Ted talk discussion (The problem with race based medicine)

[bceagle411]

I am curious to know what people think about this TED talk

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[ZedsDed]

I am curious to know what people think about this TED talk

In b4 the SPF dump.

This woman is a *****. She clearly has done zero research (or very selective research) on how race/genetics is used as a reference to treat patients.

This is what happens when you give intellectuals a useless degree in a soft discipline that is heavy on circular reasoning and light on critical thinking.

 

[organdonor]

This woman's talk is silly and ignorantly inflammatory.

No practicing physician would ever agree with any of the points she brought up.

She needs to look up and understand what "evidence based" actually means if she is going to use that terminology.

I'm not stupid enough to think that there is not racism in medicine. But that racism is not manifested in GFR or spirometry calculation

 

[nairopil]

This is so interesting! I think she makes some great points (plenty of self-identified black people might have 50% or more "Caucasian" dna). Also, my SO is from Ethiopia, and was recently prescribed a med that "tends to work better in African Americans". But his genes might be dramatically different than your average African American.
I do think science needs to have the freedom to explore trait/heritage-linked diseases (eg. red heads risk of melanoma and Ashkenazi Jewish population risk of Tay-Sachs). And while these are better framed in terms of genetics, trying to communicate to the public about them would be difficult if we could only talk about such-and-such a gene, which the average person may or may not know they have.

 

[GrapesofRath]

There are a number of valid reservations about how race is used in medical school admission and whether it is beneficial to medicine as a whole. The points she brings up are not amongst them.

 

[Mad Jack]

This is so interesting! I think she makes some great points (plenty of self-identified black people might have 50% or more "Caucasian" dna). Also, my SO is from Ethiopia, and was recently prescribed a med that "tends to work better in African Americans". But his genes might be dramatically different than your average African American.
I do think science needs to have the freedom to explore trait/heritage-linked diseases (eg. red heads risk of melanoma and Ashkenazi Jewish population risk of Tay-Sachs). And while these are better framed in terms of genetics, trying to communicate to the public about them would be difficult if we could only talk about such-and-such a gene, which the average person may or may not know they have.

The trouble is we don't know which genes cause a lot of these effects, and finding then would be a costly endeavour. We just aren't at the point yet where we can use genetics instead of race to determine treatment options. Someday we will be, and this will be a non-issue, but until then, her whole talk is nonsense.

 

[Psai]

Why should I care what a lawyer thinks about medicine outside of the courtroom?

 

[attitudeofgratitude]

Why should I care what a lawyer thinks about medicine outside of the courtroom?

The majority of health policy in this county is written by Lawyers so...

 

[PB&Jam]

There are a number of valid reservations about how race is used in medical school admission and whether it is beneficial to medicine as a whole. The points she brings up are not amongst them.

Her talk isn't about medical school admissions at all, it's about doctors using race as a factor in diagnosing and treating patients and whether or not this practice is useful and beneficial.

 

[organdonor]

Her talk isn't about medical school admissions at all, it's about doctors using race as a factor in diagnosing and treating patients and whether or not this practice is useful and beneficial.

But she doesn't have any credibility on that subject. She demonstrates that in her talk. She has no clinical background at all. The most credence she gives to any of her points (other than racism is bad) is that "I've been told that" without ever mentioning a name, a research paper, or any data whatsoever.

 

[getdown]

This lady is ****ing stupid. She has no idea what's she talking about.

 

[JustAPhD]

This lady is ****ing stupid. She has no idea what's she talking about.

She's an alum of Yale and Harvard so I don't think stupid is correct, but I'll say this Ted talk is one of the worse ones I've seen.

 

[ZedsDed]

She's an alum of Yale and Harvard so I don't think stupid is correct, but I'll say this Ted talk is one of the worse ones I've seen.

Some things are so obviously stupid that only very smart people can do the intellectual gymnastics necessary to convince themselves that they are true.

 

[getdown]

She's an alum of Yale and Harvard so I don't think stupid is correct, but I'll say this Ted talk is one of the worse ones I've seen.

