Katy Jackson
Course: Human Biology 1090
Taking Sides – Issue #7: “Should Doctors
Prescribe Drugs Based on Race?”
On the Yes side:
Summarize the major thesis
The major thesis for the yes argument were that recognizing patterns of disease prevalence
and response to various treatments of different races would enable doctors to treat their
patients more effectively, and successfully. All patients should be treated equally, and this
theory implies that there should be an equality of medicine among different races and that
racial based medicine is useful
Briefly state in your own words three facts presented
1. The preliminary sequence of the human genome was announced in June of 2000 and I
verified this fact by checking other sources like CNN
2. Dr. Jerome P. Kassirer use to be the editor of The New England Journal of Medicine. I
checked this fact by researching information on The New England Journal of Medicine
publications.
3. The FDA indeed authorized the testing of BilDil among African American subjects in March
2001. This fact was cross referenced on a website called theheart.org
Briefly state in your own words two opinions presented
1. The author Sally Satel states that she believes doctors much use a patient’s race as a
guideline to determine their diagnosis and treatment, instead of denying that no genetic
differences among races exists.
2. While it is noted that 99.9% of the human genome is the same, Sally Satel believes that the
.01% of the genetic variations within humans are distinct enough to warrant racial based
medicine.
Briefly identify as many fallacies as you can
1. The difference in salivation rate of African Americans is not statistically significant, as Satel
stated, but actually negligible. I couldn’t find any credible sources confirming that the
salivation rates differed between races, and Satel actually issued an erratum 4 years after the
initial article was publishing in the New York Times magazine.
2. The Asian population is more sensitive to narcotics. After running a search on Google
scholar’s website, I could not find any reliable sources of studies examining an Asian
population sensitivity to narcotics, and therefore, don’t think this statement should be
considered truth.
3. African Americans have a higher chance of having a nitric oxide insufficiency than
Caucasians. After researching this theory, I couldn’t find any relevant articles, and if there
were some out there, I would hope that Satel would have cited them.
Identify in your own words the propaganda techniques used, if any.
1. Appeals to pride – Satel is appealing to the pride of doctors to provide the best medical
treatment they can, and argues that racial profiling is a key clue that can guide doctors in the
right direction. Satel states, “doctors must not be blind to its (race) clinical implications” (pg.
18), as if to imply that doctors not involved in racial profiling are inadequate.
2. Pseudo Solutions: Satel proposes that one day in the future doctors will have a ‘genomic
profile’ (pg17) for each of their patients so that they may better treat their patients some time
in the future. She continues to suggest that racial profiling is the step towards this future, but
does not list how this genomic profile will be possible.
3. Generalizations and Name Calling: Satel writes, “no serious scientist, in fact, believes that
genetically pure populations exist” (pg.16). She not only delegitimizes any scientist who might
in fact believe that pure genetic populations exists but using the name calling propaganda
technique, but she also generalizes this vague term which takes our attention away from this
important question- it might be possible that a pure genetic population does exist. Satel also
stereotypes individuals by applying a general isolated behavior to a larger population.
4. Generalization- reification. An example of this would be Sally Satel’s title, “I am a Racially
Profiling Doctors”.
5. Appeal to Fear- Satel states, “we must realize that it is not in patients’ best interests to deny
the reality of differences” (pg. 18). This statement is almost like a threat, and certainly appeals
to the fear for one’s own health. I know that I would want the best medical treatment out there
if I were sick.
What cause/effect relationships were stated or implied by the author?
The cause and effect relationships implied by Satel are that practicing racial base, or racial
profiling within medicine will lead to better medical treatment. She implies that a patients’
race is an important clue that doctors can use for better diagnosis procedures.
On the No side:
Summarize the major thesis
People of different backgrounds, or of different race should not be medically treated
differently is ancient history that we should move away from to focus on treating the patient
independently of their race. Dorr/Jones continue state that humans are fundamentally similar
and that medical science has progressed to the point that specialized medications should
would in every patients. Racial based medicine would introduce several dilemmas into our
community. In addition, their article served as a commentary and update on a debate that they
see as controversial and politically incorrect.
Briefly state in your own words three facts presented.
1. BilDil was approved by the FDA in 2005. Hydralazine and isosorbide dinitratre are drugs
approved by the FDA prior to them being combined to form BilDil, and are both vasodilators.
2. There is 0.1% genetic variation among all humans and this was verified by research. It is
noted that 1 of 1000 nucleotides will differ among human beings.
3. Nitro Med the maker of BilDil gave a donation of 1.5 million dollars to the NAACP. I
checked this fact, and it seems that this donation was given around the same time that the
NAACP endorses the drug.
Briefly state in your own words two opinions presented.
1. Dorr/Jones suggested that BilDil failed to takeoff as the new medication for African
Americans with heart disease because BilDil was more expensive compared to its generic
competitors, and therefore insurance companies were not reimbursing for this particular
medication.
