When cardiologist Raymond Givens read the article in the Journal of the American Heart Association last year, it stopped him in his tracks. Written by a fellow cardiologist, it claimed educational affirmative action programs were promoting underprepared Black and Hispanic trainees who would not gain admission to top medical schools or become the best doctors. While the article was widely condemned as racist and error-filled and was swiftly retracted by the journal, its publication left Givens with a host of questions.
“I thought, ‘How did this get published? Who gets this kind of space — 8,000 words — in a medical journal?’ That’s unheard of,” he said. “That started the wheels turning. Who’s on the masthead?”
So began a deep dive by Givens into the race and ethnicity of the editors and decision-makers at top-tier medical journals. His findings were stark, and stretched beyond the heart association publication, to the nation’s two premier medical journals.
At the time of his analysis in late October, Givens found that of 51 editors at the New England Journal of Medicine, just one was Black and one was Hispanic. Of 49 editors at JAMA, two were Black and two were Hispanic.
“Maybe it’s not a surprise, but it’s the first time someone’s documented this on this scale,” said Givens, an assistant professor of medicine at Columbia University Irving Medical Center and a self-professed data nerd. “It’s the receipts.”
What happened next was more upsetting, he said. He sent his findings to the journals’ top editors, hoping to start a conversation about how they could diversify their editing staffs. His email to JAMA editor-in-chief Howard Bauchner was ignored. “Crickets,” Givens said. NEJM editor-in-chief Eric Rubin acknowledged his email last fall and offered to talk, and Givens sent Rubin his cellphone number, but the two never connected at the time.
The entire experience has left Givens angry, frustrated, and tired. That he could not get the attention of his fellow physicians even as medical associations and journals were vowing commitment to racial equality after the killing of George Floyd and the summer’s racial unrest was a bitter disappointment. “There was a feeling on my part that this was the time, that if ever there was going to be a time to change medicine, this was it,” he said, “And to run into entrenched resistance then, that was difficult.”
Both NEJM and JAMA said they have increased the number of editors of color on their boards since October — NEJM has hired a Black deputy editor among others, and JAMA now has three Black and three Hispanic editors on its masthead. But Givens and other critics say the troubling overall lack of diversity on editorial boards may be one reason the issue of health inequities that shorten the lives of people of color has received less clinical and research attention than it should.
“You can see that far and wide these boards lack diversity of all kinds — age, racial and ethnic, gender, and sexual orientation,” said Melissa Simon, vice chair of research and professor of clinical gynecology at Northwestern University Feinberg School of Medicine. “The biggest problem is that journal editors are gatekeepers. Those are critical roles because they decide who gets reviewed and who gets rejected off the bat.”
The lack of diversity has come to the forefront in recent weeks after JAMA aired, then took down, a podcast in which one of its editors questioned whether racism exists in medicine, and the journal tweeted that “physicians can’t be racist.” The episode stunned many in the medical community because it revealed a lack of understanding by some JAMA editors about the extent of structural racism in their field. But it came as no surprise to Givens.
“When someone tells you your house is on fire, and you ignore them, it’s not a surprise when their house burns down,” he said.
“This deficit in diversity means there are tremendous blind spots. They don’t even know what they don’t know.”
Givens wrote to JAMA and American Medical Association leaders in a March 5 email, the day after Bauchner and AMA CEO James Madara made public apologies for the content of the podcast. (The AMA owns JAMA, though the journal is editorially independent.)
“You ignored that email,” he wrote, referring to his initial attempt to raise the diversity issue last fall. “Apologizing now for ‘lapses’ that are the foreseeable consequence of your deliberate indifference is an insult. We say to you, again, that your editorial board is embarrassingly and dangerously unrepresentative.”
Bauchner responded this time, acknowledging receipt of the email and saying he would review it carefully. After Givens thanked him for the reply, Bauchner wrote back: “Please call me Howard — these are difficult times — but regardless, I try to maintain a collegial relationship with individuals.”