She can go to Harvard and Yale but if she talks about things that are out of her realm of expertise while stating obviously deficient and exceedingly incorrect facts, she is stupid. If I start talking about how to do a whipple (incorrectly) to a bunch of long time practicing surgeons they'll undoubtedly think what I'm saying is pretty stupid as well.

 

[Lucca]

The trouble is we don't know which genes cause a lot of these effects, and finding then would be a costly endeavour. We just aren't at the point yet where we can use genetics instead of race to determine treatment options. Someday we will be, and this will be a non-issue, but until then, her whole talk is nonsense.

This is really the takeaway. No reason to take up arms in righteous anger. She has identified some research questions we are very familiar with and are actively working on. "Personalized medicine" is already reaching buzzword status. Her talk does reveal a lack of appreciation for the art of medicine, which requires the physician to draw from both evidence, heuristic and individual judgement. For a lawyer speaking at TED (which tends to have an educated audience) her argument is remarkably simplistic. A freshman philosophy student could dismantle it in a couple of minutes. That being said, there are some honest points in the talk which is, overall, lacking. It's basically one massive straw man with slippery slopes peppered throughout.

My first thoughts:

Her first point about how race is used in medical diagnosis started off talking about how the lazy handling of a variable might compromise the results (which I think is a valid critique, although I would have to know more about the goals of the study to say anything) but then moves on to make claims about how this means that taking race into consideration during a diagnosis is bad. I could see how you could get from A --> B here but it reduces a multidimensional and complicated mental process to a robotic, one-dimensional algorithm predicated on a single variable which is obviously garbage; if this point were to be effective, she is missing a lot of connective tissue and thought and this deficit is repeatedly present throughout the talk.

Similarly, her talk about diagnostic tools, measurements and drugs which take race into account ignores the scientific fact which she, in other places, relies on to make her argument: people's bodies are different. Yes, the main driver is not "race", which means a lot of things and nothing at the same time, but genetics (which are often but not necessarily tied to one's race). She first asserts that "wow doctors think black people's bodies are substandard" and uses an anecdote about a black lady saying "give me the drug white people are taking" to further this point. In the first case, she is clearly on a slippery slope. That is not at all what those diagnostic measurement standards are saying. They are saying, broadly, people's bodies are different and people of a certain background tend to present some things differently than others. There is more wrong with this point: the example of GFR is poor. She presents the numbers 86 and 89 and then says "wow look at this difference based on race" but we have no medical context for what those numbers mean. Is 3 points a really big difference? They are both in the normal range so is the difference truly important? Not to mention the fact that she once again pretends physicians are robots either do not or cannot exercise judgement. The example about the old lady is even worse. She later admits that race is tied to complex socio-economic factors which have consequences for a population's health but ignores these very same socio-economic factors which lead to patients mistrusting a drug. Sure, maybe this drug was **** and maybe the trial was not very good but the old lady anecdote tells us nothing about that. It's a red-herring attempting to appeal to a "common sense" approach to medicine when the reality is far more complicated.

Then there is this deal about the justifications for the measurements. The example with GFR she says is due to the assumption that black people have more muscle mass. She then says "well what about a white female body builder, I think she will have more muscle mass than me". No ****, your physician will probably pick up on that and interpret your GFR accordingly because (once again she is reducing the diagnostic process to a single-variable algorithm) he not only knows your particular condition but also the reason behind the different GFR standards and can put two and two together to conclude that your GFR standard might be closer to the number for non AAs than AAs. It's like a "heuristic" (which I know is a super common term in sociology and behavior science) is supposed to be a rigid algorithm and that's not the case. Straw man, moving on.

I'm not even going to touch the Cartwright example because her reasoning is so awful and specious there.

It's also remarkable to me that someone so concerned with history does not even understand that "evidence-based" medicine is basically in its infancy. In many respects we are very poor at practicing true evidence based medicine in that we dont have a large volume of evidence for every possible permutation of variables on the planet and our scientific understanding of many disease mechanisms is also lacking, if you do not understand that part of the art of medicine is dealing with how much you don't know then you have not thought very hard about a very important and obvious concept. The fact that we need to improve in this area is a valid critique but its not groundbreaking. Everyone understands we need to do better. Many many good, smart people are doing everything they can to make that a reality and those same people appreciate the importance of multi-hidden variables like race, SES, etc.

