Stereotyping Patients

There is a burgeoning psychological literature indicating that health professionals are influenced in their clinical judgment and decision making by implicit biases. Implicit biases are automatic and unintentional associations that are made between members of particular social groups (racial, gender, socioeconomic, and so on) and certain traits (e.g., laziness, greed, athleticism, and so on) or affective responses (i.e., positive or negative affectivity). When automatic stereotyping occurs through the operation of implicit bias, people are associated with particular traits in virtue of their social group membership rather than their other personal characteristics. This stereotyping has been found to influence the judgment and decision making of health professionals, leading to differential medical outcomes. The quality of care that patients receive can be determined in part by their social group membership and the associations that are made with their social group by those responsible for patient care. The operation of implicit biases can thus bring substantial ethical costs , leading health professionals to treat their patients in ways that are unfair and unjust. Ethical principles of justice and fairness demand that differential outcomes are eradicated (see, e.g., Matthew 2015). They demand that people are treated equally, and given equal access to high-quality health care, without stereotypes about the social groups to which they appear to belong impacting upon the care that they receive. Ethical demands thus prima facie favor interventions that prevent health professionals from being responsive to the social group status of their patients in their clinical judgment and decision making. However, it can be crucial to successful clinical judgment and decision making that health professionals are responsive to the social group status of their patients. Certain conditions are significantly more prevalent in some social groups than others. For health professionals to make correct clinical judgments, they need to reflect the prevalence of medical conditions across different groups. In addition to this, health professionals who engage in interactions with their patients that are required to obtain the information required to make correct diagnoses and treatment decisions will often discover their social group status. For these reasons, it seems that with respect to epistemic goals, gaining true belief, knowledge, or understanding about patients’ conditions, health professionals should be responsive to their patients’ social group status.