Givens never heard from Bauchner again. He was placed on administrative leave March 25. Bauchner, JAMA, and the AMA have all declined to comment on specific matters relating to Bauchner or the podcast.
Rubin said he had received Givens’ October email just as he was leaving on vacation and regretted losing track of the conversation, but told STAT he had spoken with Givens at length recently. “I agree with him,” Rubin said in an emailed statement. “I’m dedicated to changing things.” Rubin said that in addition to hiring more people of color, the journal was publishing and highlighting more work on systemic racism (including a recent piece by Givens) and had joined a coalition of scientific publications working to make scholarly publishing more diverse.
While Givens is now becoming a leading voice among those calling for change in medicine, he never sought to speak loudly, or even publicly, about the lack of diversity at medical journals he carefully documented. “It wasn’t presented as a ‘gotcha’ or ‘I’m going to tell everyone about you.’ It was more like, ‘Guys, hey, I think we have a problem, and you’ll want to know about this,’” Givens said. “I was trying to be collegial.”
Like many Black physicians, Givens said he had remained quiet about the racism he has seen in medicine, for fear of reprisals and worry he might jeopardize the career he had worked so hard to build.
Raised by a single mother in Florida and Georgia, Givens, 45, is the first physician in his immediate family. He earned an M.D. from Duke and a Ph.D. in public health from the University of North Carolina, did his residency at Johns Hopkins, and completed two fellowships at Columbia University Irving Medical Center. In 2019, his hospital named him physician of the year.
“The culture of medicine is very much about conforming and I’ve done that,” said Givens, who has two young sons. “I didn’t feel I could risk my career, or not be able to support my family.”
That all changed in 2020.
Givens is associate director of the cardiac intensive care units at Columbia University Irving Medical Center in New York’s Washington Heights. His hospital treated one of New York’s first Covid-19 patients, and then faced a deluge. The hospital had to place two patients in each coronary care unit room instead of just one, and had IV poles and machinery filling the hallways to minimize the risk of contamination. “It looked like a war zone,” he said.
The emotional fallout was intense. “We’d never been in a situation where you couldn’t help someone,” he said. “Patients would die right in front of you.” Many of those patients, he said, were Black and Dominican. “We felt very helpless.”
He worried after every shift, especially in the early months, that he would infect his family. “Was I bringing home something deadly? We didn’t know. We didn’t know if we’d have enough PPE,” he said. “But we still showed up.”
Then came George Floyd’s death.
One of Givens’ sons had been born just a few weeks after Eric Garner, an unarmed Black man, was killed in a police chokehold in New York. George Floyd dying in much the same way, struggling for air and begging for his life, is what finally pushed Givens to speak out about the racism he saw all around him. Because he was so busy treating Covid patients, it took Givens months to realize just how upset he was about Floyd’s death. “The pain of walking this tightrope was too much. I decided I didn’t care if I lost my career if I couldn’t be myself.” His first target was not the medical establishment, but his own university, where he has been on the faculty since 2016.
“There was a feeling on my part that this was the time, that if ever there was going to be a time to change medicine, this was it. And to run into entrenched resistance then, that was difficult.”
Cardiologist Raymond Givens
For two years, Givens had taken his son to the medical school preschool, on the third floor of Bard Hall, a dormitory named after Samuel Bard, who was George Washington’s physician, the founder of Columbia University’s medical school — and a slave owner. Givens said he recalled his mother telling him she had worked hard to make sure he never had to live in a place named after a plantation, and he felt he was letting her down every time he walked his son into the building. But at the time, he didn’t feel comfortable speaking out. (Givens also received the university’s Samuel Bard Young Investigator Award in 2011 when he was a cardiology fellow.)
Despite a university project to research Columbia’s connection to slavery that started in 2015, Givens was upset that the university had not chosen to remove Bard’s name from the building. The name was finally removed in August in response to a petition Givens started. The Bard name was also removed from the professorship held by the school’s chair of the department of medicine.
