Privilege Prevails: Being “unbiased” is still being biased


Multiple news items report that Los Angeles hospitals are now so short of oxygen, anaesthetic, syringers, PPE and other supplies that they will likely start “rationing care” as is done in a war zone or a natural disaster.  Hospitals will decide who lives or dies based on their likelihood of survival.

According to the linked item, the doctors and nurses directly treating people will not make the decision. It will be a group of four who will NOT be told the patient’s race, ethnicity, religion, citizenship, insurance, etc.

That sounds like they’re trying to be unbiased until you remember the reality of the US medical industry and inherent racism and classism.  Black people are more likely than others to have high blood pressure.   And the poor are less likely be healthy because they couldn’t afford proper medical care before 2020.  When your health is already compromised, you are at a disadvantage when that committee makes its decision.

Los Angeles hospitals could begin rationing care

As Los Angeles hospitals continue to be overwhelmed with COVID-19 patients, hospitals may begin rationing care and would force healthcare providers to determine the type of care a patient will receive based on available resources.

According to the New England Journal of Medicine, even a conservative estimate shows that the health needs created by the pandemic go well beyond the capacity of U.S. hospitals.

Dr. Kimberly Shriner [. . .] told us, “Every hospital has a scarce resource policy that we’ve had for years in anticipation and perhaps dread of an event like this.”

Shriner says their “Scarce Resource Policy” could kick in when any number of supplies are in short supply. It could be, she says, “a shortage of equipment, a shortage of beds, a shortage of ventilators; a shortage of medications…” that could trigger rationing.

First and foremost she says, no doctor or nurse would make a decision but a committee of people, The Scarce Resource Committee, would. No one who was caring for the patient could be involved in that decision.

As Los Angeles hospitals continue to be overwhelmed with COVID-19 patients, hospitals may begin rationing care and would force healthcare providers to determine the type of care a patient will receive based on available resources.

[. . .]

Shriner says [The Scarce Resource Committee] would be “made up of a bioethicist, a physician, a nurse and a community member. And none of those people are involved in the care of the patient that’s being considered for that issue.”

She also says that no committee members will know about a patient’s race, ethnicity, religion, citizenship, insurance, or other information unrelated to the patient’s health.According to the New England Journal of Medicine, even a conservative estimate shows that the health needs created by the pandemic go well beyond the capacity of U.S. hospitals.

 

Comments

  1. John Morales says

    Hospitals will decide who lives or dies based on their likelihood of survival.

    That sounds like they’re trying to be unbiased until you remember the reality of the US medical industry and inherent racism and classism. Black people are more likely than others to have high blood pressure. And the poor are less likely be healthy because they couldn’t afford proper medical care before 2020.

    Is not their actual blood pressure and health status part of the consideration regarding the likelihood of survival?

    When your health is already compromised, you are at a disadvantage when that committeed makes its decision.

    Same thing. If their health is already compromised, surely that is a factor for their likelihood of survival.

  2. jrkrideau says

    @ john M

    I am afraid you may be correct. By the time one ends up in the ICU, it is too late to correct 2 or 3 hundred years of systemic discrimination.

  3. says

    She also says that no committee members will know about a patient’s race, ethnicity, religion, citizenship, insurance, or other information unrelated to the patient’s health.

    But they’ll still be working from patient files written by people who did know and who might be biased. A perfectly unbiased evaluation of biased data will still produce bias, so this is not a guarantee.

    That’s one of the reasons algorithms sometimes go way wrong, like concluding that a black neighborhood has more crime because the police patrol there more often. The algorithm might not be biased, but the information it’s working from is.

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