May 6, 2002

MUST PC = M&M? :

I Am a Racially Profiling Doctor (SALLY SATEL, May 5, 2002, NY Times)
In practicing medicine, I am not colorblind. I always take note of my patient's race. So do many of my colleagues. We do it because certain diseases and treatment responses cluster by ethnicity. Recognizing these patterns can help us diagnose disease more efficiently and prescribe medications more effectively. When it comes to practicing medicine, stereotyping often works.

But to a growing number of critics, this statement is viewed as a shocking admission of prejudice. After all, shouldn't all patients be treated equally, regardless of the color of their skin? The controversy came to a boil last May in The New England Journal of Medicine. The journal published a study revealing that enalapril, a standard treatment for chronic heart failure, was less helpful to blacks than to whites. Researchers found that significantly more black patients treated with enalapril ended up hospitalized. A companion study examined carvedilol, a beta blocker; the results indicated that the drug was equally beneficial to both races.

These clinically important studies were accompanied, however, by an essay titled ''Racial Profiling in Medical Research.'' Robert S. Schwartz, a deputy editor at the journal, wrote that prescribing medication by taking race into account was a form of ''race-based medicine'' that was both morally and scientifically wrong. ''Race is not only imprecise but also of no proven value in treating an individual patient,'' Schwartz wrote. ''Tax-supported trolling . . . to find racial distinctions in human biology must end.''

Responding to Schwartz's essay in The Chronicle of Higher Education, other doctors voiced their support. ''It's not valid science,'' charged Richard S. Cooper, a hypertension expert at Loyola Medical School. ''I challenge any member of our species to show where this kind of analysis has come up with something useful.''

The wife is a doctor. She went to school in Chicago and did rotations at Cook County. Then we moved to NH. When we got here, she all of a sudden saw a lot of cystic fibrosis cases, which she'd rarely seen previously. On the other hand, the folks here were largely inexperienced with AIDs cases and totally unfamiliar with Sickle Cell Anemia. You don't have to be a racist to figure out that the differing racial makeup of the two patient populations played a role in this. You do have to be some kind of fanatic to ignore it. Dr. Satel is neither a racist nor a fanatic; she's a scientist. That used to matter in medicine.

One of the points she makes in her fine book, PC, MD, is that when you try applying politically correct dogma to medicine you are likely to provide inferior care. For instance, if I went to the doctor today because I felt ill and he checked me for Sickle Cell, he might be behaving in an admirably "colorblind" way, but he'd in all likelihood be wasting his time and my money and not be getting any closer to finding out what ailed me. Is this Leftwing ideology really worth the price we'll all end up paying? It can't be.

Posted by Orrin Judd at May 6, 2002 11:46 AM
Comments for this post are closed.