2. Dorr/Jones summarize articles that state a need for a stricter standard for the categorization
of race be implemented into the field of biomedical research. With out a strict standard for the
classification of race, results of research are compromised, and therefore shouldn’t’ be used.
Briefly identify as many fallacies as you can.
1. It was a lot harder to identify any fallacies in this article than in Sally Satel’s. This article
was more of a meta-analysis of several different articles. Therefore, they summarized
previously written pieces.
Identify in your own words the propaganda techniques used, if any.
1. Name Calling: Dorr/Jones do not directly insult how a study classifies a patient of African
American descent, but instead quote that patients can self identify with a race. This selfidentification process is subjective which undermines the authority of their research, as I, a
Caucasian women can self identify as an African American. The article suggests that BilDil is
not a new drug, but just repackaged, and refers to it as a ‘copy cat’ drug (pg. 26).
2. Slogans and Analogies: ‘Racial medicine has returned from history’s dustbin to today’s
examination room and tomorrow front page’ (pg. 25). Dorr/Jones analogy seems to suggest
that this issue has already been put to rest, and is needlessly being brought back into
conversation with more hype than it deserves.
What cause/effect relationships were stated or implied by the authors?
1. The authors suggest a potential cause and effect relationship to exist between analyzing
genetic variance among humans and the ‘revivifying’ of prejudices (pg. 25).
2. The medical re-conceptualization of race will influence the development of pharmaceuticals.
For example new hair and skin products, and vitamins are claimed to be on the market now
(pg. 26).
Overall:
Which author (e.g., Satel or Dorr/Jones) impressed you as being the most empirical in
presenting her or their thesis? Why?
In my opinion, Dorr/Jones seemed to be more empirical with their research than Satel, and I
was more impressed with the presentation of the Dorr/Jones’ thesis. They have 16 different
references listed at the end of their article and Satel does not have any references cited. Instead,
Satel used terms like, “I do this in part because my clinical experience…” (Pg. 14) which is a
form of anecdotal evidence, which is a much weaker source than empirical research. I was
unimpressed with the lack of research that supported Sally Satel statements. For example,
when she stated, ‘it may seem counter intuitive, but the 0.1 percent of human genetic variation
is a medically meaningful act’ (pg. 16). Well how do we know that we should go against our
initial instinct to conclude that this variation is indeed statistically significant?
It is also important to note that the Dorr/Jones article came from a peer-reviewed journal and
not a magazine.
Are there any reasons to believe the writers are biased? If so, why do they have these
biases?
Given the fact that Satel quoted misleading anecdotal evidence from another doctor about the
findings of salivation rates between African Americans and White patients, one can’t help but
question her motives and biases. Satel’s position seems to be directed by her clinical experience
and anecdotal evidence, which can be influenced by working environment, incentives, and
other influencing factors. After researching information on Sally Satel, it should be noted that
she has her own book titled, “How Political Correctness is Corrupting Medicine’ in 2001. This
controversial topic and catchy title are bound to turn heads, you wonder if she is trying to
separate herself from the mainstream by talking about controversial subjects. It seems to be
that the title is an example of reification, which is part of a generalization propaganda
technique. The Dorr/Jones article seemed to be written to demystify what is fact and what is
fiction about racial based medicine and the reveal how this concept has been received.
I also thought that Satel’s article engaged more propaganda techniques than the Dorr/Jones
article. In addition, it was also harder to find fallacies within the Dorr/Jones article, which
leads me to think that they are less biased and not pushing an agenda.
Which side (Yes or No) do you personally feel is most correct now that you have reviewed
the materials in these articles? Why?
If I believed there were genetic variations that influenced the efficacy of modern medicine that
followed populations of different races, then yes, I would be in support of racial based
medicine. That said I am not convinced of the existence of significant genetic variations among
different races. What I think would be more politically correct is to look at the genetic
variations between different biological populations separated by geographical means. Given
the fact that Sally Satel’s article lacked empirical research and support, I feel that the no
argument by Dorr/Jones is more reflective of my personal opinion. It is also seems to be the
Dorr/Jones questioned the motive behind BilDil by explaining that a race specific patent on
BilDil which is a combination of two previously approved and preexisting drugs, was a
marketing attempt to make money (pg. 21). That said, after reading ‘Race in a Bottle ‘by
Jonathan Kahn from Scientific America, and then the response by Nitro Med, the maker of
BilDil to Kahn’s article, it seems that the underlying mechanisms of BilDil are still unknown. I
think that there are too many confounding variables surrounding the segregation of medicine
like socioeconomic status, availability to medicine, diet, lifestyle, etc. Therefore don’t feel like I
can say that I support racial based medicine until a more comprehensive research is done.