The denial of racism is racism itself
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* Marcia Anderson

Responses to a recent *CMAJ* issue, dedicated to Black health and anti-Black racism in health care, indicated that some physicians hold a view that racism does not exist in Canada, based on their own observations. Such responses are not uncommon in discussions of racism in medicine. However, we must reflect on why some physicians think their own biased interpretations of what they have seen are a superior form of evidence to inquests, investigations, reports and peer-reviewed published literature.

Racism in health care in Canada is documented in many places, including the In Plain Sight report,1 the Joyce Echaquan inquest,2 survey findings on the experience of Black nurses in Ontario3 and published research reports showing inequitable health care for Indigenous Peoples.4 A meta-analysis that evaluated different types of colour-blind ideologies and their effects found that power-evasion colour-blindness (i.e., the denial, minimization and distortion of the existence of institutional racism) was associated with increased anti-Black racism.5 It serves as a barrier to the disruption of systemic racism, thus reinforcing and restabilizing the status quo system of advantaged white access to power, money, resources and opportunity.

We must apply principles of evidence-based medicine and ethical responsibilities to name and take action on racism in Canadian health care.

## Footnotes

*   **Competing interests:** None declared.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: [https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/)

## References

1.  Turpel-Lafond ME. In plain sight: addressing Indigenous-specific racism and discrimination in B.C. health care. Vancouver: Community-Based Research Centre; 2020. Available: [https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Summary-Report.pdf](https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Summary-Report.pdf) (accessed 2022 Dec. 2).
    
    

2.  Kamel G. Investigation report for the protection of human life: law on the investigation of the causes and circumstances of death concerning the death of Joyce Echaquan. 2020-00275. Québec: Bureau du coroner; 2020:1–28. Available: [https://www.coroner.gouv.qc.ca/fileadmin/Enquetes\_publiques/2020-06375-40\_002\_\_1\_\_sans\_logo\_anglais.pdf](https://www.coroner.gouv.qc.ca/fileadmin/Enquetes\_publiques/2020-06375-40\_002\_\_1\__sans_logo_anglais.pdf) (accessed 2022 Dec. 2).
    
    

3.  Black Nurses Task Force report: acknowledging, addressing and tackling anti-Black racism and discrimination within the nursing profession. Toronto: Registered Nurses’ Association of Ontario; 2022:1–72. Available: [https://rnao.ca/sites/default/files/2022-02/Black\_Nurses\_Task\_Force\_report.pdf](https://rnao.ca/sites/default/files/2022-02/Black\_Nurses_Task_Force_report.pdf) (accessed 2022 Dec. 2).
    
    

4.  Breese LC, Knudtson ML, Zhang J, et al.Alberta Kidney Disease Network (AKDN) and the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH). Likelihood of coronary angiography among First Nations patients with acute myocardial infarction. CMAJ 2014;186:E372–80.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTg2LzEwL0UzNzIiO3M6NDoiYXRvbSI7czoyMToiL2NtYWovMTk1LzUvRTE5Ny5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

5.  Yi J, Neville HA, Todd NR, et al. Ignoring race and denying racism: a meta-analysis of the associations between colorblind racial ideology, anti-Blackness, and other variables antithetical to racial justice. J Couns Psychol 2022 May 23 [Epub ahead of print]. doi: 10.1037/cou0000618.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1037/cou0000618&link_type=DOI)