 

[Lucca]

Some things are so obviously stupid that only very smart people can do the intellectual gymnastics necessary to convince themselves that they are true.

This is so true.

 

[PB&Jam]

But she doesn't have any credibility on that subject. She demonstrates that in her talk. She has no clinical background at all. The most credence she gives to any of her points (other than racism is bad) is that "I've been told that" without ever mentioning a name, a research paper, or any data whatsoever.

I never said her talk had any evidence or credibility (in fact I agree that it's largely founded on her own preconceived notions and not on any sort of research). However, I was merely pointing out that her talk was not about medical school admissions, which, regardless of its merit, it is clearly not.

 

[ZedsDed]

This is really the takeaway. No reason to take up arms in righteous anger. She has identified some research questions we are very familiar with and are actively working on. "Personalized medicine" is already reaching buzzword status. Her talk does reveal a lack of appreciation for the art of medicine, which requires the physician to draw from both evidence, heuristic and individual judgement. For a lawyer speaking at TED (which tends to have an educated audience) her argument is remarkably simplistic. A freshman philosophy student could dismantle it in a couple of minutes. That being said, there are some honest points in the talk which is, overall, lacking. It's basically one massive straw man with slippery slopes peppered throughout.

My first thoughts:

Her first point about how race is used in medical diagnosis started off talking about how the lazy handling of a variable might compromise the results (which I think is a valid critique, although I would have to know more about the goals of the study to say anything) but then moves on to make claims about how this means that taking race into consideration during a diagnosis is bad. I could see how you could get from A --> B here but it reduces a multidimensional and complicated mental process to a robotic, one-dimensional algorithm predicated on a single variable which is obviously garbage; if this point were to be effective, she is missing a lot of connective tissue and thought and this deficit is repeatedly present throughout the talk.

Similarly, her talk about diagnostic tools, measurements and drugs which take race into account ignores the scientific fact which she, in other places, relies on to make her argument: people's bodies are different. Yes, the main driver is not "race", which means a lot of things and nothing at the same time, but genetics (which are often but not necessarily tied to one's race). She first asserts that "wow doctors think black people's bodies are substandard" and uses an anecdote about a black lady saying "give me the drug white people are taking" to further this point. In the first case, she is clearly on a slippery slope. That is not at all what those diagnostic measurement standards are saying. They are saying, broadly, people's bodies are different and people of a certain background tend to present some things differently than others. There is more wrong with this point: the example of GFR is poor. She presents the numbers 86 and 89 and then says "wow look at this difference based on race" but we have no medical context for what those numbers mean. Is 3 points a really big difference? They are both in the normal range so is the difference truly important? Not to mention the fact that she once again pretends physicians are robots either do not or cannot exercise judgement. The example about the old lady is even worse. She later admits that race is tied to complex socio-economic factors which have consequences for a population's health but ignores these very same socio-economic factors which lead to patients mistrusting a drug. Sure, maybe this drug was **** and maybe the trial was not very good but the old lady anecdote tells us nothing about that. It's a red-herring attempting to appeal to a "common sense" approach to medicine when the reality is far more complicated.

Then there is this deal about the justifications for the measurements. The example with GFR she says is due to the assumption that black people have more muscle mass. She then says "well what about a white female body builder, I think she will have more muscle mass than me". No ****, your physician will probably pick up on that and interpret your GFR accordingly because (once again she is reducing the diagnostic process to a single-variable algorithm) he not only knows your particular condition but also the reason behind the different GFR standards and can put two and two together to conclude that your GFR standard might be closer to the number for non AAs than AAs. It's like a "heuristic" (which I know is a super common term in sociology and behavior science) is supposed to be a rigid algorithm and that's not the case. Straw man, moving on.

I'm not even going to touch the Cartwright example because her reasoning is so awful and specious there.

