The Mount Sinai journal of medicine, New York
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Asian patients receive, with significant frequency, suboptimal medical care. The sources of shortcomings in the treatment of the Asian American patient are examined in this paper. ⋯ Misunderstanding begets further "noncompliance," initiating a downward spiral. The way out of such spirals lies, I argue, in seeking a more adequate understanding of the patient's beliefs and their behavioral consequences.
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Barriers to the delivery of health care services to the Latino community are described and analyzed. Fear of deportation, unfamiliarity with modern medicine, inability to speak English and reliance upon traditional curing practices all contribute to the harmful underutilization of medical services which we see in the Latino community. Health care providers who serve that community need to overcome these obstacles by expanding their cultural awareness and increasing the effectiveness of their communication.
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What steps, if any, should be taken to eliminate the distrust that many racial minorities feel toward the health care system in the United States? Is this distrust an issue of social justice or should it be viewed as an instance where people unreasonably fail to take advantage of existing opportunities? I argue that this distrust is an issue of social justice and that the state does have an obligation to eliminate or mitigate it, especially in the area of public health.
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The justifications of affirmative action, the compensatory, corrective and redistributive, have been widely recognized in legal thinking. They have been applied, principally, to employment practices. ⋯ At the very least, these arguments mandate much needed research into the causes of minorities' poor health. Without such research, racism remains the presumptive cause of, and affirmative action the appropriate remedy for, the health care problems minorities face.
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This article reviews the current legal arguments for and against affirmative action in medical education. It concludes that many of the traditional legal defenses for race-based admissions are imperiled or defunct. The author suggests that the best and probably most viable justification for affirmative action policies is the one that recognizes that racial diversity in the medical profession is important because it provides the physicians with whom minority patients can feel safe and comfortable. ⋯ Unfortunately, minorities' historical and current experience with the medical profession and health delivery system frequently breeds suspicion rather than faith. As a result, society and the medical profession have a compelling interest and duty to produce physicians who can inspire trust in patients. In the short-to-medium term, race-conscious admissions policies may be necessary to fulfill this duty.