When the article questioning affirmative action appeared in March 2020, it gave Givens a new target: the prestigious journals of his own profession.
The article was retracted by the journal in August, with a statement that said it “contains many misconceptions and misquotes and that together those inaccuracies, misstatements, and selective misreading of source materials void the paper of its scientific validity.” The AHA said it would investigate just what Givens had wondered: “how a paper that is completely incompatible with the Association’s core values was published.” Last week, a Heart Association spokeswoman told STAT it has been working to diversify its editorial ranks and prioritizing the publication of research on health inequities, and in January announced it would spend $230 million on efforts to increase health equity.
The paper‘s author, Norman Wang, did not agree to the retraction and has sued both the AHA and his employer, the University of Pittsburgh Medical Center, for violating his right to free speech by removing him from his position as program director for the clinical cardiac electrophysiology fellowship. Neither Wang nor his lawyer returned a request for comment, but when filing the lawsuit last December, lawyer Terence Pell, president of the Washington, D.C.-based Center for Individual Rights, said: “What’s remarkable about this is that he was not punished for an inappropriate joke or an intemperate remark in the classroom, but for publishing a thoroughly researched article in a peer-reviewed journal.”
Spurred by his outrage, Givens combed the mastheads of more than 100 journals, including JAMA, the journals of the JAMA Network, NEJM, and dozens of cardiology journals. He compiled a list of the names of more than 7,500 editors. Then came the hard part. Race is not listed on mastheads, so to establish the gender and race of editors, Givens spent months searching the internet and social media for pictures and references to people. Many of the cardiologists he knew personally.
His analysis showed that as of October 2020, of 51 editorial board members at the New England Journal of Medicine, just one was Black and one was Hispanic, four were East Asian, and two were South Asian. Of the 49 editorial board members at JAMA, two were Black, two were Hispanic, three were East Asian, and one was South Asian. Not a single board member at either publication was Native American. In one particularly absurd detail, his analysis showed the editorial boards included more people named David than Black and Hispanic editors combined.
Givens said his analysis of JAMA and the 12 journals in its network showed that as of October, of 532 editorial positions, 25, or less than 5%, were Black, and 26, or less than 5%, were Latinx, nearly 19% were Asian, and nearly 70% were white.
A JAMA spokesperson said Givens’ data were out of date and that of the 341 editors and editorial board members across JAMA and the other 12 JAMA Network journals, 72% are white, 18% are Asian, 6% are Black, 4% are Hispanic, and 38% are women. JAMA did not provide a breakdown of its data, so it is unclear which positions they chose to include and why the numbers differ.
“We can quibble about a couple of people here and there, but it doesn’t change the big picture,” Givens said.
Givens acknowledged that his data are imperfect since race is not self-reported and that additional editors of color have been hired since he compiled his data. He said there could be some uncertainty about the race of some editors, including those who may be biracial. Givens included only editors who had an M.D. or Ph.D., he said, in part because these people had more information online, and also did not include statistical review editors, out of what he said was fairness to the journals, because so few medical statisticians are African American.
He plans to present his findings on the racial makeup of cardiology journals, which showed that of more than 7,000 editorial positions at dozens of journals, fewer than 2% are held by Black editors, at an upcoming American College of Cardiology meeting, he said.
NEJM did not refute Givens findings. “I’m afraid that they weren’t surprising to us,” Rubin said. Rubin said he had been working to address structural racism and the lack of diversity at the journal since taking the helm 18 months ago. He said that of eight additional editors and editorial board members hired since September 2019, four are people of color. “We readily acknowledge that we aren’t diverse enough, but we’re improving,” Rubin said.
