Unconscious bias in medicine

Last week, the American Veterinary Medical Association (AVMA) released the second module in their Journey for Teams initiative on unconscious bias, on which I partnered with them to create.

Unconscious bias refers to the associations, categorizations, and preferences that we as humans tend to make on a daily basis about all sorts of things. Our brains take shortcuts where we make decisions quickly without much or any conscious thought. This is often a useful mechanism, but can become problematic when the decisions we’re making or the biases we hold relate to people and align with negative stereotypes that participate in larger systems of oppression. When our biases further marginalize people with historically and contemporarily marginalized or minoritized identities, we are propagating systems like racism, sexism, heterosexism, ableism, Islamophobia, antisemitism, classism, etc. And, often these biases are enacting multiple systems of oppression at once, for instance conflating race and class and education level works to multiply marginalize certain people.

To learn more about unconscious bias, including how it works in veterinary medicine, I encourage you to read my essay for AVMA.

Understanding unconscious bias is a useful tool to understand how systems of oppression and marginalization work particularly on an interpersonal level, but they are only a small piece of understanding how these systems work in medicine. In human medicine, we know that not only individual practitioners, but health research, protocols, and policies have racism, heterosexism, ableism, etc. embedded in them. For instance, race has been used as a proxy for lung size and other biometrics and standards. Darker skin tones have been neglected in medical literature related to skin disease. Heteronormative and cisgender standards have been applied to babies who present as intersex. And, body size has been used to assume health outcomes and comorbidities.

Too often, unconscious bias is seen as a quick fix for any system of oppression the moment it is identified. By addressing any of these issues with unconscious bias training alone, we do very little to counteract systems of oppression. Instead, if we look at building our understanding of unconscious bias, including our own biases (unconscious and conscious), we make initial steps in our life-long journey toward justice, equity, diversity, and inclusion.