Recently, the American Academy of Pediatrics announced a new policy to remove antiquated “race-based” medicine from its clinical guidelines. Prior to these recent efforts, AAP guidelines included recommendations based on “pseudoscience and racism”.
One example of this was the idea that Black children were at lower risk than white kids for urinary infections. Instead, the biggest risk factors for developing urinary infections have nothing to do with race. Another example is in the context of newborn jaundice. The current guidelines suggest that race plays a part in a newborn’s risk of jaundice. A revision of this guideline is planned for this summer.
Although the AAP notes it began re-examining its guidelines for race-based factors prior to the summer of 2020 (and the uproar and social justice focus following George Floyd’s death), since that time efforts have intensified to hold themselves accountable for producing guidelines that resulted in “Black youngsters (being) undertreated and overlooked”.
In the medical malpractice arena, jurors who are tasked with determining whether or not a health care provider was negligent (committed malpractice) may consider guidelines – including those published by the AAP – in making this determination. A patient/plaintiff may point to a specific guideline and argue that it was not followed, causing a child harm.
Alternatively, a doctor may point to an AAP guideline, and evidence the doctor followed it, as proof that she or he was not negligence.
Imagine a scenario where a child of color is treated differently based on her or his race, and an AAP guideline based on racist premises. As a result, that child is harmed. In that scenario, if the defendant doctor defends her or himself by citing the guidelines that she or he followed, the child may be victimized by the racist guideline again: first in being injured, and second if a jury decides the doctor was not negligent because she or he was simply following it.
Although that example may seem far-fetched, it serves to illustrate the inherent and far reaching negative outcomes that AAP hopes to remove as it critically examines these guidelines and hopefully removes any bases for them that are not grounded in evidence-based science.
