Author: Sara Habibipour
Racism and xenophobia are everywhere, including medicine. It's about time we address it.
We now recognize that racism, xenophobia, and discrimination are deeply rooted within the political, social, and economic sectors of American society, in particular. Not only do outcomes of systemic racism such as lack of access to education, housing, healthy food, and healthcare affect patients of color, but the doctors' own personal biases toward a particular race can lead to lack of proper care. Doctors are humans too, and as humans, we tend to have our own personal biases, even if means the mistreatment of another race. Although physicians take an oath to treat all patients with equality, more often than not, that's not the case. Sometimes doctors are even susceptible to believing medical misinformation as a result of racism and xenophobia.
EXAMPLES OF RACISM/XENOPHOBIA IN MEDICINE
Tuskegee Syphilis Experiment:
In 1932, a clinical trial was conducted to study possible treatment plans for black Americans. It was also called the "Tuskegee Study of Untreated Syphilis in the Negro Male."
The study initially involved 600 black men (399 with syphilis, 201 without). The study was conducted without the benefit of patients’ informed consent (meaning that the study participants did not give their proper consent to the study after fully understanding what they were going to be participating in). The participants were also greatly influenced to participate in the study because they received free medical exams, free meals, and burial insurance. Although it was intended to last 6 months, it lasted 40 years. Because of this situation, modern-day clinical trial practices have been greatly modified and are greatly supervised in order to ensure proper ethical standards (CDC).
Racism was involved in this study because rather than treating the participants ethically with good clinical practice, they were not even informed about the study or its true purpose. They had not even been given the proper information needed to make an informed consent. Those with syphilis were never given adequate treatment for the disease, even after penicillin became widely available to the public. Their condition worsened and many even died. This part of American history leads many black Americans today to continue to not trust the healthcare system and the US government.
Nazi Medical Experiments:
From 1933 to 1945, Nazi Germany carried out a campaign to cleanse German society of individuals of other races, religions, etc. The Nazis enlisted physicians to experiment on the Jewish prisoners in the concentration camps against their will. Some of the experiments were aimed to develop and test drugs and treatment methods for injuries and illnesses which German military and occupation personnel encountered on the battlefield. Scientists used imprisoned Jews to test immunization compounds and antibodies for the prevention and treatment of contagious diseases, including malaria, typhus, tuberculosis, typhoid fever, yellow fever, and infectious hepatitis against their will (USHMM).
Other experiments include the Nazi Twin Experiments. Jewish twins were separated from the other prisoners at concentration camps, and whisked off to a laboratory to be examined. One twin was used as a control and subjected the other to everything from blood transfusions to forced insemination, injections with diseases,amputations, and murder. Those that died were dissected and studied; their surviving twins were killed and subjected to the same scrutiny (History). All of these experiments were to prove that the white race was superior to all others. These racist events forever changed how clinical research would be practiced in medicine.
Pain Tolerance Studies:
A 2016 study looked at the personal biases that medical students and doctors had when it came to African American patients. Both medical students and doctors believed that African Americans had a higher pain tolerance than any other race, which is very false as pain cannot be quantified especially when it comes to an entire race (PNAS). Pain tolerance is on an individual basis.
This finding is significant because it can lead to mistreatment of African American patients, disregard for the pain that they say they are feeling, and overall lack of care.
Maternal Mortality in Black Women:
Black women are 3 to 4 times more likely to die of pregnancy related causes than white women, regardless of socioeconomic status (NCRP).
The maternal mortality crisis is rooted in the marginalization of black women.
Decreased funding for Black maternal health indicates the root that racism continues to have in medicine, leading to increased pregnancy related deaths in the U.S.
Health outcomes are largely tied to social determinants including health and systems services, location, employment, education, race and income: all things influenced by systemic racism.
Due to systemic racism, black women are more likely to:
Be uninsured before becoming pregnant.
Die of conditions related to pregnancy than white women with the same condition.
Receive subpar medical care based on their location.
Experience racial bias from health care providers.
What Can We Do to Stop Racism/Xenophobia in Medicine?
To fight racism, xenophobia, and discrimination, we all need to recognize and understand our own personal biases (Harvard). We need to be able to educate others on the topic of racism in medicine as well (as I'm trying to do with my platform). Therefore, these themes need to be a part of medical education. We need to practice and model tolerance, respect, open-mindedness, and peace for the medical health of others.
And as a future physician, it is my job to break the mold that has been set by society. If you are also a future physician reading this, I hope you spread this message. We are the only way that racism/xenophobia can end in medicine.