In November, NEJM hired the first Black deputy editor in its 200-year history, Winfred W. Williams, who is associate chief of the division of nephrology at Massachusetts General Hospital. (No person of color has ever helmed either of the two journals; in the JAMA network of 13 journals, some of which are 150 years old, there has only been one non-white top editor, Givens said.)
Williams said he has spent his career focused on ameliorating medical inequities and he took the editing position to further that work. “I believe I am well-suited to breathe new energy and life into this critical area for NEJM,” he told STAT by email. He said he agreed that the lack of diversity Givens has highlighted is a major problem. “Having editorial representation by clinicians, physician-scientists, and other professionals-of-color is critically important,” Williams said. “It’s a matter of who has a seat at the table. … Who sets the priorities? It’s those who occupy those seats.”
JAMA officials said they were not responding to media questions while the AMA is undertaking a thorough review of their journals in response to the furor over the recent podcast, which raised numerous issues about how the journals handle issues of racism in medicine, including how few editors of color contribute to publication decisions.
Despite his focus on data, Givens said his fight is about more than numbers. While he wants to see more physicians of color (and women, and LGBTQ+ people, and people from outside of the Northeast) on editorial boards, he said the boards also need to include people who are willing to speak out and challenge the establishment.
“People who have a history of speaking bluntly and assertively are not asked to be on these panels,” he said. “It’s not team of rivals. People who are picked are your buddies, people who won’t challenge you. They need to make sure they have some bold voices in there.”
He’s also frustrated that his fellow physicians, able as they may be to handle a heart vascularization or craniectomy, seem paralyzed when it comes to dealing with, or even discussing, racism and the way it may be harming patients. “As physicians, either by instinct or training, we run to problems. If people are bleeding, we put our hands on them,” he said. “But when it comes to racism, people just run away.”
“As physicians, either by instinct or training, we run to problems. If people are bleeding, we put our hands on them. But when it comes to racism, people just run away.”
Cardiologist Raymond Givens
Givens is not running away. He has joined a group of Black physicians called the Black Healers Network who are calling for medicine to confront and dismantle the systemic racism within their field. And now they are finally getting the meetings they wanted. Givens said he appreciated the chance to speak with Rubin about the lack of diversity on the New England Journal’s editorial board. He said a group of seven Black physicians met with the American Medical Association’s top leadership last week. “It was NWA meets AMA — straight outta Covid,” said Givens.
“It was terrifying,” Brittani James, an assistant professor of clinical family medicine at the University of Illinois College of Medicine and co-founder of the Institute for Antiracism in Medicine, said of the meeting. “It was definitely a David and Goliath moment.”
James, one of the physicians who started a petition against JAMA and the AMA after the podcast, said the meeting was productive and association officials listened and “said all the right things.” But she said her group told the AMA it wants to see change, and quickly. The participants asked the association’s leaders for a progress report within a month.
“This is not the time for the AMA to continue to be cautious and conservative,” Givens said. He said AMA officials acknowledged the data he presented. “They said it was compelling and showed the scope of what was going on,” he said.
In a statement, the AMA said its leaders were grateful to physicians, including long-standing AMA members, for expressing concern about the podcast. “AMA leaders are listening and learning and we are committed to dismantling structural racism across the AMA and in health care,” the statement said.
Among other changes, Givens and James are asking the AMA, which excluded Black physicians until the 1960s, to diversify the editorial boards of JAMA and the other journals in its network. “The AMA has a history of brutal racism,” said James. “And when you look at the makeup of the editorial boards, it’s the same thing. We’re still being excluded.”
About the Author Reprints
The key issue is lack of transparency. Diversity combined and meritocracy are by products of an open and fair selection process. Unfortunately, vast majority of opportunities in medicine (including medical associations, medical boards, and medical journals) are systemic issues plagued by many unhealthy practices. On the surface everything is made to look fair but the realty is otherwise. Congrats to Dr. Givens for a very nice article, and is timely and thought provoking.
