Misconceptions and Fallacies on Race and Medical Treatment
The Health Humanities is the study of the intersection of health and humanistic disciplines (such as philosophy, religion, literature) fine arts, as well as social science research that gives insight to the human condition (such as history, anthropology, sociology, and cultural studies.)* The Health Humanities use methods such as reflection, contextualization, deep textual reading, and slow critical thinking to examine the human condition, the patient’s experience, the healer’s experience, and to provide renewal for the health care professional.
*Adapted from the National Library of Medicine’s definition for Medical Humanities (“Defining Health Humanities”, 2021).
As a first year medical student in anatomy lab, a few White students at another table with a black cadaver proclaimed their surprise at the fact that the brain was the same size as those of non-Black cadavers. I asked them plainly why they were surprised and they told me everyone knew most Black people had smaller brains, making them less intelligent or able to navigate the world. They made sure to add that I, of course, was an exception.
This way of thinking, where race is applied to human anatomy and physiology in a way that makes non-White patients non-human and in some cases, less than human, goes back to racist dogmas of the past. Dr. Thomas Hamilton, a 19th-century slave owner proposed that Black skin was less sensitive because it was thicker and had fewer nerves (Akinlade, 2020). Despite this having no scientific proof, Black patients continue to be systematically undertreated for pain today (Hoffman et al., 2016).
As of September 23, 2021, the National Kidney Foundation (NKF) no longer includes race when calculating the estimated Glomerular Filtration Rate (eGFR). The eGFR is the standard by which medical professionals measure how well the kidneys are working (“Race and EGFR”, 2020). Previously, patients who identified as Black/African American, had calculated eGFR’s higher than that of their non-black counterparts. Since the eGFR is used as a variable in medical decision making, the previous calculation resulted in treatment disparities. This included eligibility to be listed on the transplant list for a new kidney or when to start dialysis because the kidneys are failing.
Though this calculation was changed over a year ago, it is unclear if this change has taken place in laboratories across the country outside of major academic centers. Most troubling, is that it is unclear if medical professionals will adopt these changes or how this racially biased calculation is still affecting patients who identify as Black/African American today.
In order to change the treatment of Black/African American patients, there must be a paradigm shift in how medical professionals think about and view them. This shift can start with the Health Humanities. By identifying, learning more about and discussing treatment disparities, medical professionals can better understand systemic disparities and can better understand their patients, resulting in more equitable care.
Akinlade, Oluwafunmilayo. “Taking Black Pain Seriously.” New England Journal of Medicine, vol. 383, no. 10, Sept. 2020, p. e68. Taylor and Francis+NEJM, https://doi.org/10.1056/NEJMpv2024759.
“Defining Health Humanities.” Health Humanities Consortium, 4 Sept. 2021, https://healthhumanitiesconsortium.com/hhc-toolkit/definitions/.
Hoffman, Kelly M., et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about Biological Differences between Blacks and Whites.” Proceedings of the National Academy of Sciences, vol. 113, no. 16, Apr. 2016, pp. 4296–301. world, http://www.pnas.org, https://doi.org/10.1073/pnas.1516047113.
“Race and EGFR: What Is the Controversy?” National Kidney Foundation, 3 Aug. 2020, https://www.kidney.org/atoz/content/race-and-egfr-what-controversy.
Image Attribution: Josiah Wedgwood (1730-1795) and either William Hackwood or Henry Webber; “Josiah Wedgewood…produced the emblem as a jasper-ware cameo at his pottery factory. Although the artist who designed and engraved the seal is unknown, the design for the cameo is attributed to William Hackwood or to Henry Webber, who were both modelers at the Wedgewood factory.” (https://www.pbs.org/wgbh/aia/part2/2h67.html PBS]), Public domain, via Wikimedia Commons