It's also remarkable to me that someone so concerned with history does not even understand that "evidence-based" medicine is basically in its infancy. In many respects we are very poor at practicing true evidence based medicine in that we dont have a large volume of evidence for every possible permutation of variables on the planet and our scientific understanding of many disease mechanisms is also lacking, if you do not understand that part of the art of medicine is dealing with how much you don't know then you have not thought very hard about a very important and obvious concept. The fact that we need to improve in this area is a valid critique but its not groundbreaking. Everyone understands we need to do better. Many many good, smart people are doing everything they can to make that a reality and those same people appreciate the importance of multi-hidden variables like race, SES, etc.

How you managed to do this off-the-cuff is beyond me. Guess I should've majored in philosophy

 

[Lucca]

How you managed to do this off-the-cuff is beyond me. Guess I should've majored in philosophy

You spend enough time arguing with nerds on the Internet and on campus libraries and you pick up a few tricks. Also being a liberal in Texas helps

 

[nairopil]

This is really the takeaway. No reason to take up arms in righteous anger. She has identified some research questions we are very familiar with and are actively working on. "Personalized medicine" is already reaching buzzword status. Her talk does reveal a lack of appreciation for the art of medicine, which requires the physician to draw from both evidence, heuristic and individual judgement. For a lawyer speaking at TED (which tends to have an educated audience) her argument is remarkably simplistic. A freshman philosophy student could dismantle it in a couple of minutes. That being said, there are some honest points in the talk which is, overall, lacking. It's basically one massive straw man with slippery slopes peppered throughout.

Well said. Yes, she wandered outside of her area of expertise, and it's fair to call her out on incorrect or incomplete statements. However, I'm a little concerned by the rabid nature of a lot these responses. If a lawyer (or other intelegent non-medical person) had a valid and well-researched critique of the way medicine relates to race, I would want to hear it. I'm happy to hear reasonable critiques of her conclusions, but less happy to see this, "why is a lawyer talking about medicine."

 

[Lucca]

Well said. Yes, she wandered outside of her area of expertise, and it's fair to call her out on incorrect or incomplete statements. However, I'm a little concerned by the rabid nature of a lot these responses. If a lawyer (or other intelegent non-medical person) had a valid and well-researched critique of the way medicine relates to race, I would want to hear it. I'm happy to hear reasonable critiques of her conclusions, but less happy to see this, "why is a lawyer talking about medicine."

Yah I don't think that's a fair approach either. Her argument was just poor lol. Medicine is a lot more than just docs.

 

[getdown]

Well said. Yes, she wandered outside of her area of expertise, and it's fair to call her out on incorrect or incomplete statements. However, I'm a little concerned by the rabid nature of a lot these responses. If a lawyer (or other intelegent non-medical person) had a valid and well-researched critique of the way medicine relates to race, I would want to hear it. I'm happy to hear reasonable critiques of her conclusions, but less happy to see this, "why is a lawyer talking about medicine."

Well, imagine something you're really passionate about, something you have dedicated your life to. Then have someone come in and criticize it publicly. Then imagine that person not only has poorly thought out arguments and facts but has no experience in the field whatsoever. Would you not be offended? I'm all for criticizing something but you better damn well have good facts to support it not just some made up bull**** she seemed to have cherry picked from history.

 

[nairopil]

Well, imagine something you're really passionate about, something you have dedicated your life to. Then have someone come in and criticize it publicly. Then imagine that person not only has poorly thought out arguments and facts but has no experience in the field whatsoever. Would you not be offended? I'm all for criticizing something but you better damn well have good facts to support it not just some made up bull**** she seemed to have cherry picked from history.

Of course it's easy to get riled up when someone criticizes something that you're passionate about. But here's how I see it: Firstly, she was criticizing something rather specific (the use of race as a medical category) not medicine as a whole, so unless you're publishing research about GFR differentials by race, I wouldn't take it too personally. Secondly, I'd almost say that the less cohesive her argument is, the less threatening it is. People have pointed out several obvious holes in her reasoning, which in my opinion makes her criticism that much less concerning.
I'm not a physician yet, so I'm sure that makes it easier for me to brush it off. I watched the video and noticed some weak arguments (they weren't all obvious to me right away), but was more interested in the questions she was asking, and where these types of questions might lead medical research in the future. It probably doesn't make a lot of sense for her to be lecturing on this topic as an "expert", but I'm happy for her to be pursuing the ideas she's pursuing.