The real issue should not be diversity at the expense of quality. Are there more qualified persons of “diverse” backgrounds than those “non-diverse” persons who now hold the positions? If so, then reorganization is warranted. The article does not concern itself with quality, only diversity
The greater question is why do you doubt the existence of qualified physicians who aren’t white? Why do assume that quality may be jeopardized if greater representation is pursued, despite the fact that the author provided clear examples of how the lack of representation impaired the quality of articles selected for publication as well as the quality of academic discourse?
This is the URL for a different article that provides some additional insight into JAMA’s issues: https://www.buzzfeednews.com/article/stephaniemlee/jama-racism-medicine-podcast-boycott
The article certainly suggests, and I adamantly contend, that diversity is a component of quality. I would say that some of the goofs that these journals have made, such as the JAMA structural racism podcast, reflect a diversity deficit. But I admit that it’s just a contention. I could be wrong. As a physician, you certainly are familiar with the need for evidence in medicine, for data to drive our practices where possible.
You and I appear to hold opposing hypotheses. Mine is that higher editorial diversity results in higher publication quality. Yours, if I understand, is that higher diversity results in lower quality. Note that neither of these is the null hypothesis, that there’s simply no relationship between diversity and quality. How can we learn the truth?
Let’s design a study. The gold standard would be a randomized trial in which we would randomly assign journals to diversifying their editorial boards or leaving them as they are. This study would be impractical if not impossible to conduct. We could do a cross-sectional study of journal diversity and quality but our power would be limited by the current extreme lack of diversity. What is more likely is that journals will get the message about the need to diversify. We can then do a pre/post study, controlling for inter-journal differences and intra-journal differences over time.
Given that we both understand science, perhaps we should both agree to hold off on bold statements of fact until we have actual data. Now, I’m Black. Do you suspect that I would be less qualified as an editor than my average white colleague? I would suggest- again hypothetically- that in addition to a functional understanding of statistics and causality, my life experiences would add value to my contributions. But not every editor should be just like me, just as not every one should be just like you. That’s diversity.
This does not surprise me. I worked at the AMA. They’re attitude toward diversity and inclusion is at the very least embarrassing and at its worst it’s harmful. I witnessed the harm first hand.
Hi Alexis. Sorry for your experience as you noted. As to the AMA, it has had a sort of moral reckoning in its ‘past’ ill-treatment of Black American Physicians as evidenced by the organization apologizing for such maltreatment over scores of years. The treatment was so horrendous that Black American Physicians started a separate medical organization – The National Medical Association – to declare for our professional interest at the time. The thing is is that change does occurs. Maybe not fast enough for some. But it does occur. Charles Darwin showed us that.
Stay safe!!
With all the percentages and numbers in this article there is a glaring oversight : what percentage of ALL doctors or qualifyers for editorial positions is white, and what percentage is non-white ? If the majority of all doctors / qualifyers is white, and if that percentage is applied to the number of positions (on Boards etc) – then you might find that the actual blend of white and non-white is not so lobsided as pictured. This article omits that likely rather substantial element completely – and it might need to be retracted / re-done.
The racial diversity at these journals is even worse than the diversity in the physician workforce. The same is true for gender. But representation is only one facet of the problem. Another is justice. I would argue that health disparities at least partly reflect the biases and blind spots of the people who decide which papers that may affect clinical practice get to be published. I would argue that the journals have a duty to make sure they’re getting the story right, which requires a diversity of insight and a break from groupthink. They have to figure out how to start diversifying the journals while the wider medical profession figures out how to diversity the physician workforce from which the journals draw.
Did the editors actually reject good papers because their authors were not white guys? That claim is not actually being made, at least not in the article.
Instead, a professor demanded more black people be hired by these prestigious journals.
It is not clear he has stated a valid complaint. In fact, the closest the article comes is “We don’t know what we don’t know” – apparently, white people will be blind to medical problems of non-white people. He does not offer evidence for THAT, either, but we are not allowed to demand it, I guess.
