Still from 2021:
As Race 'Equity' Advances in Health Care, Signs of a Chilling Effect on Dissent
"The national movement to eradicate what activists call systemic racism and white privilege from medicine and health care has few public critics in the medical profession. A possible reason: Skeptics who have questioned these efforts have been subject to harsh Twitter campaigns, professional demotions and other blowback.
A podcast of the Journal of the American Medical Association caused a furor this year when one of its editors suggested that discussion of systemic racism is an unfortunate distraction that should be taken off the table. In response to a protest petition, the AMA launched an internal investigation into the creation of the podcast (and a since deleted Tweet that promoted it). Eventually, the Journal’s top two editors, who are both white, resigned – the editor-in-chief’s departure coming after he issued a public apology in which he affirmed the existence of structural racism in the United States and in the health care field.
In Minneapolis, Hennepin Healthcare System removed gynecologist Tara Gustilo, of Filipino descent, from her position as chair of the OB/GYN department after members of her department questioned her “ability to lead.” The demotion followed her series of Facebook posts criticizing critical race theory, Black Lives Matter and “How to Be an Antiracist” author Ibram X. Kendi, and her insistence that her department must strictly adhere to race-neutral policies with regard to patient care.
Colleagues and other doctors on Twitter denounced as racist University of Pittsburgh cardiologist and professor Norman Wang, who is ethnically Chinese, after his peer-reviewed paper last year critiqued affirmative action as illegal and discriminatory. The Journal of the American Heart Association, which published the paper, soon retracted it, alleging “deliberate misinformation or misrepresentation.” Wang’s employer demoted him from his role as director of a fellowship program for physicians, barred him from contact with fellows and residents, and temporarily prohibited Wang from contact with med students. Kathryn Berlacher, director of the cardiology fellowship program, reprimanded him in an email: “It is clear to us that any educational environment in which you partake is inherently unsafe, increasing our learners’ risk for undue bias and harm."
In each case, the dissenting doctors broadcast opinions counter to the official positions and policies of their organizations. The American Heart Association and Pitt officials, on Twitter and in public announcements, said Wang’s critique of affirmative action was inconsistent with their institutional values of diversity and inclusion.
Such incidents are noteworthy because of their eerily scripted language of moral outrage and public denunciation, coming from the nation’s highest levels of professional achievement, often on internal issues that would typically be handled with sensitivity and discretion as personnel matters.
“Rise up, colleagues!”Mayo Clinic cardiologist and diversity director Sharonne Hayes Tweeted in August in response to Wang’s article. “The fact that this is published in ‘our’ journal should both enrage & activate all of us.”
Berlacher announced Wang’s demotion in a Tweet. “We stand united for diversity, equity and inclusion,” she proclaimed. “And denounce this individual’s racist beliefs and paper.”
The American Heart Association chimed in: “JAHA is editorially independent but that’s no excuse. We’ll investigate. We’ll do better.”
Those who are concerned by the social justice fervor sweeping through the medical profession say that such examples are evidence of the movement’s chilling effect on open debate of complex social issues.
“Most in academic medicine who are troubled by this are keeping their heads down and keeping their mouths shut,” said Thomas Huddle, who retired this year as professor at the medical school at the University of Alabama at Birmingham. “They’re deeply afraid of social media mobs and of academic administrative superiors who’ve taken this stuff on.”
In the wake of George Floyd’s killing last year, the social justice movement has generated tremendous support. Brittani James and Stella Safo, both African American doctors, drew more than 10,000 signatures for their petition to review and restructure JAMA in the aftermath of the February podcast...
James, a Chicago-based physician and assistant professor in the College of Medicine at the University of Illinois, said she has little patience with accusations that social justice fosters cancel culture.
“I have to chuckle,” James said. “As a black woman, I absolutely cannot express my opinion, ever.
“I have to consistently think whom I’m in the room with. And I will be fired quickly without fanfare, without anyone advocating for me,” James said. “This idea that they’re uniquely persecuted is totally divorced from reality. My entire life has been a tightrope of being careful what I say, because there’ll be retribution against me.”...
Erica Li, a West Coast pediatrician and FAIR volunteer active in the development of the medicine chapter, agrees that racism exists in some situations, but said that racial disparities could have multiple causes. She opposes using affirmative action and other race-based standards to achieve equity, a term that refers to mandating equal outcomes by race.
