Disparities in health care for minorities in the US correlate with racial and ethnic disparities.
For example:
- The mortality rate for black babies in their first year of life is twice that of white babies, and American Indian babies are 1.5.
- Native Americans and Hispanics have twice the rate of diabetes compared to the rest of the US population.
- Hispanics had 20% of new tuberculosis cases twenty years ago.
- Vietnamese women are five times more likely to develop cervical cancer than white women.
In addition to genetic variations and environmental factors, race and ethnicity are believed to play a crucial role in these disparities.
Basic principles of ethics prohibit race and ethnic origin from playing any role in health care. However, there is racism in the medical profession, explicit or unconscious. Immediate action must be taken based on the ethical principles of medicine. What are these principles?
People deserve respect
People are autonomous agents, and people with diminished autonomy have the right to protection. This principle reflects that people must be treated as autonomous agents, and those who do not have this capacity deserve protection.
Thus, respect and empathy towards people are reflected. Their autonomy is recognized and those who do not possess it by natural means are protected. There must be this pact of mutual trust between a doctor and a patient. Honesty must be the basis of this relationship since it implies a series of obligations and notions of technical competence.
A medical professional must meet expectations of technical competence, otherwise, her act is inauthentic. Patients expect their doctors to be technical experts, able to apply their knowledge based on their professional concerns.
Minorities have cited the lack of proper assessment and management of medical conditions as a problem. There are disparities between whites and minorities in many disease areas. African Americans believe more strongly that their doctors will not fully explain research or that they will be treated as part of an experiment. The biases of some doctors are compromising their technical competence.
Informed consent
Regardless of whether a medical treatment is experimental or not, patients have the right to receive information about the advantages and disadvantages of their treatment, as well as available alternative treatments.
Minorities have been found to be unable to give informed consent in many cases because they are not aware of all their options for managing their illnesses. There are various medical professionals who violate this informed consent.
As a result of past and present injustices, both factual and perceived, informed consent procedures have often been interpreted as exemptions from liability for researchers. As possible protection against possible lawsuits and one more obstacle for patients.
People should never be treated simply as a means to an end when it comes to the principle of respect for people. The caregiver should not use the patient as another means, or as an end. She must provide all the relevant information about the risks and benefits, inform about the available treatment options, give a “standard” treatment, or see the possibilities.
Minority patients suffer needlessly due to the prejudices of medical professionals. This prejudice clearly violates respect for people. No patient would have to endure pain, suffering, and even death when her hardship could be alleviated. This autonomy must not be exceeded.
Beneficence and not maleficence
The doctor is obliged to prevent, minimize and eliminate harm and risk to others and improve their well-being.
It is also prohibited to harm, injure or kill others. The “maxim primum non nocere” (“above all, do no harm”) has been associated with this principle in medical ethics. If a person is experiencing pain that can be managed and relieved, you are not acting in their best interest, and you are not preventing their harm. Physicians must act in the best interest of the patient, even above their own.
However, it is known that factors such as race, gender, and other sociodemographic factors can affect the course of the disease, response to treatment, toxic effects, and health-related behavior. Medical researchers tend to avoid recruiting minorities because of their belief that poor compliance is common among these groups.
Thus, the number of black people living with AIDS has outnumbered whites in absolute terms since 1996. The AIDS epidemic has disproportionately affected blacks and Hispanics due to their lack of participation in clinical trials. This results in minorities suffering higher death rates than whites with similar illnesses.
Ethical Rights to patients
Patients must be treated in a way that maximizes benefit and minimizes harm. Serious diseases, such as cancer, diabetes, and cardiovascular disease, disproportionately affect minorities the most. Not to mention the abysmal difference between the treatment of different socioeconomic strata.
These statistics, biases, and stereotypes in the medical profession prove that minority patients are exposed to unnecessary risks, including injury and death, as a result of disparities in health care.
To provide good patient care, doctors need to remember their moral responsibility. The doctor has an ethical responsibility if prejudice or bias prevents him from exercising reason or free will. If this is the case, the doctor would have to overcome the impediment or transfer the patient to a doctor who follows the basic precepts of medicine and seeks the patient’s good.
Justice
As a result of this principle, each individual has the right to be treated fairly, equitably, and in their own right. There are two applications of this principle.
The inequitable allocation of resources is also contrary to the principle of justice. In minority populations, appropriate cardiac medications and coronary bypass surgery are less likely to be offered than in privileged populations. The best diagnostic tests and treatments, as well as kidney dialysis and kidney transplants. More sophisticated HIV treatments are also less likely to be available to them.
It is tradition to believe that all men and women are equal. As long as we truly believe it, all men and women should be treated equally, regardless of race, ethnicity, color, sexual orientation, or identity. When whites receive these treatments as standard care, it is unfair to deny such treatment to minorities.
Clinicians and researchers are ethically responsible for using and distributing resources fairly. Not doing so is morally and ethically wrong. Compromises with the basic ethics of medicine destroy minority patients and all of society alike.
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