As for renaming the medical school – the school was named after it’s founder? And that is not acceptable? I understand this offends him, but this is not a matter of someone choosing to randomly honor a slaveowner because he was such a great guy – this was the founder – like him or hate him, founding the medical school is an historical fact – is he pushing to rename Washington DC and Washington state?
No, he said “they don’t even know what they don’t know.” in proper context. Why would you misquote him, and who is “We”? Medical racism has already been established. Survival rates for Black newborns are doubled when they are cared for by Black doctors, and the converse is true if they are cared for by white doctors in a review of 1.8 million births. Many white people are, in fact, blind to medical problems of non-white people, as you state. A large percentage of white doctors believe in the 21st century, that Black people don’t feel pain or have a higher pain threshold, according to evidence. Another word for that is sadism. Decades of treating white patients for pain while withholding pain medicine from indicated Black patients helped fuel the opioid epidemic in white patients. Racism is a scourge. Now that the problem, medical racism, has been established, “We” have moved on to facing and fixing the problem.
I am not sure how to respond to your comment, except that, if the white obstetricians lose twice as many black babies, that is a very serious problem which obviously badly needs to be fixed some way.
I am not sure renaming the medical school does anything to fix these kinds of problems. Are we allowed to name the pyramids after the Egyptian rulers who used slavery to build them? This name cancellation is far too extreme in my view. In fact, even if the founder was more evil than the typical man of his time – he STILL founded the school – he can have it named after him. It’s only fair. If someone wants to preach about him being a bad guy because he had slaves -fine with me – that is part of his history, and he owns it just as he owns the medical school. But it proves even slaveowners were not all bad, doesn’t it? Is that the point of renaming, to remove that fact from all history?
The cancel culture generally, and in regard to renaming these ancient institutions in particular, seems to have an intention to erase the history of people the cancelers disagree with doing good things. They seem to want to deny that good things could have been done by racists, or royalists, or religious people, or even Republicans. It seems to be based on the same psychology that lead the Spanish missionaries to burn all the records of the Aztecs, or the Taliban to blow up the Buddha statue, which is something like “TRULY good things – TRULY good – can only come through my God – every false path should be destroyed, and apparently even mere symbols of the false path can not be permitted to exist, even as warning posts to guide the wise.
I do not trust it.
I am not alleging that editors are deciding the fates of papers based upon the ethnicities of the authors. I am indeed demanding more editors of color. I cannot say with certainty that monolithic editorial boards have blind spots about people with different identities. That is one of the unknown unknowns. I am not confident in my ability to consider the all of the complex issues underlying all of the health threats to women or to LGBTQ people, because I lack the experiences and insights of members of those groups. I am also not confident in my ability to appreciate the health issues facing white people.
This issue is not about politics- it’s about trying to get the story right. Human health depends upon us getting the story as correct as we can. As physicians and scientists, we must be led by evidence. Does editorial diversity affect the quality of studies that influence medical care? We don’t know. We could study it, but first we would need enough diversity to study. Resisting change “just because” is not sensible.
Columbia’s medical school was not renamed. A dormitory named for the school’s founder, Dr. Samuel Bard, was renamed upon my insistence. If Columbia had disagreed, I would have been happy to have that debate. The “cancel culture” argument is tiresome and not relevant here. I want everyone to know both about Dr. Bard’s contributions to medicine and his enslavement of human beings. But I don’t think a university can expect Black people to live and work in a building named for someone who would have seen us as property.
You may not be able to appreciate why that matters to me. That’s OK. But your voice shouldn’t be the only one at the table; the decision-makers should also include people with the ability to think differently. Now if you follow that logic, then maybe you can understand why a journal whose papers affect a diverse population should also have a diverse editorial board.
JAMA’s blatant refusal to acknowledge the existence of systemic racism in medicine despite an overwhelming amount of published evidence, and conducting a discussion of the issue with three unqualified white physicians illustrates the problem; that only certain perspectives were receiving attention by JAMA due to the lack of diversity in its leadership. So they didn’t have to reject articles based upon the race of the author, they just had to reject articles that addressed issues, contained language or reached conclusions they didn’t like.
Interesting discussion with regards to Dr. Bard. Simply changing the name of a dormitory at the medical school is cancellation of him. I am reminded of recent debate and actions in NYC regarding J Marion Sims MD (‘famed’ Gynecologist, Confederate spy while in Europe) and his slave-holding and subsequent experimentation on enslaved women. Clearly, he is still, probably, celebrated in his home state of South Carolina. Further, I suspect the surgical tools he conceived, and the procedures he developed are probably still in use, as well. Yet his statue in NYC was moved from its prominent place in Central Park. These actions are mostly symbolic in nature. Yet, on the other hand, these actions can bring some measure of social healing to the conscious for some in the society as a whole without complete social disruption. Then – if that be the case – so be it.
I wonder what a similar study about medical journals’ editors on the basis of gender would show…
Women are also underrepresented, even in their presence in the medical workforce. According to my survey of >7K editorial positions at >100 cardiology journals, Women account for 16% of editors and very few editors-in-chief.
Interesting article.
One of the notions concerning the intent of Affirmative Action programs was to provide some measure of redress to the black descendants of slavery and white women.
It has been great benefit for the latter group but not so much for American blacks descendants of slavery.
Because of the conflating of the Black American redress efforts, for the centuries long instituional margilization, by lumping them together with the designation as POC political narrative has further diffuse or deflated our redress efforts. As such, we will need a new way of thinking of equitable regimes for this specific group, Black Americans descendants of slavery.
Finally, was not this article referred by Dr. Givens itself written by a “POC”?
If I understand your comment- and please correct me if I’m wrong- you are suggesting there must be specific attention to the descendants of American slaves. I would agree with such a comment.
Yes Dr. Givens. You are absolutely correct in your interpretation of my comment.
Conflating our American narrative is not conducive to our lived privations and the redress required to fix it, so to speak. See what has happen to remedy the privations to Native Americans, Japanese Americans and Jewish Americans for examples.
Thank you.
So that i am clear in my contention: though we mentioned the Black descendants of American slavery, it is clear that the official, or real institutional black subjugation, did not end until the 1964 Civil Rights act. There are individuals currently living from this period to this day.
Laws of the land that allowed for American apartheid in both public and private spheres post Slavery until 1964 Civil Rights act:
Berea v. Kentucky:
https://supreme.justia.com/cases/federal/us/211/45/
Plessy v. Ferguson:
https://www.history.com/topics/black-history/plessy-v-ferguson.
The bigger problem in medical journals is the influence of money from health to recipients who purposely skew the results of articles because they are being paid consulting fees
“affirmative action programs were promoting underprepared Black and Hispanic trainees who would not gain admission to top medical schools or become the best doctors. ” I’m confused. Isn’t the whole idea of affirmative action the fact that people of color are admitted to med schools in place of White candidates who may be better qualified academically, meaning that these less qualified students might not be the best MDs. These are the facts. There are arguments pro and con affirmative action and I understand both sides. But what is wrong with stating the facts?
Ah, Fred, didn’t you know? Facts are stubborn things. Very very stubborn.
If, for example, an institution — let’s call it a medical school — makes decisions contrary to facts, the facts have this crazy tendency to win out.
Inconvenient and uncomfortable facts can also make even intelligent people get causality backwards, what Richard Feynman called the “wet streets cause rain” hypothesis. The thinking? If I take a small subset of a overall less qualified group then that action will somehow redress the issues of a much LARGER group.
Political and social activists — and that includes the administrations of educational institutions — have a very very hard time understanding the concept of root causes, because root causes are factually grounded, and facts, as we have seen, are very stubborn.