 

[getdown]

Of course it's easy to get riled up when someone criticizes something that you're passionate about. But here's how I see it: Firstly, she was criticizing something rather specific (the use of race as a medical category) not medicine as a whole, so unless you're publishing research about GFR differentials by race, I wouldn't take it too personally. Secondly, I'd almost say that the less cohesive her argument is, the less threatening it is. People have pointed out several obvious holes in her reasoning, which in my opinion makes her criticism that much less concerning.
I'm not a physician yet, so I'm sure that makes it easier for me to brush it off. I watched the video and noticed some weak arguments (they weren't all obvious to me right away), but was more interested in the questions she was asking, and where these types of questions might lead medical research in the future. It probably doesn't make a lot of sense for her to be lecturing on this topic as an "expert", but I'm happy for her to be pursuing the ideas she's pursuing.

Oddly enough, I see it the complete opposite of you. She used the GFR and bidil example to attack the art of medicine and how physicians practice as a whole. She's basically saying that we shouldn't use race as a factor in making decision making at all and that's completely false. People's race does matter because their genetics will have some differences despite being 99.9% equal relative to the rest of the human race.

A quick read on antihypertensive differences in African Americans. Skip to section 3.3 regarding the specific rebuttal for her bidil example.

http://www.medscape.com/viewarticle/740380_4

African American men have also been known to have a higher risk for prostate cancer. Prostate screening guidelines recommend to screen them at an earlier age.

http://www.stanford.edu/~alicesw/FreedmanProcNASSep2006.pdf

But did she address this at all? No. She conveniently just addressed that there are anti hypertensive drugs marketed for blacks without addressing the research behind it. I'm an anesthesia resident and in anesthesia there's a well known term called "Asian airway". This basically means that Asians, especially Asian females, have really anterior airways and short jaws that make them more challenging to intubate. This could potentially lead to deadly consequences if you're not aware and not prepared to secure their airway. Is this always the case? No, but surprisingly more often than not. Does this make me sexist and anti-asian? I don't think so since I'm actually thinking about my patient's best interest.

So, to me the less cohesive the argument the more insulting it is when people try to criticize something they poorly understand.

This race-baiting stuff has been way too common in today's society. People just choose examples that support their ideology and conveniently ignore or misinterpret everything else.

 

[nairopil]

Oddly enough, I see it the complete opposite of you. She used the GFR and bidil example to attack the art of medicine and how physicians practice as a whole. She's basically saying that we shouldn't use race as a factor in making decision making at all and that's completely false. People's race does matter because their genetics will have some differences despite being 99.9% equal relative to the rest of the human race.

A quick read on antihypertensive differences in African Americans. Skip to section 3.3 regarding the specific rebuttal for her bidil example.

http://www.medscape.com/viewarticle/740380_4

African American men have also been known to have a higher risk for prostate cancer. Prostate screening guidelines recommend to screen them at an earlier age.

http://www.stanford.edu/~alicesw/FreedmanProcNASSep2006.pdf

But did she address this at all? No. She conveniently just addressed that there are anti hypertensive drugs marketed for blacks without addressing the research behind it. I'm an anesthesia resident and in anesthesia there's a well known term called "Asian airway". This basically means that Asians, especially Asian females, have really anterior airways and short jaws that make them more challenging to intubate. This could potentially lead to deadly consequences if you're not aware and not prepared to secure their airway. Is this always the case? No, but surprisingly more often than not. Does this make me sexist and anti-asian? I don't think so since I'm actually thinking about my patient's best interest.

So, to me the less cohesive the argument the more insulting it is when people try to criticize something they poorly understand.

This race-baiting stuff has been way too common in today's society. People just choose examples that support their ideology and conveniently ignore or misinterpret everything else.

I completely agree that there are times when particular medical treatments or procedures are informed by race. However, she does bring up an interesting point about biracial/multiracial individuals. Do we assume that someone who is 1/4 African American and 3/4 Caucasian will respond to a treatment the way African-Americans did in a study, just because they might self-identify (or we visually identify them) as black? Our social understanding of race can impact how we understand and apply the research that's available. I wouldn't call this race-baiting.

