Say What?

 Posted by on 20 May 2009 at 11:01 pm  Health Care
May 202009

Breaking news from the American Medical Association on dealing with the swine flu:

In the event that quarantine and isolation measures are needed, physicians should ensure that the least restrictive measures are employed in a manner that does not discriminate against particular socioeconomic, racial or ethnic groups.

OK, let me try to unpack this.

A physician makes a determination that a patient sick with swine flu (or any other communicable disease) is so dangerous that isolation and quarantine is warranted. The factors which the physician took into account in reaching this determination are scientific: how easily the disease spreads, what stage of illness the patient is in, and so on. The socioeconomic, racial or ethnic status of the patient is immaterial to this determination. The only question is: does the patient’s condition pose a danger to the public?

If the patient is a danger to the public, does he or she become any more or less of a danger depending on his or her socioeconomic, racial or ethnic status? Are rich white people more dangerous when sick with the swine flu than poor black people? If there is no difference in communicability of a disease based on socioeconomic, racial or ethnic status, what possible rationale is there for basing decisions to isolate or quarantine based on socioeconomic, racial or ethnic status?

Clearly, there is none. So the only point of the AMA’s exhortation is to remind physicians: your decision to quarantine a rich white guy will not be subject to second-guessing, but you must be prepared to defend as medically necessary your decision to isolate or quarantine any poor, non-WASP.

If doctors’ decisions to quarantine poor non-whites are vulnerable to attack as discriminatory, don’t you think it’s likely that some doctors will tend to quarantine fewer dangerous patients simply to avoid the charge that they’re prejudiced?

It looks like the AMA is saying: it’s OK to endanger the public if your reason is to avoid hurting the feelings of some hypersensitive tribalists. To which I say — say what?

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