A legislator has suggested a piece of legislation aiming to prohibit Diversity, Equity, and Inclusion programs in medical schools. Physicians warn this could set back efforts towards enhancing Black maternal well-being.
An instructor of obstetrics and gynecology at the University of Michigan Medical School, Pleasant created a training program that tackles the history of racism within her field in the US.
The course, part of a trial project, discussed James Marion Sims, a surgeon who conducted experimental procedures on enslaved Black women without anesthetics, resulting in the false belief that Black women can tolerate more pain than White women.
Although Pleasant didn't teach the course this year, she's concerned that reintroducing it could be met with resistance if the "Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act" becomes law.
Rep. Greg Murphy, a North Carolina Republican, introduced this bill, which would bar medical schools from receiving federal funding if they require DEI policies, including the promotion of the idea that one's sex, race, ethnicity, or skin color determines their oppressed status or that the US is systematically racist.
The bill was assigned to the House Committee on Education and the Workforce in March but has yet to be voted on.
If it's enacted, some medical professionals and health equity advocates believe it could undo the progress they've made in designing educational programs for medical students that embrace many identities. They are also concerned about the legislation hampering efforts to prepare students to work with diverse populations, hire students that reflect the nation's racial makeup, and dispel prejudiced ideas in healthcare.
A 2016 study at the University of Virginia found that medical students and residents thought Black patients had a higher pain tolerance and recommended less accurate treatment due to their flawed beliefs about Black physiology.
In a study released last year, researchers observed that mortality rates among the Black population were consistently higher than the White population for diabetes and kidney disease, maternal and neonatal disorders, and HIV/AIDS and sexually transmitted infections.
"The racial health disparities we have today are unacceptable," Pleasant commented. "We need to make an effort to educate our future medical professionals about this, since they are the ones who will be treating patients."
Since the Supreme Court outlawed affirmative action in college admissions, conservative legislators have led a push to eliminate diversity, equity, and inclusion programs from workplaces and public colleges across the United States.
There was no response from Murphy's office to CNN's request for an interview about the EDUCATE Act. In a statement released last month, however, the representative argued that medical schools shouldn't have space for discrimination and maintained that DEI was a "divisive ideology."
Murphy asserted that the EDUCATE Act would compel medical schools and accreditation agencies to enforce color-blind admissions and forbid compelling students with specific political viewpoints.
Dr. Stanley Goldfarb, a former associate dean at the Perelman School of Medicine at the University of Pennsylvania who supports the EDUCATE Act, said DEI offices intrude politics into medicine and patient care, training students to be social justice advocates.
Dr. Goldfarb insisted that medical schools ought to be "race blind" and opposed race-based affinity groups and race-conscious admissions, asserting there was no evidence to support better healthcare outcomes from these practices.
Physicians and academics from some elite medical institutions counter this argument, insisting that their DEI initiatives aren't exclusionary and were intended to help resolve ongoing disparities in medicine.
Pleasant warned that prohibiting DEI could endanger the efforts medical schools are making to combat the Black maternal health crisis. Black women are 2.5 times more likely to die from pregnancy-related complications than White women, according to the Centers for Disease Control and Prevention.
In 2023, President Joe Biden declared April 11-17 of each year as Black Maternal Health Week, aiming to increase awareness of the disparity.
Fleming, director of the Leadership Development to Advance Equity in Health Care at Harvard's T.H. Chan School of Public Health, argued that some of the university's medical school courses cover the nation's legacy of racial health disparities—including discussions about slavery and oppression—while educating students and faculty on overcoming their biases.
Fleming contended that the EDUCATE Act would hinder medical schools from examining the roots of racist beliefs in healthcare and learning from them.
"If we don't think about and discuss those disparities right now and where they originated, we won't be able to create interventions to correct them," she said.
Dr. Italo Brown, a clinical professor in emergency medicine at Stanford University School of Medicine, explains that offices dedicated to Diversity, Equity, and Inclusion (DEI) were established at Stanford and other medical institutions to create a secure and welcoming environment for students of various cultural backgrounds, those with disabilities, and the LGBTQ+ community.
These offices assist in creating a curriculum that reflects the life stories of these diverse groups, Brown says. Often, discussions in the classroom address the implicit biases that people, including minority mothers, may face in healthcare settings and outline methods to mitigate them.
Brown states, "You're teaching physicians about this in real-time." Instead of waiting to teach physicians about healthcare equity after graduation, these lessons are integrated into the training process itself.
Dr. Rachel Blake, a Boston-based obstetrician-gynecologist and board member for the nonprofit Chamber of Mothers, believes that laws like the EDUCATE Act could make it hard for medical schools to enroll students that match the racial and ethnic makeup of the United States population.
As demonstrated by a study conducted at the Perelman School of Medicine of the University of Pennsylvania, patients are more likely to highly rate their doctors when they share the same racial or ethnic background.
Blake argues that diversity is essential not only for promoting an increase in Black and brown OB-GYNs but also for cultivating doctors who offer culturally sensitive care to all patients.
A study involving 32 Black women conducted by researchers at the University of North Carolina at Chapel Hill revealed that these women generally prefer Black OB-GYNs due to their lifetime experiences with racism and discrimination in medical care.
Blake asserts, "Black moms, Indigenous moms, and their babies benefit from having professionals on their medical team who look like them or share their ethnicity." She emphasizes how detrimental this bill would be to the healthcare system's pursuit of a workforce that mirrors its patient population.
Pleasant, in contrast, is concerned that the absence of DEI in medical education may lead to physicians who are unprepared to fully evaluate and address patients of various racial and gender identities.
"Sacrificing DEI in the curriculum," Pleasant states, "impairs the preparation of our future healthcare professionals to battle racism and prejudice in medicine."
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Source: edition.cnn.com