Li said she is not fearful of retaliation, but asked that her precise location not be disclosed in this article. She said she “has taken great lengths to take my photos and contact information off the Internet” after a colleague received death threats over an issue not related to critical race theory."
If you are for racial non-discrimination, you are racist, unsafe and will lose your job
If you're a left wing "minority", thinking that you're a victim of discrimination is proof you're one, but if you're not on the left, even if you get fired you're not a victim of cancel culture.
Doctors' Dilemma: Replacing Colorblindness to Favor Minority Care
"In March 2020, when the pandemic prompted fears that overwhelmed hospitals would run out of beds and equipment, two medical ethicists proposed an ostensibly race-neutral framework for rationing ventilators to save patients’ lives.
Writing in the prestigious Journal of the American Medical Association, University of Pittsburgh bioethicist Douglas White and University of California, San Francisco, professor emeritus Bernard Lo reiterated the longstanding view that ventilators should “not be allocated on the basis of morally irrelevant considerations, such as sex, race, religion, intellectual disability, insurance status, wealth, citizenship, social status, or social connections.”
Less than a year later, race was no longer a “morally irrelevant” consideration for White and Lo. In a February 2021 paper about “mitigating inequities” in intensive care, they wrote: “Although at first glance it seems unproblematic to focus on saving as many lives as possible with scarce critical care resources, this approach may disproportionately deny critical care treatment to persons of color and the poor.”
Thus saving as many lives as possible in a colorblind manner becomes a classic example of systemic racism: a neutral standard that benefits white people. That’s because people of color, with lower life expectancies, are more likely to be downgraded in priority for emergency lifesaving measures.
“In our view, when society is substantially responsible for creating disparities through unfair social policies, there is a special obligation to prioritize disparity mitigation,” they wrote, “even if doing so results in somewhat fewer overall lives saved compared with purely utilitarian triage.”
Although White and Lo could not be reached for comment, the differences between the two papers published less than a year apart reflect the remarkable velocity of change that has occurred in medicine during the past year...
“To achieve equitable access and distribution of care, critical race theory must be a part of the process utilized to create broad, population-focused guidelines,” four doctors wrote in a Health Affairs article last year...
The public may be receptive to race-based medicine. According to two independent online surveys conducted in September 2020, “respondents endorsed prioritizing racial/ethnic communities that are disproportionately affected by COVID-19.”
The tradeoffs involved in this moral rebalancing of competing interests encapsulate the underlying source of the tension: individual rights versus group rights. White and Lo seek to achieve the best of both worlds, but they acknowledge that improving outcomes for some groups in the name of racial justice comes with a price: It may result in a greater loss of life.
Others have articulated a similar moral position when deciding who should be prioritized for vaccinations: essential workers, who are disproportionately minority, or the elderly, who are disproportionately white.
"Older populations are whiter," Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania, explained in The New York Times in December 2020. "Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit."...
This year a number of states sought to give priority for vaccinations to black, Hispanic and other at-risk residents, but most states used proxies for race, such as the Centers for Disease Control and Prevention’s Social Vulnerability Index.
They were following the October 2020 recommendation of the National Academies of Sciences, Engineering, and Medicine...
U.S. courts have never considered a case over the use of race to allocate scarce health care resources, according to an October 2020 paper co-authored by Schmidt, who wrote that the U.S. Supreme Court is not likely to approve an explicitly race-based allocation policy. He urged public health agencies to devise proxies to achieve their intentions.
“The Supreme Court is likely to uphold racially neutral vaccine allocation criteria, which are designed to capture worse-off minorities but not explicitly,” Schmidt and his co-authors wrote. “A vaccine distribution formula, therefore, could lawfully prioritize populations based on factors like geography, socioeconomic status, and housing density that would favor racial minorities de facto, but not explicitly include race.”
Hesitating to proceed with this ethical tightrope act would amount to a dereliction of duty, the authors suggested...
One active case study of explicit racial favoritism is a medical reparations pilot project at Brigham and Women’s Hospital in Boston that provides “a preferential admission option for Black and Latinx heart failure patients to our specialty cardiology service.”
The project, explicitly anchored in critical race theory, seeks to repay “the outstanding debt from the harm caused by our institutions, and owed to our BIPOC patients.”...
They acknowledge that offering preferential care based on race may prompt legal challenges, but they say there is ample evidence that the current societal systems “already unfairly preference people who are white.” They further note: “Our approach is corrective and therefore mandated.”"
Ironically, covid hysteria was justified as protecting the elderly.
Disparate impact is good if it benefits "minorities".
