Debating the cause of health disparities -- implications for bioethics and racial equality.

摘要: In 2002, the health arm of National Academy Sciences, Institute Medicine (IOM), scientifically documented widespread racial disparities in healthcare and suggested that they stemmed, at least part, from physician bias. Its 562-page report, Unequal Treatment: Confronting Racial Ethnic Disparities Healthcare, noted that, although these are associated with socioeconomic status, majority studies it surveyed ‘‘find ethnic remain even after adjustment for differences other access-related factors.’’ As directed by Congress, IOM committee defined ‘‘disparities’’ as ‘‘racial or quality care not due to factors clinical needs, preferences, appropriateness intervention’’ (pp. 3–4). Treatment concludes factoring out differences, remaining can be attributed part discrimination medical profession—physician prejudices, biases, stereotyping their minority patients. Some commentators took offense report’s charge It was unfair, argued, suggest blatant prejudice, demonstrated Tuskegee syphilis experiment, example, still lingered contemporary care. ‘‘I would stress attitudes physicians today have shown a true revolution those permeated generation two ago,’’ wrote University Chicago law economics professor Richard Epstein. ‘‘It is shame attack so many people good will on evidence admits much more benign interpretation.’’ The ‘‘benign’’ interpretations offered critics were stem patient behavior, cultural difference, biological economic inequality. Each explanations sounds familiar historians race America. Although firmly established, pinpointing cause has been controversial. this article, I challenge recent claims caused race-based genetic difference race-neutral grounds both ignore roots social develop my argument examining controversy surrounding report bias healthcare,