“First do no harm”: Clinical practice guidelines, mesolevel structural racism, and medicine's epistemological reckoning

Ashley C. Rondini and Rachel H. Kowalsky

Social Science & Medicine, 2021, vol. 279, issue C

Abstract: This paper presents a critique of clinical practice guidelines (CPGs) that standardize the use of race as a proxy for biological difference in medical settings. Drawing on the illustrative example of a pediatric UTI testing guideline, we contend that when CPGs necessitate that Black patients meet a higher threshold of illness severity or duration than their non-Black counterparts to receive comparable medical testing or other medical care, they function as mesolevel sites of race-racism reification processes (see Sewell, 2016) that contribute to the reproduction of racial health disparities. We describe broader implications and make recommendations for the conceptualization and implementation of future research in the sociological study of race, health, and medicine.

Keywords: Medical sociology; Race; Racism; Structural racism; Mesolevel; Clinical practice guidelines (CPGs); Standardization (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (1)

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DOI: 10.1016/j.socscimed.2021.113968

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