Sent from my Nexus 5 using SDN mobile app

 

[getdown]

I completely agree that there are times when particular medical treatments or procedures are informed by race. However, she does bring up an interesting point about biracial/multiracial individuals. Do we assume that someone who is 1/4 African American and 3/4 Caucasian will respond to a treatment the way African-Americans did in a study, just because they might self-identify (or we visually identify them) as black? Our social understanding of race can impact how we understand and apply the research that's available. I wouldn't call this race-baiting.

Sent from my Nexus 5 using SDN mobile app

I see your point. However, I would say that in the case of your example one would start them on one type of hypertensive med and monitor how they respond to it. I'd see them in follow up and change the dose or medication around. This is not unique to how we manage BP in the general population since people behave differently regardless of what race they are.

 

[idontwatchgreysanatomy]

So many people here are missing the point of this talk. I feel so much second-hand embarrassment from reading these posts.

 

[ZedsDed]

So many people here are missing the point of this talk. I feel so much second-hand embarrassment from reading these posts.

Enlighten us then.

 

[WingedOx]

Her talk isn't about medical school admissions at all, it's about doctors using race as a factor in diagnosing and treating patients and whether or not this practice is useful and beneficial.

yeah, but you wouldn't have clicked this thread if we weren't talking about admissions.

 

[idontwatchgreysanatomy]

Enlighten us then.

Race is a social construct. Biologists acknowledge that there is no biological component to race. Therefore, treatments should not be tailored to race. I feel like if a geneticist made this same argument that people here would agree. However, SDN has some weird hard-on against social sciences. That is all I will say, because just like any time race gets mentioned on SDN, it turns into a ****show, and I have more important things to worry about.

 

[ZedsDed]

Race is a social construct. Biologists acknowledge that there is no biological component to race. Therefore, treatments should not be tailored to race. I feel like if a geneticist made this same argument that people here would agree. However, SDN has some weird hard-on against social sciences. That is all I will say, because just like any time race gets mentioned on SDN, it turns into a ****show, and I have more important things to worry about.

Oh right, that argument again. Then I'll repeat my original statement that I don't think you know anything about race, genetics or how the two are used in medicine. Race roughly correlates with the genetic variance we see in humanity.

Maybe know what you're talking about before implying that others are ignorant next time?

 

[Instatewaiter]

Race is a social construct. Biologists acknowledge that there is no biological component to race. Therefore, treatments should not be tailored to race. I feel like if a geneticist made this same argument that people here would agree. However, SDN has some weird hard-on against social sciences. That is all I will say, because just like any time race gets mentioned on SDN, it turns into a ****show, and I have more important things to worry about.

First, I am surprised the TED talk people would not consult a physician to review her claims. Her examples are just wrong.

Second, were race just a social construct why are there physiological differences for instance in the correlation between GFR and creatinine or the likelihood of salt sensitivity? These are heuristics for true genetic differences. There is a reaons why we use a different set of normal values for different groups- men, women, black, white, asian, etc. Because the average values are different. Perhaps one day we will be able to sequences a genome completely for very little money and not use race as a shortcut.

Her bidil example was a poor one. In subgroup analysis, there was a signal that it was beneficial for blacks. Anyone who knows even a hint of statitistics realizes that if you analyze enough subgroups you will find one that is statistically significant. So before the FDA would grant approval for bidil, they forced them to perform a AHEFT where the entire population and not just some subgroup was self identified african americans. I assure you, tthe makers of Bidil would have much rather save the millions of money it cost to perform A-HEFT. And A-HEFT did look at polymorphisms getting at the underlying differences for the effect of bidil.

 

[PB&Jam]

yeah, but you wouldn't have clicked this thread if we weren't talking about admissions.

That's literally the only post in this thread that mentioned admissions in any form. The other comments and the talk itself were referring to race in medical practice.

 

[nairopil]

Oh right, that argument again. Then I'll repeat my original statement that I don't think you know anything about race, genetics or how the two are used in medicine. Race roughly correlates with the genetic variance we see in humanity.

Maybe know what you're talking about before implying that others are ignorant next time?

