Racial Profiling in Health Care: An Institutional Analysis of Medical Treatment Disparities
Posted: 26 Jun 2002
This Article suggests that medicine often attaches negative characteristics to particular racial and ethnic groups, and physicians, for a variety of reasons, resort to these profiles in making individual treatment decisions. For example, African-American patients are understood to be less likely to survive invasive medical procedures, more likely to possess more virulent tumors, and less likely to respond to the standard course of treatment, because of presumed biological differences. From a cultural perspective, African-American patients are understood to be less likely to adhere to risky and costly courses of treatment, and less likely to understand their medical condition.
The biomedical professions are largely responsible for creating, reproducing, and legitimating these unjustified race-based expectations. Within the disciplines of science and medicine, biomedical researchers continue the historical practice of attempting to attribute health differences to race-based biological and cultural differences between Black and White patients. This race-based research has not discovered the causes and processes of diseases. Instead, race-based research into health differences may paradoxically help to support institutionalized expectations and stereotypes within the medical community that unwittingly produce the disparities in treatment that most researchers rightly decry.
Far from providing a solution to the problem of racial health disparities, this Article shows that race-based health research fuels a collection of dubious background assumptions, creates a negative profile of African-American patients, and reinforces taken-for-granted knowledge that leads to inferior medical treatment. This Article attempts to particularize the claim that physicians rely on the findings of flawed racialized research by suggesting concrete ways that these racial profiles may influence clinical decision-making.
One remedy is to require each health care entity that receives federal funds to collect and report data on racial disparities in the use of services, and the choices of diagnostic and therapeutic alternatives. Existing "report cards" offer a well-established system for data collection; all that is needed is to stratify the reporting by race. This proposal has the obvious advantage of withholding federal funds from institutions that have statistically significant racial disparities. Equally important, it would force institutions to think about race, racial profiling, and medical treatment disparities.
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