Calling Out Implicit Racial Bias as a Harm in Pediatric Care

• Published in: Cambridge quarterly of healthcare ethics 2016-07, Vol.25 (3), p.540-552
• Main Authors: LANG, KELLIE R., DUPREE, CLARETTA Y., KON, ALEXANDER A., DUDZINSKI, DENISE M.
• Format: Article
• Language: English
• Subjects: African Americans; Bias; Bioethics; Child; Children; Children & youth; Departments and Columns; Ethics; Health care; Health disparities; Humans; Meditation; Mental disorders; Pediatric Ethics; Pediatrics; Race; Racial bias; Racism; Social psychology; Students; United States
• ISSN: 0963-1801; 1469-2147
• DOI: 10.1017/S0963180116000190

The past and present effects of historical racism on the health of, and care for, those labeled minorities is well documented. Grier and Cobbs analyzed the effects of historical racism and current oppressions and humiliating disenfranchisements on African Americans as they transition into adulthood. Research in clinical settings has demonstrated that African American children receive less counseling during well child visits and have lower rates of treatment of mental health disorders. Additionally, African American children with appendicitis are hospitalized less frequently, have higher rates of perforation and a greater delay to surgical management, and experience increased rates of appendix rupture. With the exception of Alegria, the authors cited earlier found these results troubling but suggested no provider-based possible cause; Alegria and her colleagues suggested providers be given incentives to reduce their negative attitudes toward minority youths. Washington also discussed the impact of racism on children, concluding that "African American children are still being harmed not only by abusive experimentation but also by the fear of research that follows in its wake. An implicit bias is an inflexible, unconscious belief about a particular category of people. Categorizing groups is an inevitable aspect of human nature and may be positive or negative. Implicit bias operates in an unintentional manner, is activated quickly and unknowingly, and exerts its influence on perception, memory, and behavior.