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- Page navigation anchor for RE: Dangerously, correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of careRE: Dangerously, correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care
In a recent statement the Canadian Prime Minister said ‘We Can’t Pretend that Racism Doesn’t Exist’ in Canada(1). He used the terms “unconscious bias” and “systemic racism” in his address to highlight and define current racism in Canada.
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According to a recent CMAJ article, racism in the Canadian health care system is endemic. However, this study also reiterated that systemic racism in health care is not unique to Canada. It is also pervasive in other countries, as outlined in a recent report from the College of Family Physicians of Canada (2).
Veteran pediatrician, ardent writer and renowned journal editor Dr. F. Rivara, argued that medical journals should increase their inclusion of studies that examine the role of structural racism in perpetuating racial gaps in morbidity and mortality. Journals can help to elucidate the uncomfortable issues that Black and indigenous people experience from structural racism in academic medical centers (3).
The COVID-19 pandemic has laid bare many of the structural challenges of the Canadian health care system. Furthermore, the COVID-19 pandemic could provide the opportunity to reduce the impact of the public health crisis posed by health inequity and racism. Since publication of Unequal Treatment by the Institute of Medicine (IOM) in 2003, there has been a growing recognition of the role of provider implicit racial bias in patient care. Provider implicit racial bias has been consistently negatively associated with diagn...Competing Interests: None declared.References
- (1). Canadian Prime Minister: ‘We Can’t Pretend that Racism Doesn’t Exist’ in Canada 2020. https://www.macleans.ca/politics/ottawa/trudeaus-daily-update-we-cant-pretend-that-racism-doesnt-exist-in-canada-full-transcript/ (accessed on 4 Feb. 2021).
- (2). Boyer Y. Healing racism in Canadian health care. CMAJ 2017; 189; E1408-E1409.
- (3). Rivara FP, Fihn SD. Call for papers on prevention and the effects of systemic racism in health. JAMA Netw Open. 2020; 3(8):e2016825.
- (4). Maina IW, Belton TD, Ginzberg S, Singh A, Johnson TJ. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc Sci Med. 2018;199:219-229.
- (5). FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017; 18;19.https://doi.org/10.1186/s12910-017-0179-8.
- Page navigation anchor for Antiracism a Human CompetencyAntiracism a Human Competency
Antiracism is a human, not a professional, competency. Public schools, high schools and universities should teach how to advocate for fairness. Is there any research on using the admission process to screen for and reject racist applicants?
David Zitner, M.D.
Halifax, Nova ScotiaCompeting Interests: None declared.References
- Saroo Sharda, Aruna Dhara, Fahad Alam. Not neutral: reimagining antiracism as a professional competence. CMAJ 2021;193:E101-E102.
- Page navigation anchor for RE: impartialityRE: impartiality
Let it be resolved that no acts of racism have a place in the medical system. Having said this, it is a stance of neutrality that ensures equal treatment for all, regardless of gender, race, or religion.
The medical community should confine itself to responding to clear ACTS of racism. It is only in these situations that clears facts can be discussed, and dealt with objectively.
When these acts are identified they should be dealt with systematically, and with transparency for the medical community and the public at large.
With all the criticism of our profession in recent times ( some of which is warranted), it is also appropriate to recognize that the vast majority of our healthcare workers continue to provide unbiased, neutral and compassionate care, day after day, year after year.
Competing Interests: None declared.References
- Saroo Sharda, Aruna Dhara, Fahad Alam. Not neutral: reimagining antiracism as a professional competence. CMAJ 2021;193:E101-E102.