Last June, the editor-in-chief of the Journal of the American Medical Association (JAMA), Howard Bauchner, was forced to resign over podcasts and conversations challenging structural racism in medicine. Nearly a year later, the influential medical publication has just announced the appointment of its first African-American editor-in-chief, Kirsten Bibbins-Domingo.
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“I think what happened in JAMA last year is part of the general re-evaluation of the concept of race in medicine,” said Dr.d Bibbins-Domingo in interview with The press† “Yes, we need to consider the barriers to health maintenance and the difficulties in accessing care for racialized and other disadvantaged groups. But race must be taken out of screening and treatment decisions. †
Aren’t there genetic traits that are more prevalent in certain racialized groups? “Yes, for example, there are certain blood metabolism issues that are more common in African Americans,” says Dr.d Bibbins-Domingo. But above all, it should not be used to legitimize the idea that race is a biological category. It’s a social division. †
These particular genetic traits tend to decline with society’s progressive admixture, argues Joseph Wright, lead author of an American Psychological Association statement published this week calling for the “end of race-based medicine.” “.
“There may be a few cases where there is still a rationale for using a person’s appearance to guide clinical decisions, but in the vast majority of cases, current race-based practices must be abandoned,” said the D. .r Wright, the vice president of equity for the University of Maryland Medical System.
As examples of inappropriate practices, the Dr Wright cites the idea that African-American women are less likely to have a vaginal birth after cesarean section, or that African-American babies are less likely to have urinary tract infections.
Racialized groups and COVID-19
Since the onset of the COVID-19 pandemic, parts of the United States have included racialized groups among patients at risk for severe COVID-19 who have had priority access to vaccines and medications such as Paxlovid. Should this practice be encouraged?
“Yes, because racialized groups are more likely to be victims of inequalities in treatment and in living conditions,” replies the Dd Bibbins-Domingo, an epidemiologist who specializes in health inequalities. “That said, there have also been public health decisions that have been unfavorable to racialized groups. †
Some right-wing analysts have argued that prolonged school closures in some cities, attributed to unreasonable union demands, have hurt African Americans and other disadvantaged groups. Is this an example of unfavorable public health policy? “It’s very delicate, says the Dd Bibbins-Domingo. Yes, children who have missed school for a long time have suffered. But the situation in these schools also reflected the more difficult access to masks and rapid tests, and the living conditions of teachers in these schools. †
End of a controversy
No African American had ever led the JAMA† From 2000 to 2011, only one woman was editor-in-chief.
the dr Bauchner, who has been on the job since 2011, gave two white doctors a podcast in February 2021 in which they question the existence of systemic racism in medicine. The podcast was announced on Twitter with a tagline echoing a famous question from Socrates: “No doctor is racist, so how can there be systemic racism in health?” †
Before the protest, the Dr Bauchner apologized and participated in an exchange with three African-American specialists about inequalities in medicine. On this occasion, the D.r Bauchner had compounded his case with one of his interventions: “Do you realize how heavy the word ‘racism’ is for white people like me? †
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