Session: Racial Bias and Fairness in Healthcare Algorithms
The Materialized Oppression of Precision Medicine
Saturday, September 21, 2024
8:45 AM – 9:45 AM CT
Location: Grand Ballroom C (First Floor)
Abstract: In their incisive examination of the pulse oximeter, Liao & Carbonell describe the ways that medical devices materialize oppression by encoding biased attitudes, practices, or data from the past, and carrying them into the current moment. Such oppressive medical technologies, they argue, share features of invisibility, expediency, and structural factors, which must be recognized and addressed using system-level (aggregate) solutions.
While not devices as such, the present-day technologies of precision medicine, namely the multigene panels, exomes, and genomes that are interrogated in a quest to deliver individualized healthcare to patients, encode numerous systematic biases that materialize oppression in very similar ways. In this presentation, the speaker will describe how the moral aggregation problem of precision medicine began well prior to the initiation of the Human Genome Project and continues to the present day, with implications for just pursuit of clinical translational genetics. Specifically, numerous invisible sampling and analytical choices based in problematic conceptions of the ‘human’, compounded by expediency-driven decisions about how and what to genotype, and social and political considerations that have long-centered US interests and expertise, have converged to create tools and tests that consistently underperform in non-white and mixed-race patients with profound implications for global health equity. These materialized biases, which are deep and multifaceted, will not be overcome by efforts to increase participation of minoritized populations in biomedical research or even sustained efforts at community engagement. Instead, multi-level approaches, that address multiple causal mechanisms simultaneously, will be needed.
Learning Objectives:
After participating in this conference, attendees should be able to:
Upon completion, participants will recognize the ways in which precision medicine tools and tests can be viewed as materializing oppression.
Upon completion, participants will recognize the role of invisibility, expediency, and structural factors in determining the currently biased natures of most medical genetic tests
Upon completion, participants will be able to discuss the need for multi-level strategies designed to tackle the diverse causes of bias in current precision medicine approaches