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6 - Health Law

Cognitive Bias in Medical Decision-Making

Published online by Cambridge University Press:  05 June 2012

Justin D. Levinson
University of Hawaii, School of Law
Robert J. Smith
University of North Carolina, School of Law
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On any given day in the United States, disparities in the quality of health care and health outcomes for racial and ethnic minority groups in comparison to whites are evidenced in our nation's hospitals and clinics. These disparities are not fully explained by differences in patient education, income, insurance status, expressed preference for treatments, and severity of disease. Compelling research indicates that even for African Americans able to gain access to health care services, disparities persist in diagnostic screening and general medical care, mental health diagnosis and treatment, pain management, HIV-related care, and treatments for cancer, heart disease, diabetes, and kidney disease.

For example, despite the implementation of standardized pain assessment in health care settings, disparities in pain management persist by race and ethnicity. African Americans and Hispanics are more likely to have their pain undertreated than non-Hispanic whites. Even with adjustment for multiple confounders, studies reveal the consistent under-treatment of African Americans and members of other marginalized racial and ethnic groups experiencing cancer pain, postoperative pain, chest pain, chronic low back pain, and other acute pain who present in emergency, primary care, inpatient hospital, and nursing home settings.

Publisher: Cambridge University Press
Print publication year: 2012

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