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Tags: clustering | hopkins | race

Goldfarb: Put Patients First, Politics Last

patient healthcare first politics last

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By    |   Thursday, 07 March 2024 10:18 AM EST

Johns Hopkins Health System chief diversity officer Sherita Golden recently ignited a firestorm when she sent an email claiming that all whites, heterosexuals, and Christians benefit from privilege. While that idea is absurd and offensive, it’s hardly the most dangerous idea she has championed.

A May 2022 news release from the Johns Hopkins Health System announces the adoption of a "race-free" kidney function equation.

Whereas race was previously considered in equations that estimate kidney function, the decision to scrap it, as Golden explains in the article, reflects her belief that "there are not biological differences in the kidney attributable to race, and therefore it should not be considered in the equation for kidney function."

The question whether there are biological differences in kidney function attributable to race is a red herring. For those who prioritize the optimization of care, the critical question is simply whether using race in the equation enhances its accuracy.

Decades of data indicate that it does.

Black Americans tend to have higher levels of muscle mass compared other groups.

On average, that also means higher levels of creatinine (a waste product produced by muscles) in their blood. Because creatinine is used as a marker to assess kidney function, the kidney function equation must be adjusted to account for this biological reality. Otherwise, kidney function for blacks would tend to look worse than it is.

Proposed alternatives to the popularly used race-based equation are either very expensive or introduce systematic bias that underestimates kidney function in black patients, which would result in black patients leapfrogging needier patients on the kidney transplant list.

Nevertheless, some activists are so determined to reify the view that race is solely a social construct that they demand its removal from all medical equations, consequences be damned.

Golden for example claimed that removing race from the equation represents a "necessary step toward achieving health equity and eliminating structural racism in medicine."

Last year, the American Medical Association similarly labeled the race-based equation a "a manifestation of structural racism in medicine."

Their ideologically captured journal (i.e. the Journal of the American Medical Association) has published several pieces expressing consternation or opposition to race adjustments.

Unfortunately, it appears the pursuit of eliminating sensible race considerations in medicine is winning out. As of November 2022, one third of U.S. labs had stopped using race-based equations to diagnose kidney function.

A more sensible approach acknowledges that race is a social construct, but one that features biological and genetic clustering that can be useful to doctors in making diagnoses, treating patients, or advising them on risk.

Sickle cell disease, for example, is 100 times more common in Black Americans than white Americans.

If Golden and other activists get their way, black expecting parents won’t receive any indication of their elevated risk.

Thankfully, other experts are starting to sound the alarm.

Commentary in Cureus comprehensively reviews the science behind kidney function estimates and rightly concludes that that concerns about how to label "race" (i.e. whether it’s a social construct or something else) are irrelevant to the fact that featuring race in kidney function equations improves their accuracy.

Commentary in the New England Journal of Medicine meanwhile expresses ideological sympathy for opposition to race adjustments but rightly concludes that scrapping these adjustments in the name of political correctness would imperil patient care, including among populations that activists are ostensibly most concerned about helping.

Only time will tell whether common sense or woke hysteria prevails. Still, the ongoing debate is a jarring indication that DEI in medicine is not simply a nuisance or an instrument for elevating progressive orthodoxies, but a different approach altogether.

It values feelings over facts, representation over excellence, and political correctness over patient care. Indeed, it threatens patients of every race and political orientation, and it must be dismantled.

Dr. Stanley Goldfarb, Board Chairman of Do No Harm and Ian Kingsbury, Director of Research at Do No Harm?

© 2024 Newsmax. All rights reserved.


Politics
The ongoing debate is a jarring indication that DEI in medicine is not simply a nuisance or an instrument for elevating progressive orthodoxies, but a different approach. It values feelings over facts, representation over excellence, and political correctness over care.
clustering, hopkins, race
654
2024-18-07
Thursday, 07 March 2024 10:18 AM
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