Root, Michael. “The Use of Race in Medicine as a Proxy for Genetic Differences”. Philosophy of Science, Vol. 70, No. 5, 2002, pp. 1173-1183. Accessed 30 March 2017.
Race is a prominent category in medicine. Doctors often consider the race of patients when deciding whether or not to test for a particular illness, or what drug to use and epidemiologists often use race to describe the varying rates of morbidity and mortality. However, while this is present, many other critics say that race is false and it is only an illusion or scientifically meaningless. This paper seeks to explain how race is used in medicine and that proper understanding of this term may call into question long held practices of using race as marker of any medically relevant genetic trait..
Race is like marital status; no one would be married or single if matrimony had not been invented; however, given that we did, we now divide ourselves along discernible boundaries and treat each other differently depending on which of these categories we belong to. So with race; we assign each other a race and treat each other differently depending on that race. As a result, epidemiologists can discover that the rates of mortality or morbidity are different for one race than another even though race is not biological just as they can discover that health risks vary with marital status even though marital status is not in our genes. Therefore, race can mark the risk of a biological condition, even though race is not itself a biological condition but a social status.
“Though both blacks and whites carry the sickle-cell gene, when tests developed to identify carriers of the gene, many states in the United States targeted blacks for screening because health officials continued to treat the sickle gene as a black gene and used race as a proxy for the disease.” Though race is still used in the United States as a proxy for sickle-cell anemia, the author believes that they are are good reasons not to. First, race over-estimates the sickle-cell trait in black people and under-estimates the trait in white individuals. Also, to use race as a proxy for a genetic trait encourages the belief that race is a genetic category, for many people assume that if a disease is genetic and it is much prevalent in one race than another, then race must be a genetic. As a result, using race as a proxy for the sickle-cell trait or disease helps to sustain the assumption that people of different races differ in their genetic makeup and that there are more genetic differences between than among black and white people in the U.S. Finally, to use race as a proxy for a genetic trait distributes the risk of genetic discrimination unequally between black and white. Firms unable to practice racial discrimination, because of the civil rights laws, are able to use the results of the sickle-cell test to deny black individuals employment. If black people are targeted for testing and individuals who test positive are denied jobs, then black people are at greater risks than white individuals of suffering genetic discrimination. Race-conscious screening has a disparate impact on black people in employment, especially whenever an employer has access to genetic information about job applicants.
The author argues that race, should not be used in medical practice as a proxy for a disease or for a response to a medical treatment. To stratify health statistics by race is reasonable, as long as employment, housing, income, education, or healthcare are stratified by race; but to use race as a proxy for a gene is: 1) bad science, because race and genes vary independently, and 2) bad policy, because the practice helps to sustain a harmful racial ideology.