Biased, me? Yes, of course.

13 Oct

Preacher Gary Steve Moore had spinal-fusion surgery at St. Dominic Hospital on April 7, 2011. He died hours after surgery.

The reason Moore’s death made the The Wall Street Journal (http://online.wsj.com/article/SB10001424053111904106704576582621677354508.html?mod=WSJ_hp_LEFTWhatsNewsCollection) is because his tragedy is an example of what appears to be a growing trend in conflict of interest for doctors: his surgeon Adam Lewis is part-owner of the medical device company that manufactures the implants Lewis recommended to and personally placed in Moore. 

While this is a big story, this post is about a seemingly small point.

While a conflict of interest seems reasonable to suspect, “Dr. Lewis’s lawyer says his client’s financial interest in Spinal USA had nothing to do with his decision to operate on Mr. Moore. Dr. Lewis used Spinal USA implants because he helped design them and believed they “were the best on the market for the procedure,” not because he stood to profit from them.”

Oh, come on.

I would actually have a lot more faith in the doctor if he would just acknowledge the obvious potential for–and upside for him in acting on–bias. If he would just admit that his dual roles–as Spinal USA co-owner and Moore’s surgeon–did complicate his position, and after acknowledging this to himself, he proceeded as Moore’s doctor with deliberation and clarified intention.

Yes, this is idealistic, considering the litigation he’s now involved in, but let’s leave Lewis to his legal battle and think big–because this isn’t just one case of bias denial. We do it all the time. Yes, us.

It seems there’s an aversion to admitting that we could ever, possibly, even in the slightest way, perhaps be–I’m speaking theoretically here (about a friend of mine)–biased. Instead, we resort to ridiculous expressions, such as, “He doesn’t have a racist bone in his body.” I’m not even going to bother providing a context or source for that phrase. Just google it, and see how many hits you get (in reference to Donald Trump, Representative Joe Wilson, Rush Limbaugh and Governor Rick Perry, to name a few). What this phrase intends is: he (or she) isn’t racially biased at all, when the truth is, we’re all racially biased. (The Implicit Association Test and associated research bears this out in studies that consistently demonstrate a positive bias associated with whiteness and a negative bias attached to blackness, across racial groups: https://implicit.harvard.edu/implicit/demo/). But just the admission of a racial bias means condemnation as a racist, so instead of conceding that we’re human, we try to locate bias as the tumor in the bone of someone else’s sick body.

How did we end up being unable to admit what’s as human, universal and true as the sky is blue (except where it’s yellow from smog)? I blame it on confusion over the difference between what we think and what we do. To be biased–even prejudiced–is not the same as to discriminate against others in our words and actions. But understanding the relationship between bias (potential) and discrimination (action and effect) is critical to interrupting their connection.

Here’s what I understand:

As a result of individual experience, cultural norms and hard-wiring, it’s impossible for us to be completely neutral about identities and differences: we inevitably form preferences for and against individuals and groups. But we can choose whether or not to act on our preferences. That’s the distinction between bias and discrimination: while we can’t help having biases, we can help acting on them to advantage some people over others. So while I’m a big fan of Louise Derman-Sparks’ work, I am actually anti-“anti-bias.” In practice, I think the “anti-bias” movement sets children and the adults who mentor them up for denial and dishonesty about our human and unavoidable inclinations. And this has major consequences for social justice: only when we can acknowledge our human tendency not to be fair, can we do something about it.

So here’s an invitation: next time a question of your bias comes up, practice saying, “Yes, and…” See what happens if you acknowledge that the bias is real and relevant, and that you’re susceptible to it. And also that… [see where this goes] Do this privately or with someone you trust to be honest with you and keep your confidence. It’s an exercise in complex integrative thinking, which is our capacity to accept multiple, simultaneous and sometimes seemingly contradictory truths and synthesize them not as equal variables, but as factors of differing import and impact, depending on circumstances. Consider how ageism, sexism, sizeism, racism, classism or US Americanism does, in fact, have something to do with how you think and even how you act.

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