July 17, 2008

I Am a Racially Profiling Doctor

In practicing medicine, I am not colorblind. I always take note of my patient's race. So do many of my colleagues. We do it because certain diseases and treatment responses cluster by ethnicity. Recognizing these patterns can help us diagnose disease more efficiently and prescribe medications more effectively. When it comes to practicing medicine, stereotyping often works.

But to a growing number of critics, this statement is viewed as a shocking admission of prejudice. After all, shouldn't all patients be treated equally, regardless of the color of their skin? The controversy came to a boil last May in The New England Journal of Medicine. The journal published a study revealing that enalapril, a standard treatment for chronic heart failure, was less helpful to blacks than to whites. Researchers found that significantly more black patients treated with enalapril ended up hospitalized. A companion study examined carvedilol, a beta blocker; the results indicated that the drug was equally beneficial to both races.

These clinically important studies were accompanied, however, by an essay titled ''Racial Profiling in Medical Research.'' Robert S. Schwartz, a deputy editor at the journal, wrote that prescribing medication by taking race into account was a form of ''race-based medicine'' that was both morally and scientifically wrong. ''Race is not only imprecise but also of no proven value in treating an individual patient,'' Schwartz wrote. ''Tax-supported trolling . . . to find racial distinctions in human biology must end.''


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