I liked the article and agree the vaccine should be made available for anyone that wants to use it, provided it is administered with safety precautions due to its novel use in human beings.
while I agree with your main point, why the gratuitous slap at Biden and Pelosi, are you accusing them of talking about racism too much??
More generally, I think it is bad messaging to keep saying the problem is covid mainly affects people of color, climate change mainly affects people of color, pollution mainly affects people of color, loss of consumer protection mainly affects people of color, voter suppression mainly affects people of color… as I keep hearing over and over - this messaging makes it encourages the rest of the population, which has plenty of problems to deal with, tune out such issues
I agree, this article explains how easy it is to assign racial stereotypes: Over time I think this has happened to Palestinians and requires a changed dialog.
At the beginning of the twentieth century, renowned sociologist William E. B. Du Bois warned that “the problem of the twentieth century” would be “the problem of the color line” . I suspect that Du Bois would not have imagined that this color line would be as enigmatic and troubling in the twenty-first century. But the fact is that today’s issues of race and identity reveal an arguably more complicated terrain. To illustrate this point, consider the background of the following patients .
Ms. A’s father is Nigerian and her mother is British.
Ms. B’s mother and father are both from Jamaica. She has lived in the United States since birth.
Ms. C’s parents were both born in the United States. Her father is from Detroit’s inner-city and her mother is white.
Ms. D’s parents were born in Ghana and South Africa.
Ms. E, who has curly blond hair, fair skin and green eyes, has checked the box for “black or African-American” on her medical history form. She was adopted at birth.
In fact, each of these patients has checked that same box—“black or African American”—on their patient history forms. What does this tell us?
The quick answer is that it tells us not much at all about the patient—but a whole lot about whomever provided the box. Just the quick background sketch I provided for patients 1-5 indicates how different they are. In fact, the receptionist who made the appointment for the woman with Jamaican parents was surprised to see a woman with brown skin report at the scheduled time. “On the phone, you sounded like you were British,” she told her as she gave her a clipboard with the new patient information form attached to it. In the receptionist’s racial imaginary, being (or sounding) British is a stand-in for being white.
The receptionist is not alone. When you read about the first woman (the one with the Nigerian father and the British mother) did you make a presumption about the race of the British mother that would coincide with the receptionist’s? Did the third patient’s “inner-city Detroit” father signal a particular race for you? If so, you’re not alone. For the majority of Americans, “urban” (or “inner-city”) is a synonym for black or African American. “Suburban” is a synonym for white. Geography matters. Before we leave this example, did it occur to you that the fourth woman’s South African parent might be white (something we tend to ignore when we imagine “African” ancestry)?
These examples indicate the ways in which U.S. residents are primed to make certain presumptions regarding race. We’ve given race its substance and assured its viability despite its growing complication as a coherent category of identity. There’s little doubt of medicine’s interest in sustaining these racial designations. Patient history questionnaires betray this preoccupation. But what is it that we learn from a patient’s response? Is it worth the sustained stereotyping that comes from some people being assigned to a community and others not?
Our research and our practices both confuse and conflate the many social referents of the word “race.” We commit this error most frequently when we tolerate the notion that prompts our assigning someone membership in an “African American community.” It is an affiliation that suggests that being “black or African American” places you into immediate and reasonable consonance with any other black person in this country. Our habit of assigning community also suggests that phenotype reveals something about biology in a reliable and consistent enough manner to make that categorical assessment have standing equal to other factors like weight, dietary habits, smoking history, and whether or not you had rheumatic fever as a child.
The black folk whose souls Du Bois worried over in 1903 had a peculiar history of visibility and vulnerability. It is a history replete with narratives about medical care of lesser quality and exploitation sutured to institutionalized racial biases and stereotypes. When contemporary medicine takes up the category of race as a biologic rather than a social indicator, it ignores the complexity that is resident in “African American communities.” A community-based medicine or research ethic cannot escape this history of identity and vulnerability and the significant variables that accompany the experience of race. This is not an occasion when new and good intentions erase the impact of past bad acts. Language has a habit of entanglement.
“Vulnerable” patient populations are not an invention of bioethicists in search of a subject. When bioethicists refer to vulnerable populations these persons might be minorities, women, children, the elderly, the imprisoned or other institutionalized persons. We sometimes forget that the source of their vulnerability is not intrinsic. It is decidedly extrinsic. They are, as the title of this essay indicates, vulnerable to patterns of institutionalized bias. Categorical vulnerability is a consequence of medical research and medical practices that have exposed persons to bad acts because of a guiding presumption about the value of their identities . The labeling does not develop a neutrality simply because we bring it to a different setting and a new era. We take ourselves wherever we go. The assignation of community and color began as a way to distinguish rights and assign moral value. That history is not dissoluble simply because a contemporary society accepts this labeling as benign—just one among several options. There is a lived history in our words.
Vulnerable” Populations: Medicine, Race, and Presumptions of Identity | Journal of Ethics |
COVID killed far more Black, Hispanic, refugees here in NYC, due to “essential workers” being exposed to it, since they’d go get infected, waiting for hours in ice rain, trying to get unavailable PCR tests to get non-existent sick days, being turned away, UNREMITTINGLY LIED TO by State and City health department, Cuomo, de Blasio, Trump and all media & virtually all websites. They’d be sent home, only to infect family, coworkers, MTA riders, clerks, teachers and friends. None knew it was most infectious while asymptomatic in young or the more immune; so, the vulnerable simply took 7-10 days to go into ARDS, panic when they couldn’t breath or have strokes, have coronaries… crowd ER waiting rooms, ICU corridors on gurneys, or simply be cursorily intubated doped up and ~88% to 93% died, survivors suffer chronic illness they can’t afford, so many are working ill, all are going exponentially deeper into medical debt and tens-of-millions are about to end up out on the street in winter as the second wave hits like a tsunami. They were bringing the nice “well-to-do” liberals their food, booze and silly Amazon purchases, from our 70-80% windfall on cascading equities portfolio, based upon flipping their homes, indenturing them into debt slavery… so if you’re STILL in denial, FUCK YOU! They’re intentionally forcing poor workers to get infected, harvest their homes, W4 jobs, savings, labor and indenture any survivors. It’s called Capitalism. We’re back to NORMAL!