Materialized Oppression in Medical Tools and Technologies

It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including race, gender, class, and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems.

Population Genomics and the Statistical Values of Race: An Interdisciplinary Perspective on the Biological Classification of Human Populations and Implications for Clinical Genetic Epidemiological Research

The biological status and biomedical significance of the concept of race as applied to humans continue to be contentious issues despite the use of advanced statistical and clustering methods to determine continental ancestry. It is thus imperative for researchers to understand the limitations as well as potential uses of the concept of race in biology and biomedicine. This paper deals with the theoretical assumptions behind cluster analysis in human population genomics. Adopting an interdisciplinary approach, it demonstrates that the hypothesis that attributes the clustering of human populations to "frictional" effects of landform barriers at continental boundaries is empirically incoherent. It then contrasts the scientific status of the "cluster" and "cline" constructs in human population genomics, and shows how cluster may be instrumentally produced. It also shows how statistical values of race vindicate Darwin's argument that race is evolutionarily meaningless. Finally, the paper explains why, due to spatiotemporal parameters, evolutionary forces, and socio-cultural factors influencing population structure, continental ancestry may be pragmatically relevant to global and public health genomics. Overall, this work demonstrates that, from a biological systematic and evolutionary taxonomical perspective, human races/continental groups or clusters have no natural meaning or objective biological reality. In fact, the utility of racial categorizations in research and in clinics can be explained by spatiotemporal parameters, socio-cultural factors, and evolutionary forces affecting disease causation and treatment response.

Philosophy of race meets population genetics

In this paper, I respond to four common semantic and metaphysical objections that philosophers of race have launched at scholars who interpret recent human genetic clustering results in population genetics as evidence for biological racial realism. I call these objections 'the discreteness objection', 'the visibility objection', 'the very important objection', and 'the objectively real objection.' After motivating each objection, I show that each one stems from implausible philosophical assumptions about the relevant meaning of 'race' or the nature of biological racial realism. In order to be constructive, I end by offering some advice for how we can productively critique attempts to defend biological racial realism based on recent human genetic clustering results. I also offer a clarification of the relevant human-population genetic research.

The development of race-based perceptual categorization: skin color dominates early category judgments

Prior research on the development of race-based categorization has concluded that children understand the perceptual basis of race categories from as early as age 4 (e.g. Aboud, 1988). However, such work has rarely separated the influence of skin color from other physiognomic features considered by adults to be diagnostic of race categories. In two studies focusing on Black-White race categorization judgments in children between the ages of 4 and 9, as well as in adults, we find that categorization decisions in early childhood are determined almost entirely by attention to skin color, with attention to other physiognomic features exerting only a small influence on judgments as late as middle childhood. We further find that when skin color cues are largely eliminated from the stimuli, adults readily shift almost entirely to focus on other physiognomic features. However, 6- and 8-year-old children show only a limited ability to shift attention to facial physiognomy and so perform poorly on the task. These results demonstrate that attention to 'race' in younger children is better conceptualized as attention to skin color, inviting a reinterpretation of past work focusing on children's race-related cognition.

BiDil in the Clinic: An Interdisciplinary Investigation of Physicians' Prescription Patterns of a Race-Based Therapy

BACKGROUND

The African American Heart Failure Trial (A-HeFT) and the FDA approval of BiDil for race-specific prescription have stirred the debate about the scientific and medical status of race. Yet there is no assessment of the potential fallouts of this dispute on physicians' willingness to prescribe the drug. We present here an analysis of the factors influencing physicians' prescription of BiDil and investigate whether exposure to the controversy has an impact on their therapeutic judgments about the drug.

METHODS

We conducted an electronic survey with physicians in the department of internal medicine at the University of Cincinnati. Participants were randomly assigned to two groups, with one group receiving information about the controversy over BiDil. We used various statistical tests, including a linear mixed effects model, to analyze the results.

RESULTS

27% of the participants reported using patients' race as a major factor in making treatment decisions. 33% reported the inefficacy of standard therapies, 25% the severity of the disease, and 15% other unspecified factors as primary determining criteria in prescribing BiDil. With respect to the controversy, 68% of physicians reported that they were not aware of any controversy surrounding BiDil. Physicians' willingness to prescribe BiDil as a therapy was associated with their awareness of the controversy surrounding A-HeFT (p < 0.003). But their willingness to prescribe the therapy along racial lines did not vary significantly with exposure to the controversy.

CONCLUSIONS

Overall, physicians prescribe and are willing to prescribe BiDil more to black patients than to white patients. However, physicians' lack of awareness about the controversial scientific status of A-HeFT suggests the need for more efficient ways to convey scientific information about BiDil to clinicians. Furthermore, the uncertainties about the determination of clinical utility of BiDil for the individual patient raise questions about whether this specific race-based therapy is in patients' best interest.

The inherence heuristic as a source of essentialist thought

Humans are essentialists: They believe hidden "essences" underlie membership in natural and social kinds. Although essentialism has well-established implications for important societal issues (e.g., discrimination), little is known about its origins. According to a recent proposal, essentialism emerges from a broader inherence heuristic-an intuitive tendency to explain patterns in terms of the inherent properties of their constituents (e.g., we have orange juice for breakfast [pattern] because citrus aromas [inherent feature] wake us up). We tested two predictions of this proposal-that reliance on the inherence heuristic predicts endorsement of essentialist beliefs, even when adjusting for potentially confounding variables (Studies 1 and 2), and that reducing reliance on the inherence heuristic produces a downstream reduction in essentialist thought (Studies 3 and 4). The results were consistent with these predictions and thus provided evidence for a new theoretical perspective on the cognitive underpinnings of psychological essentialism.

The inherence heuristic: An intuitive means of making sense of the world, and a potential precursor to psychological essentialism

We propose that human reasoning relies on aninherence heuristic, an implicit cognitive process that leads people to explain observed patterns (e.g., girls wear pink) predominantly in terms of the inherent features of their constituents (e.g., pink is a delicate color). We then demonstrate how this proposed heuristic can provide a unified account for a broad set of findings spanning areas of research that might at first appear unrelated (e.g., system justification, nominal realism, is–ought errors in moral reasoning). By revealing the deep commonalities among the diverse phenomena that fall under its scope, our account is able to generate new insights into these phenomena, as well as new empirical predictions. A second main goal of this article, aside from introducing the inherence heuristic, is to articulate the proposal that the heuristic serves as a foundation for the development of psychological essentialism. More specifically, we propose thatessentialism – which is the common belief that natural and social categories are underlain by hidden, causally powerful essences – emerges over the first few years of life as an elaboration of the earlier, and more open-ended, intuitions supplied by the inherence heuristic. In the final part of the report, we distinguish our proposal from competing accounts (e.g., Strevens's K-laws) and clarify the relationship between the inherence heuristic and related cognitive tendencies (e.g., the correspondence bias). In sum, this article illuminates a basic cognitive process that emerges early in life and is likely to have profound effects on many aspects of human psychology.