{"id":6614,"date":"2012-05-21T20:56:18","date_gmt":"2012-05-21T20:56:18","guid":{"rendered":"http:\/\/www.mixedracestudies.org\/wordpress\/?p=6614"},"modified":"2016-06-22T15:42:35","modified_gmt":"2016-06-22T15:42:35","slug":"%e2%80%9cracially-tailored%e2%80%9d-medicine-unraveled","status":"publish","type":"post","link":"https:\/\/mixedracestudies.org\/wp\/?p=6614","title":{"rendered":"\u201cRacially-Tailored\u201d Medicine Unraveled"},"content":{"rendered":"<p><strong><em><a href=\"http:\/\/www.wcl.american.edu\/journal\/lawrev\/55\/hoffman.pdf?rd=1\" target=\"_blank\">\u201cRacially-Tailored\u201d Medicine Unraveled<\/a><\/em><\/strong><\/p>\n<p><a href=\"http:\/\/www.wcl.american.edu\/journal\/lawrev\/\" target=\"_blank\">American University Law Review<\/a><br \/>\n<a href=\"http:\/\/www.wcl.american.edu\/journal\/lawrev\/55\/55-2.cfm\" target=\"_blank\">Volume 55, Number 2<\/a> (December 2005)<br \/>\npages 395-452<\/p>\n<p><strong><a href=\"http:\/\/www.case.edu\/med\/bioethics\/facultystaff\/sxh90.htm\" target=\"_blank\">Sharona Hoffman<\/a><\/strong>, Professor of Law, Professor of Bioethics, and Associate Director of the Law-Medicine Center<br \/>\n<em>Case Western Reserve University School of Law<\/em><\/p>\n<p><strong>Table of Contents<\/strong><\/p>\n<ul>\n<li><strong>Introduction<\/strong><\/li>\n<li>I. \u201cRace-Based\u201d Research and Therapeutic Practices\n<ul>\n<li>A. The Story of BiDil<\/li>\n<li>B. \u201cRace-Based\u201d Research<\/li>\n<li>C. A Growing Interest in \u201cRace-Based\u201d Medicine: Why Now?<\/li>\n<\/ul>\n<\/li>\n<li><strong>II. Does \u201cRace\u201d Mean Anything?<\/strong>\n<ul>\n<li>A. \u201cRace\u201d in the Medical and Social Sciences<\/li>\n<li>B. \u201cRace\u201d and the Law<\/li>\n<li>C. Shifting the Focus Away from \u201cRace\u201d<\/li>\n<\/ul>\n<\/li>\n<li><strong>III. The Dangers of \u201cRacial Profiling\u201d in Medicine<\/strong>\n<ul>\n<li>A. Medical Mistakes<\/li>\n<li>B. Stigmatization and Discrimination<\/li>\n<li>C. Exacerbation of Health Disparities<\/li>\n<\/ul>\n<\/li>\n<li><strong>IV. Violation of Anti-Discrimination Provisions<\/strong>\n<ul>\n<li>A. Constitution and Federal Civil Rights Laws<\/li>\n<li>B. State Laws Prohibiting Discrimination in the Medical Arena\n<ul>\n<li>1. Civil rights statutes<\/li>\n<li>2. Hospital and medical facility licensing requirements<\/li>\n<li>3. Patients\u2019 bill of rights laws<\/li>\n<li>4. Public services regulation<\/li>\n<li>5. Insurance codes<\/li>\n<\/ul>\n<\/li>\n<li>C. Violation of Research Regulations and Guidelines\n<ul>\n<li>1. NIH policy and guidelines<\/li>\n<li>2. Federal research regulations<\/li>\n<\/ul>\n<\/li>\n<li>D. Discrimination Theory<\/li>\n<\/ul>\n<\/li>\n<li><strong>V. Recommendations<\/strong>\n<ul>\n<li>A. Review of Research Studies by Scientific Review Boards and IRBs\n<ul>\n<li>1. Scientific reviews<\/li>\n<li>2. Institutional review boards<\/li>\n<\/ul>\n<\/li>\n<li>B. Investigators and Health Care Providers<\/li>\n<li>C. Public Discourse Concerning Attribute-Based Medicine:The Responsibilities of Investigators, Institutions, and the Media<\/li>\n<\/ul>\n<\/li>\n<li><strong>Conclusion<\/strong><\/li>\n<\/ul>\n<p><strong>Introduction<\/strong><\/p>\n<p><em>F.D.A. Approves a Heart Drug for African-Americans.<\/em> This June 2005 headline announced the arrival of <a href=\"https:\/\/en.wikipedia.org\/wiki\/Isosorbide_dinitrate\/hydralazine\" target=\"_blank\">BiDil<\/a>, a heart failure edication that is approved for African-Americans only. BiDil is the first drug in pharmaceutical history that will constitute standard therapy for only one particular \u201crace.\u201dHealth care professionals are becoming increasingly interested in \u201cracebased\u201d medicine in the research and therapeutic contexts. Many researchers are attempting to discern \u201cracial\u201d differences in disease manifestation, biological functioning, and therapeutic response rates. As this approach develops, physicians may prescribe different dosages of medication for people of separate \u201craces\u201d or may provide them with entirely different drugs. In light of the success of BiDil, investigators are also likely to pursue the development of additional \u201cracially-tailored\u201d medications. In fact, several academic and professional conferences have already devoted significant time to the discussion of \u201crace-based\u201d medicine. On April 18, 2005, the University of Minnesota hosted aconference entitled <em>Proposals for the Responsible Use of Racial &amp; Ethnic Categories in Biomedical Research: Where Do We Go From Here?<\/em> Likewise, the Eighth World Congress on Clinical Pharmacology and Therapeutics, held in 2004 in Brisbane, Australia, devoted an afternoon to ethnopharmacology.While \u201cracial profiling\u201d in medicine has generated significant discussion in medical and bioethics circles, it has thus far gained relatively little attention in legal literature. This Article aims to develop the discourse concerning this important topic. It argues that \u201crace-based\u201d medicine is an inappropriate and perilous approach. The argument is rooted partly in the fact that the concept of \u201crace\u201d is elusive and has no reliable definition in medical science, the social sciences, and the law. \u00a0Does \u201crace\u201d mean color, national origin, continent of origin, culture, or something else? <em>What about the millions of Americans who are of mixed ancestral origins\u2014to what \u201crace\u201d do they belong?