut the door on racial-consciousness especially when it might save a person's life.
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