Maybe it is patient choice, not racism?

Stuff reports:

‘Woeful’ is how a leading doctor is describing her own unconscious bias in prescribing contraceptives, amid the launch of a world-first cultural safety plan imploring clinicians to turn a mirror on themselves.

Dr Samantha Murton, chairperson of the Council of Medical Colleges, ran the numbers on 987 patients who identify as female from her Wellington practice. “My question to myself is do I prescribe contraception fairly and safely for all populations that I look after?” 

The answer was a resounding no: a total of 17.3% are prescribed contraception, but for Māori, that figure drops to 12.2% and for Pasifika, 5.8%.

“This is woeful. What am I doing differently for this population? What am I not doing that is creating this discrepancy? I will need to explore further,” she said.

It is a good thing to have a doctor look at an area such as contraception, to see if there is a difference by ethnicity.

But upon finding there is, I don’t understand the self-flagellation that it must be due to some sort of racism on the part of the doctor – ie it is what they are doing or not doing.

First of all, contraception is the choice of patients. Some patients do want to get pregnant. Some are too old to get pregnant. Some are not having sex. Some may not like contraception. Some may have religious beliefs about contraception.

There may be differences in the age composition of the patients. If one ethnic group is much younger that may explain why they use less contraception. There could be confounding variables.

Now it might be that there is some implicit bias on the part of the doctor – that they doesn’t push contraception to Maori and Pasifika patients as much as they do to Europeans.

But it also might be they see certain patients less often, and hence don’t get the chance to discuss contraception as often. Or it might be that European women are more confident in asking for contraception.

Having found that there is a discrepancy by ethnicity, I would have thought the next step would to try and use data to work out why, rather than jump to conclusions it is the fault of the doctor. What you really want to find out is whether women of particular ethnic groups are not accessing contraception, that they would like to access. Would make for an interesting research project – so long as the researchers genuinely wanted to find out the answer, as opposed to have an ideological answer decided at the outset.

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