<\/em> To the extent that \u201crace\u201d means \u201ccolor\u201d in colloquial parlance, should physicians decide what testing to conduct or treatment to provide based simply on their visual judgment of the patient\u2019s skin tone? \u201cRace,\u201d consequently, does not constitute a valid and sensible foundation for research or therapeutic decision-making.<\/p>\n<p><strong>Further, this Article contends that \u201cracial profiling\u201d in medicine can be dangerous to public health and welfare.<\/strong> A focus on \u201crace,\u201d whatever its meaning in the physician\u2019s eye, can lead to medical mistakes if the doctor misjudges the patient\u2019s ancestral identity or fails to recall that a particular condition affects several vulnerable groups and not just one \u201crace.\u201d The phenomenon can also lead to stigmatization and discrimination in the workplace and elsewhere if the public perceives certain \u201craces\u201d as more diseased or more difficult to treat than others. In addition, \u201cracial profiling\u201d could exacerbate health disparities by creating opportunities for health professionals to specialize in treating only one \u201crace\u201d or to provide different and inferior treatment to certain minorities. It could also intensify African-Americans\u2019 distrust of the medical profession. Finally, \u201crace-based\u201d medicine might violate numerous anti-discrimination provisions contained in federal law, state law, and federal research regulations and guidelines&#8230;<\/p>\n<p>&#8230;The Article will proceed as follows. Part I of the Article will describe \u201crace-based\u201d research and therapeutic practices and will examine the growing interest in \u201crace-based\u201d medicine and the reasons for it. Part II will argue that \u201crace\u201d is a concept that has no coherent meaning and that is potentially pernicious. Part III will focus on the dangers of \u201craciallytailored\u201d medicine, and Part IV will analyze a variety of anti-discrimination mandates that could potentially be violated by the practice. Finally, Part V will detail recommendations for the development of attribute-based medicine in a manner that will promote the health and welfare of all population groups&#8230;<\/p>\n<p>&#8230;This Article argues against substantial use of the concept of \u201crace\u201d in medical settings. A primary reason for this restriction is that \u201crace\u201d has no coherent meaning, and therefore, reliance upon it for research or treatment purposes can be confusing at best and can lead to significant adverse consequences at worst. This section will build the argument that based on medical science, the social sciences, and the law, \u201crace\u201d has no reliable definition or real meaning. Moreover, it is a pernicious concept that has been used to suggest that human beings can be divided into subspecies, some of which are morally, intellectually, and physically inferior to others. Thus, medical professionals should focus on more precise and meaningful aspects of human identity rather than on the amorphous concept of \u201crace.\u201d&#8230;<\/p>\n<p>Read the entire article <a href=\"http:\/\/www.wcl.american.edu\/journal\/lawrev\/55\/hoffman.pdf?rd=1\" target=\"_blank\">here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cRacially-Tailored\u201d Medicine Unraveled American University Law Review Volume 55, Number 2 (December 2005) pages 395-452 Sharona Hoffman, Professor of Law, Professor of Bioethics, and Associate Director of the Law-Medicine Center Case Western Reserve University School of Law Table of Contents Introduction I. \u201cRace-Based\u201d Research and Therapeutic Practices A. The Story of BiDil B. \u201cRace-Based\u201d Research [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,2039,1467,8,26,394,20],"tags":[2234,2771,2770],"class_list":["post-6614","post","type-post","status-publish","format-standard","hentry","category-articles","category-health-medicine","category-law","category-media-archive","category-politics","category-socialscience","category-usa","tag-american-university-law-review","tag-bidil","tag-sharona-hoffman"],"_links":{"self":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/6614","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6614"}],"version-history":[{"count":2,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/6614\/revisions"}],"predecessor-version":[{"id":43179,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/6614\/revisions\/43179"}],"wp:attachment":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6614"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6614"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6614"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}