Decolonising the Medical Profession Flashcards
Consequences of colonisation
Economic and social control including slavery
Disregard for indigenous people
Imposition of language and culture
Dependence and implies sense of inferiority
Control by white, male, middle class elite
Long term legacy of colonisation
Assumption of superiority/inferiority based on skin colour/language
Distrust of government and authority
Worse socio-economic, health and educational outcomes for minority groups
Segregation (USA) and apartheid (RSA)
Legacy of colonisation in health care provision
Inequalities of access - finance, education, trust leading to poorer outcomes
Clinical trials often exclude or under represent diversity - are the results widely applicable.
Specific needs of ethnic groups often under-resourced.
State some clinical signs which may appear different on darker skin
Jaundice
Cyanosis
Eczema
Psoriasis
Melanoma
Viteligo
Albinism
Keloid Scars and Nail Changes
Meningococcal sepsis - skin and eyes
Describe how capillary refill test varies in those with darker skin
For people with darker skin, it may be beneficial to check capillary refill on the palmar surface of the hand, which is lighter in colour.
Describe the difference in values for pulse oximetry in those with darker skin
Potential underestimation of hypoxia in darker skin.
Ethnic adjustment to lung and renal function measurement ?
Spirometry adjusted for age/sex/height/weight and ETHNIC group.
NICE CKD 2021
Recommendation for adjusting ethnicity has been removed as it is no longer seen as valid or accurate.
What can we do to foster a more equitable and inclusive society, which welcomes diversity in a healthcare environment ?
Be aware of the background and issues
Equality, diversity and inclusion training - applying what we learn
“Call out” racism
More inclusive use of images, manikins, clinical stories