It's a little more complex than that. Historically, yes, genetic pools would correlate to what we see as racial and ethnic groups. And as I said before, I do agree that some "race" or trait based medicine makes sense (@getdown gave a great example about "Asian airway".) However one thing that the speaker talks about is how we perceive people of mixed race. Our society still generally accepts the Jim Crow assertion that "one drop" of "black" blood makes a person black. So identifying someone by our social understanding of race might not provide the best estimate of their genetics. It's an important idea to consider.

 

[ZedsDed]

It's a little more complex than that. Historically, yes, genetic pools would correlate to what we see as racial and ethnic groups. And as I said before, I do agree that some "race" or trait based medicine makes sense (@getdown gave a great example about "Asian airway".) However one thing that the speaker talks about is how we perceive people of mixed race. Our society still generally accepts the Jim Crow assertion that "one drop" of "black" blood makes a person black. So identifying someone by our social understanding of race might not provide the best estimate of their genetics.

I'm not seeing how this rebuts my statement that "race roughly correlates with the genetic variance we see in humanity."

 

[medic86]

It's a little more complex than that. Historically, yes, genetic pools would correlate to what we see as racial and ethnic groups. And as I said before, I do agree that some "race" or trait based medicine makes sense (@getdown gave a great example about "Asian airway".) However one thing that the speaker talks about is how we perceive people of mixed race. Our society still generally accepts the Jim Crow assertion that "one drop" of "black" blood makes a person black. So identifying someone by our social understanding of race might not provide the best estimate of their genetics. It's an important idea to consider.

Do you assume that every doctor is a ***** or something?

Edit: for niceness sake

 

[nairopil]

I'm not seeing how this rebuts my statement that "race roughly correlates with the genetic variance we see in humanity."

Not trying to rebut your statement...just saying that "it's a little more complex." We can make a rough correlation a little cleaner by understanding how a social view of race differs from a genetic view.

Do you assume that every doctor is a ***** or something?

Edit: for niceness sake

I'm not sure why a discussion about how social understandings of race might be relevant to medicine has to be an attack on "every doctor." But *****ic doctors certainly do exist.

 

[GrapesofRath]

This race-baiting stuff has been way too common in today's society. People just choose examples that support their ideology and conveniently ignore or misinterpret everything else.

Truer words have never been spoken. This is the type of statement that should get stickied on here so anybody can look at it before they think about starting the next AA thread(and yes I know this isnt an AA thread). It's the ultimate summary of so many threads on here that involve race. The narrative so many people believe is pre-determined based off personal preferences and what is best for them; the racial conversation that ensues after is merely an exercise in futility and who can bring the most hot air to a conversation.

 

[idontwatchgreysanatomy]

Oh right, that argument again. Then I'll repeat my original statement that I don't think you know anything about race, genetics or how the two are used in medicine. Race roughly correlates with the genetic variance we see in humanity.

Maybe know what you're talking about before implying that others are ignorant next time?

Considering this exact topic has come up in my genetics, general bio, and 2 public health classes, and they have all echoed what I've stated, I'll have to continue to disagree with you. I get it, you really want to be a doctor so naturally your confirmation bias and lack of understanding on the subject is clouding your judgment. But what do I know, I'm apparently just race baiting because I agree that blanket statements about an entire race of people aren't the best way to approach patient care.

 

[ZedsDed]

Considering this exact topic has come up in my genetics, general bio, and 2 public health classes, and they have all echoed what I've stated, I'll have to continue to disagree with you. I get it, you really want to be a doctor so naturally your confirmation bias and lack of understanding on the subject is clouding your judgment. But what do I know, I'm apparently just race baiting because I agree that blanket statements about an entire race of people aren't the best way to approach patient care.

Not an argument -- you're still not saying anything. I can't argue against vague abstractions. I know this is hard, but if you want to convince me that "race is a social construct" you are going to have to explain to me what that means and why you believe it. Stumbling in here with your fingers in your ears and your nose in the air isn't going to impress anyone.

 

[idontwatchgreysanatomy]

Not an argument -- you're still not saying anything. I can't argue against vague abstractions. I know this is hard, but if you want to convince me that "race is a social construct" you are going to have to explain to me what that means and why you believe it. Stumbling in here with your fingers in your ears and your nose in the air isn't going to impress anyone.

