Racism in the JAMA

tl:dr two white doctors who are highly influential as to what can get published by the JAMA produced a podcast (billed as good for continuing professional education) in which they denied the existence of systemic racism, managing to pack an excellent example of systemic racism into the podcast.

Also mentioned: The JAMA has asked a ton of authors to remove any reference to “racism” in their submitted papers, and instead refer to “less triggering” terms like “socieo-economic status”

In related news, the NEJM recently published a letter by someone who said it’s not racism that pulse oximeters don’t work as well on people with dark skin because “machines can’t be racist”.

Well, that’s not the racism part.
The racism part is that the manufacturer knows it, and doesn’t modify them so that they will work on darker-skinned folks.
Also, I’m now wondering why they don’t work as well.

They work by shining light at your skin. So it’s not shocking to me that you might need to calibrate them differently by skin color or something.

And yes, of course it’s the manufacturer that is inherently racist, and not the actual device.

I doubt if the decision was based on racism. More like it works well enough and we don’t want to invest money in fixing a problem that doesn’t affect sales.

Its a problem that should be fixed if possible though. But that wouldn’t be a cheap fix. You’d have to do studies based on gradations of pigmentation and pull lots of small blood samples. Then develop some sort of setting and guide for an adjustment to the algorithm that determines results. Then you get to go through the whole FDA process for approval, trainings to medical staff, lawsuits when someone gets it wrong…

Unfortunately there’s not really a special word for accidentally being racist because you’re trying to be efficient. “Oops, we don’t care about you because you don’t have enough buying-power” is a sort of classic complaint.

I think it’s probably fair to say that the FDA or whatever should have required that testing be performed on minorities under the reasonable assumption that it would work differently for them.

FWIW, it really might not be worth fixing, or be fixable at all for that matter. Though “machines can’t be racist” is a weak argument, particularly in an era when machines regularly drop the n-bomb.

FWIW, when I google this, there’s a pretty sharp response.

There are actually several that would work. Classist, greedy, short-sighted, careless…

The blood Ox monitor and several other issues are due to a lack of rigorous study methods. Hopefully that issue has been corrected. There is no good reason today to not to get enough study subjects of multiple races to try and check for racial effects. Especially on something as blindingly obvious to color issues as “it shines a light through your finger and measures the result.”

The air quality studies, on the other hand. Those are almost certainly primarily socio-economic based issues. There could be racial factors as well. But factories and wind patterns don’t change simply because a poor neighborhood is now now majority black instead of majority Irish or Italian. Labeling issues as structural racism rather than poverty misidentifies the cause.

Sort of? Those are very vague too.

What about “we don’t bother with a ramp because 99% of our customers are abled?”

You could say that’s inconsiderate… but what if they are generally very considerate but just not about that.

Well you did say accidental. The ramp thing would be a conscious decision to not bother for disabled people. Kind of like the difference between negligent homicide and murder. Both end up with a dead person, but only one includes intent.

Good point.

But the follow-up letter says this problem had been known and published for 30 years. I would say that ignoring a problem for 30 years is intentional.


My husband was once diagnosed with a Vitamin D deficiency, and after some research I discovered that a lot of African Americans are misdiagnosed because the test isn’t measuring Vitamin D, but something else that occurs in direct proportion to Vitamin D in white people but for some reason I no longer remember, isn’t accurate for persons of color. But is still used for persons of color because who cares if they’re misdiagnosed… as long as the test works for white people. :rage: