Introduction

Toward the Abolition of Biological Race in Medicine: Transforming Clinical Education, Research, and Practice, written by the Abolishing Biological Race in Medicine Working Group of the Freedom School for Intersectional Medicine and Health Justice, bridges existing research by critical theory scholar-activists and researchers to guide clinicians and student learners in medicine, public health, and beyond on why the use of biological race must be abolished in medicine and clinical research, education, and practice. We begin with how medicine is rooted in a violent history of racism and has scientifically codified race as a biological construct throughout history. From this foundation, we draw on current examples of the use of biological race in medicine to highlight the urgent need to transform these outdated practices and center patient care. Throughout the paper, we intersperse quotes and anecdotes that have been shared with us by our medical student peers.[1]

Our paper includes four main sections:

• Section 1: Racism, Not Race, Causes Health Disparities

• Section 2: Cranial Capacities to Eugenics: How Medicine and Health Sciences Biologized Race

• Section 3: Race-Based Medicine in Diagnosis and Treatment

Drawing on existing research examples of heart disease, hypertension, BiDil, kidney disease and glomerular filtration rate, lung function and spirometry, and genetic ancestry or precision medicine, we argue that current use of race is not only outdated but harmful and violent to patient care of Black and brown communities.

• Section 4: Looking Ahead

These are our key takeaways:

1. Medicine has willfully ignored its racist history despite ongoing calls from scholars and activists to rectify its violent and oppressive history. This has resulted in medicine continuing to inflict and perpetuate racism that harms communities of color.

2. Using biological race as a heuristic for diagnosis of disease and interpretation of symptoms masks racism. 

3. Because of the biological use of race in clinical guidelines and education, patients of color are being systematically misdiagnosed and undertreated and are at risk for bad health outcomes.

4. Race-based medicine teaches people of color that their bodies and communities are abnormal, deficient, and broken, increasing stress and the burden of racist stigma. Medicine is an unwelcoming, hostile space for people of color. 

5. If we don’t dismantle race-based medicine, it will be perpetuated, ultimately harming patients in real, concrete ways. 

As physicians-in-training, we envision a world where the social construct of race is not conflated with biology and where the health consequences of racism are acknowledged, addressed, and cared for in all their forms.

To make this a reality, medicine must adopt antiracist institutional practices regarding research, practice, and education.

[1] These quotes are kept anonymous to prevent readers from within our medical school communities to specifically identify who the stories are about.