Guest post: This ideology-first movement
Originally a comment by Nullius in Verba on Nasty snobbish gatekeepers.
iknklast:
In order to provide equity and justice in medicine, we must be aware of sex, ethnic background, country of origin, and other characteristics. We do not need medicine centered on those characteristics, though. We need medicine centered on medical expertise.
You’d think that obvious, but this ideology-first movement has been in action for a while now. Sort of like how the warnings of (some) lesbians and (some) feminists regarding nascent Genderism went unheard, so too have the warnings regarding the spread of Social Justice Lysenkoism. Here’s a Boston Review article from March 2021 entitled “An Antiracist Agenda for Medicine” that argues for “medical restitution”. One form of redress the authors propose is “race-explicit protocol changes (such as preferentially admitting patients historically denied access to certain forms of medical care).” Yes, you read that right: explicit endorsement of racial discrimination in healthcare.
Pretty good example of DEI gone mad, I should think, but at least it’s not CR … Oh. … Oh, my.
Our path to this realization, as with nearly all advancements in social medicine, took us outside our discipline—through the field of critical race theory (CRT), in particular. … Recognizing this problem, public health scholars Chandra Ford and Collins Airhihenbuwa brought CRT’s legal approach to the public health realm in 2010 with their landmark proposal of a Public Health Critical Race Framework. Following their lead, we have sought to implement that framework in our own advocacy and clinical work on equitable heart failure admissions.
Well, now I have to take a look at that 2010 proposal. … … … Holy wow. No hiding the CRT here, just pure praise. We even get the discipline’s usual straw man version of colorblindness:
Colorblindness, which is both an attitude and a school of thought, posits that nonracial factors (e.g., income) fundamentally explain ostensibly racial phenomena. … Only colorblindness, however, precludes explicit examination of racism’s potential contributions to inequities.
Great googly moogly.
Indirectly (very indirectly), this has been an issue in our recent elections. The previous government (centre left) had implemented a number of policies designed to improve Maori and Pacifica health outcomes. This included a Ministry that specifically targeted health care initiatives to Maori where it was needed most (generally more impoverished regions). Another was world leading anti-smoking legislation which would have resulted in a generation of children never starting smoking (legally at least).
Oponents argued that the Maori health ministry was inherently racist because it would lead to (some) Maori getting preferential healthcare. I’m not even remotely convinced that was the case. There has been ample research to show that healthcare expenditure on Maori and Pacifica has been well below that on other populations, and that medical advice and practice for comparable Maori and European decent patients attending the same practice has been different. The policies were not creating a preference, they were correcting a deficit. In any event it became an issue and the centre-right and further right parties played it for everything it was worth. Those parties have now formed our new Government as of yesterday.
Amongst the first things announced, scrapping the Maori Health Ministry, repealing anti-smoking legislation (one senior Government Minister used to lobby for big tobacco), scrap use of Maori language by ‘ordinary’ Government Departments, pass legislation making English an ‘official language.’
Black people have historically (and possibly still) been given worse medical care, therefore, let us now give white people worse medical care. How very Biblical. What they call restitution is better termed revenge.
It is one thing to insist, as DEI bureaucrats do, that admissions to study social science at Harvard must match population fractions. It is quite another to insist on equal representation, regardless of merit, in a field like medicine where merit and competence are paramount.
The DEI overseers who are now requiring that admissions to medical school must place identity above merit (and these are not subtle effects, they are factor-of-10 effects), will then insist that graduation from medical school must also be about identity rather than merit. Any mis-match between admission rates and graduation rates would, of course, mean that the course is “racist”, and would not be allowed.
So what is a patient then going to do? If their child needs life-saving treatment, is a parent going to be happy with a doctor who — judging purely on superficial appearance — looks as though they might have graduated on “identity” rather than merit and competence? Or will they seek out doctors who, again judging purely on superifical appearance, look as though they’d have only got through today’s system by having top-end merit?
[On a recent podcast, Glenn Loury said that, if it were his kid, he’d go for the most Chinese-looking doctor he could find.]
This would be a disastrous future, increasing societal tensions. And you can bet there would be draconian taboos on even discussing the issue.
There’s no path to a better future down the DEI route, the path is to treat people according to their individual merit and character, not according to their identity group.
Judging someone by the content of their character or something on the basis of its merit doesn’t mean being blind to racism. Quite the opposite, actually.
Coel, while there is some truth to that (a lot, perhaps), one thing I observed as a college instructor was that the goal of at least some colleges is to pass everyone – no matter race, color, creed, or merit. We are not supposed to note that some students didn’t bother to turn anything in, or come to class, or get answers correct (whether opinion or fact, there is a correct way to answer. If your opinion question is answered giving your opinion, but it has no relationship to the topic, then it is incorrect).
Every year, we were subjected to a PowerPoint presentation about how many students failed in each demographic. Our highest failures tended to be Hispanic, which surprised me since they were among the lowest failures in my classes, which were by no means easy. The demographic that did the poorest in my classes was white males. They were more likely to have excessive absence, to not turn in assignments, and to blow through a test with most of the questions blank. Some of my top students were also white males, though every other demographic had about an equal distribution there, so that is meaningless to show that white males have a superior learning ability. In fact, when I look at the top students through my entire career, they were almost universally female. Bias on my part? I used computer grading, and when I used essay questions, I had a predetermined rubric of grading. Females just plain worked harder, with some exceptions, of course.
When you set a goal of 100% success rate, you will fail to meet your goal, or you will lower your standards. “Failure is not an option” does not work for higher education.
So, we weren’t giving any advantage to students of color. We expected all students to succeed (though I had a fairly normal failure rate). That is an unrealistic goal. Our administration told us that the Obama DOE was aiming for 100% success rate…I never checked to see if they were lying (they were in the habit of lying to us about a LOT of things), so I don’t know if Obama was being ridiculous, or if my administration was alone in their ridiculousness.