MEANINGLESSNESS OF RACE WATCH: Charlie Murtaugh links to this Sally Satel article about the subtle changes doctors make when treating one race or another:
In my drug-treatment clinic, where almost all of the patients use heroin by injection, a substantial number of them have hepatitis C, an infectious blood-borne virus that now accounts for 40 percent of all chronic liver disease. The standard treatment for active hepatitis C is an antiviral-drug combination of alpha interferon and ribavirin. But for some as yet undiscovered reason, African-Americans do not respond as well as whites to this regimen. In white patients, the double therapy reduces the amount of virus in the blood by over 90 percent after six months of treatment. In blacks, the reduction is only 50 percent. As a result, my black patients with hepatitis C must be given a considerably less reassuring prognosis than my white patients.
Without a doubt, there are many medical situations in which race is irrelevant. In an operation to repair a broken leg, for example, a patient's race doesn't matter. But there are countless situations in which the race factor should be considered. My colleague Ronald W. Dworkin, an anesthesiologist in a Baltimore-area hospital, takes race into account when performing one of his most important activities: intubation, the placement of a breathing tube down a patient's windpipe. During intubation, he says, black patients tend to salivate heavily, which can cause airway complications. As a precautionary measure, Dworkin gives many of his black patients a drying agent. ''Not every black person fits this observation,'' he concedes, ''but there is sufficient empirical evidence to make every anesthesiologist keep this danger in the back of his or her mind.'' The day I spoke with him, Dworkin attended a hysterectomy in a middle-aged Asian woman. ''Asians tend to have a greater sensitivity to narcotics,'' he says, ''so we always start with lower doses. They run the risk of apnea'' -- the cessation of breathing -- if we do not.''
43 minutes ago