Racism — Impact vs. Intent?
The blood pressure medication, losartan, recently faced a mass recall due to contamination with a carcinogen. A couple of months later, an aircraft model was grounded due to system malfunctions that resulted in numerous passenger fatalities. Losartan and the Boeing MAX 8 were both found by federal authorities to be ‘dangerous’ to consumers based on material evidence. In many aspects of policy, public health, and economic activity, American discourse is often governed by outcomes — the consequences or impact of products, laws, policies, and behaviors.
Guiding our actions using a consequentialist approach has proven to be a simple and effective approach in our highly connected, data-driven world. Bad Yelp reviews at a restaurant? Skip it and go to another restaurant. Did the randomized trial provide evidence that a new surgical technique is superior to the old surgical technique? Use the new surgical technique instead.
And yet, when we discuss class and racial constructs in America, simple consequentialism is regularly thrown out the window. In its place sways a fraught, guilt-riddled, evidence-free teleological framework for attributing fault and complicity. In other words, the threshold for determining an action, individual, or institution to be ‘racist’ faces a significantly more stringent criterion than does ‘dangerous’ with respect to a medication or vehicle.
When we think about whether school admissions practices, nonviolent sentencing laws, loan policies, or hospital health outcomes are ‘racist’, we do not simply look at the data. We have to do the impossible; we must prove intent.
Did administrators intend to create a medical school class that bears little demographic resemblance to the local population, thereby ensuring that the medical profession will remain disproportionately white for at least another generation? Probably not. Therefore, admissions practices are not racist. Did banking executives design housing loan policies with the intention to segregate Seattle by race well into the 21st century? There is no way to prove it. Do some high school counselors and teachers intend to skew college attendance rates by systematically dissuading students of color from pursuing higher education? Most likely not. Do emergency departments intend to increase the abounding distrust of black patients by restraining them more than all other patients? Perhaps, subconsciously. Do healthcare institutions with mortality and morbidity outcomes that stratify neatly by race intend for women of color to have higher rates of post-discharge cardiovascular deaths, missed cancer diagnoses, under-treated pain, and perinatal maternal mortality? Probably not.
What if, rather than applying a teleological requirements for determining the presence of racism, we empowered and conditioned ourselves to apply the consequentialist threshold we are accustomed to in many other aspects of our modern lives? If the plane keeps crashing, then it is dangerous, and so we must ground it. If the hospital continues generating worse outcomes for people of color, then it is racist, so we need to address the disparities in health. In order to determine whether an action, individual, or institution is racist, we suggest the following paradigm:
“Does the action, individual, or institution perpetuate disparate opportunity, life, liberty, wealth, or health for a person or persons of color?”
If the answer is yes, then the action, individual, or institution is, in fact, racist. Once we observe the impact, then we must deal with it.
