The Problem of Race

Patricia King (1992), on the “Dangers of Difference”, claims that considering racial differences in research and clinical practice creates a dilemma. She believes that even when the goal is to provide help to the stigmatized person or group, the result may cause harm. Therefore, she proposes that a study always begin with the presumption of biological identity between blacks and whites, with respect to disease. She further states that while the approach must prove the assumption wrong, it acknowledges the fact that more harm comes from imputing racial variation than ignoring it. The current scientific focus on genetics is more thorough and deep than ever, and, as a result, new knowledge of human disease and humanity comes to the fore (McMullan, 2006). On the other side, injustice and value judgments that place members of the society in unequal classes lace the social world.

Race in Research and Medicine

People judge and say that race should not be a factor in medicine and research because of potential abuses as noted in the infamous Tuskegee syphilis study (Ibid). While this approach seems to take a precautionary measure, it ignores the potential of gaining evidence-based knowledge on the influence of racial variation on the etiology of disease, diagnosis, treatment, and most significantly prevention. The key question, therefore, is when a person’s race should make a difference in medical research, treatment, and policy. There is need for a pragmatic solution, that King advocates, which discredits the notion of race based on ethical inferiority and superiority. Ignoring race, in medical studies, would result in some form of exclusion, the same problem that is creating social unrest. The racial and ethnic divide brings unique perspectives to medicine that would not be possible without considering race. According to various studies, a shift in racial profile will occur as soon as 2050. This implies that the minority racial or ethnic groups will be the majority. Therefore, by ignoring race we are sweeping crucial issues under the carpet. This has negative implications for the future societies.

Genetic and environmental interactions determine human health (MacMullan, 2006). In the quest for better knowledge of these interactions, several fundamental factors pose an opportunity and a challenge for clarification. Race and ethnicity have social dimensions that influence health practices. Focusing on race and ethnicity excessively creates the risk of undermining the potential benefits of the diversity that exist within groups and among persons. However, we need to weigh the risk against the potential impact of clinical and epidemiological research. Consideration of racial and ethnic categories is essential for developing hypotheses and exploring them against the potential environmental and genetic risk factors. It helps the exploration of the interactions between health risk factors, in order to guide realization of vital medical outcome. Placing barriers to ethnic and racial consideration in research may provide a short term protection against the negative connotation of individual, racial groups. However, it will retard the progression of epidemiological and medical research. This will limit the capacity and the effectiveness of medical decisions.

Social, Cultural, and Environmental Conditions that Make a Difference

Race, culture, ethnicity, environment, and other social factors define the groups of people we are (King, 1992). Culture defines the set of beliefs, traditions, moral values, laws, and language common to a group of people, community, or nation. It influences gender roles, dietary practices, customs, religious observances, and other aspects of behavior. Because of this, groups of people, communities, and nations are different from each other. Culture affects social status, education, income, and occupation. In relation to health, cultural values influence the nature of environmental preservation. The nature of health problems varies with culture, ethnicity, and the social environment. Ethnicity is also the basis for the variation in practices such as vegetarianism and circumcision between groups. The things that we do that are specific to cultural or racial identity may predispose us to various disease causing factors. These and other factors in the social environment are vital for human health.

The Whitehall Study

The Whitehall study findings shades light into the need for consideration of social diversity factors in research and clinical practice (MacMullan, 2006). In relation to study, social classes or divisions influence the status of health. The study investigated the relationship between mortality and social class groupings based on occupational grades (employment levels). The lowest occupational grade or level comprised doorkeepers, messengers, and others who perform almost the same jobs. The outcome revealed that men in the lowest employment grade have three times higher mortality rate than those in the highest grade. The low status has an association with high blood sugar, less physical activity, smoking, obesity, short height, and more base line illness than the high status group. In addition, controlling for these conditions resulted in 40% difference, in coronary heart disease between the low and high status group. In as much as we need to correct the historical imbalances between racial and ethnic groups, it is essential to consider the implication for health taking into consideration of the future population.

The Solution: Pragmatism

Race and ethnicity draw a line between those who perceive a persistent problem, concerning race and ethnicity, and those who do not (King, 1992). There is a never ending, fruitless debate about this social problem ignited by past injustices inflicted on minority groups by the cruel members of the majority social groups. Pragmatism deviates from this debate and instead seeks to find a solution to the problem. Pragmatism focuses on educating people to realize the facts and the significance of recognizing diversity and encouraging it for fruitful endeavors. This will move the mindset of people away from negative psychology and focus on outstanding issues such as health, education, and unemployment. Addressing these issues helps the society to nurture the capacity for equal opportunity for all which is essential for democracy. Therefore, Patricia King rejects the perspective that race and ethnicity are exclusively social constructs i.e. the idea of constructivism.People form racial groupings due to differences in geographical location (MacMullan, 2006).

The continents further subdivide to form smaller groups within them. Therefore, it is true to say that race is the shorthand method of analyzing the differences that are genetic rather than cultural or political. Therefore, the notion of ethnic or racial identity conflates political, cultural, and genetic differences. Improvement of medicine depends embracing the concept of race. It provides an accurate method of assessing the population risks for various diseases. It also acts as the foundation for the determination of the best therapy. Recognizing racial divide in research must also include extension of bioethics to ethnic and racial groups. The new perspective will appear to include all the minority racial groups who have health care experiences outside of the mainstream. The new perspective will weaken stereotyping, change social perceptions, and promote justice.

The goal of the new perspective for the minority group is to recognize health care access as a vital bioethics problem. Recognizing diversity will facilitate equal representation of all racial groups in education, health care provision, and other sectors of the economy. The profile of the future population of any county will be different. The dynamic trends in population growth, with respect to racial groups, will lead to a situation where the current minority group is the future majority group. In this sense, a diverse population needs a diverse workforce that will understand the individual problems of the population groups.

Conclusion

It is vital to discuss and analysis historical injustices that occurred on the basis of race or ethnicity (King, 1992). Discussing those issues helps identify the causes and creative awareness among people. It defines the design of future bioethics, which outlines the protection and respect of human health in general. However, there is a need to be pragmatic, in order to eliminate the negative notion that defines race based on superiority or inferiority. Knowledge of racial and ethnic diversity and consideration of racial difference in research and clinical practice provides the opportunity to offer to humans the best quality of health care service. Otherwise, the problem becomes recurrent as the population profile shifts in terms of ethnic and racial variation, in composition.

Reference

MacMullan, T. “Pragmatism and the Problem of Race”. The Journal of Speculative Philosophy, 20.1 (2006): 62-65.

Patricia, K. “The Dangers of Difference”. Hastings Center Report, 22.6 (1992):35-38.

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