Toward the elimination of race-based medicine: replace race with racism as preeclampsia risk factor.

Pregnancy-related morbidity and mortality continue to disproportionately affect birthing people who identify as Black. The use of race-based risk factors in medicine exacerbates racial health inequities by insinuating a false conflation that fails to consider the underlying impact of racism. As we work toward health equity, we must remove race as a risk factor in our guidelines to address disparities due to racism. This includes the most recent US Preventive Services Taskforce, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine guidelines for aspirin prophylaxis in preeclampsia, where the risk factor for "Black race" should be replaced with "anti-Black racism." In this commentary, we reviewed the evidence that supports race as a sociopolitical construct and the health impacts of racism. We presented a call to action to remove racial determination in the guidelines for aspirin prophylaxis in preeclampsia and more broadly in our practice of medicine.

Why Professionalism Demands Abolition of Carceral Approaches to Patients' Nonadherence Behaviors.

Some clinicians' and organizations' considerations of how a patient's prior adherence to health recommendations should influence that patient's candidacy for a current intervention express structural racism and carceral bias. When clinical judgment is influenced by racism and carceral logic, patients of color are at risk of having their health services delivered by clinicians in ways that are inappropriately interrogative, aggressive, or punitive. This commentary on a case suggests how an abolitionist approach can help clinicians orient themselves affectively to patients whose health behaviors express or have expressed nonadherence. This article argues that an abolitionist approach is key to facilitating clinicians' understandings of root causes of many patients' nonadherence behaviors and that an abolitionist approach is needed to express basic health professionalism and promote just, antiracist, patient-centered practice.

Algunos médicos y organizaciones opinan que la adhesión previa de un paciente a las recomendaciones de salud debería influir en su candidatura para una intervención actual, lo que expresa el racismo estructural y los prejuicios carcelarios. Cuando el racismo y la lógica carcelaria influyen en el juicio clínico, los pacientes de color corren el riesgo de que los médicos les presten servicios de salud que sean inadecuadamente inquisitivos, agresivos o punitivos. Este comentario sobre un caso sugiere cómo un enfoque abolicionista puede ayudar a los médicos en la orientación afectiva de los pacientes cuyos comportamientos de salud expresan o han expresado no adhesión. Este artículo sostiene que un enfoque abolicionista es clave para facilitar que los médicos comprendan las causas fundamentales de los comportamientos de no adhesión de muchos pacientes y que es necesario un enfoque abolicionista para expresar la profesionalidad sanitaria básica y promover una práctica justa, antirracista y centrada en el paciente.