I don't need to cater to your ignorance by explaining basic sociological concepts to you. Go take an intro to soc class.

 

[hailbate]

 

[getdown]

Considering this exact topic has come up in my genetics, general bio, and 2 public health classes, and they have all echoed what I've stated, I'll have to continue to disagree with you. I get it, you really want to be a doctor so naturally your confirmation bias and lack of understanding on the subject is clouding your judgment. But what do I know, I'm apparently just race baiting because I agree that blanket statements about an entire race of people aren't the best way to approach patient care.

Listen, I totally agree with what you said in the bolded statement above. Blanket statements are never a good way to approach things. BUT, as has been stated above, it's used as a PROXY of certain characteristics that a MAJORITY of the individuals in that group share. EVERY individual regardless of race - white, black, asian - are unique and respond to medications and treatment in different ways. We don't know how they'll respond individually but we do know how a majority of people do. So instead of wasting our time and your money undergoing genetic testing and trying to reinvent the wheel for the small minority we look for similar characteristics and treat based on that (again a gross oversimplification of the process). So until some cheap method for genomic individualization of treatment is invented we'll continue to make judgement based on how the majority of patients respond.

And it's not like we're saying blacks can only get drug A and B, whites drug C and D and asians E and F. No!! We want to start you on meds that work, but if they don't work then we'll add more A-F. The goal is to treat your condition with the least amount of durgs (and copay) possible.

Furthermore, you talk about blanket statements. What this lady did was the epitome of blanket statements: gross over-generalization, untrue with misleading facts. Myself and other actual physicians have come in and gave you our point of view and arguments of why she's wrong. The onus is now on you to provide proof as to why you're right.

 

[ZedsDed]

I don't need to cater to your ignorance by explaining basic sociological concepts to you. Go take an intro to soc class.

If you don't know anything then why are you spewing this conjecture? This isn't a humanities class in your liberal arts college -- evidence is a must.

Ill one-up you and say Google scholar is your friend.

 

[idontwatchgreysanatomy]

If you don't know anything then why are you spewing this conjecture? This isn't a humanities class in your liberal arts college -- evidence is a must.

Ill one-up you and say pubmed is your friend.

Yes, me not wanting to explain concepts that you should have learned freshman year means I don't know anything. Brilliant logic.

 

[ZedsDed]

Yes, me not wanting to explain concepts that you should have learned freshman year

Great! Then it should be easy for you to explain such basic concepts about race to a dullard like myself.

Il wait

 

[idontwatchgreysanatomy]

Great! Then it should be easy for you to explain such basic concepts about race to a dullard like myself.

Il wait

After reviewing your post history, it is apparent that this is falling of deaf ears. I'm sure you will interpret this as me backing down and you will revel in your little internet victory, but I hope at some point in your life you actually challenge your narrow mindset. You sound like a real joy to be around.

 

[nairopil]

Alright guys, first article that popped up on google.

http://www.the-scientist.com/?articles.view/articleNo/38950/title/On-Race-and-Medicine/

Yes, race is linked to genetics.
Yes, genetics are more complex than our social view of race.
Yes, our understanding of race can still be medically relevant until further genetic understanding is reached.
Yes, we need to be careful of racial generalizations in medicine, especially as stereotypical racial groups intermix.

I think that nicely sums up all of our respective arguments.

 

[ZedsDed]

After reviewing your post history, it is apparent that this is falling of deaf ears. I'm sure you will interpret this as me backing down and you will revel in your little internet victory, but I hope at some point in your life you actually challenge your narrow mindset. You sound like a real joy to be around.

Oh the irony

 

[ZedsDed]

Alright guys, first article that popped up on google.

http://www.the-scientist.com/?articles.view/articleNo/38950/title/On-Race-and-Medicine/

Yes, race is linked to genetics.
Yes, genetics are more complex than our social view of race.
Yes, our understanding of race can still be medically relevant until further genetic understanding is reached.
Yes, we need to be careful of racial generalizations in medicine, especially as stereotypical racial groups intermix.

I think that nicely sums up all of our respective arguments.

I'm fine with that