Intended for healthcare professionals

Rapid response to:

Letters Institutional racism

A case for “reasonable discrimination”

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1717 (Published 25 February 2014) Cite this as: BMJ 2014;348:g1717

Rapid Response:

Re: A case for “reasonable discrimination”

Derek Rosario is right to feel uncomfortable with my published letter.

I agree entirely that our efforts to free ourselves from stereotyping, irrationality, unconscious racism etc. should continue apace.

My full letter (abridged by the BMJ editor without reference to me) can be seen at http://www.bmj.com/content/348/bmj.g265/rr/685779

In my defense to Derek, might I point out that I tried hard to ask uncomfortable questions in the context of the discussion response to Nadeem Moghal's disturbing article. I certainly expected differing viewpoints, and would point out that my example of a woman raped by a black man carries no stereotyping, was posed as a question, and gave no clue as to my own view. Interestingly a later contributor described an Asian patient who refused to be seen by an Indian.

The law makes clear that discrimination on grounds of race is probably illegal. But the law goes on to mention disadvantage and harm resulting thereby. Objective justification is mentioned as a defence for racial discrimination (shades of 'stop and search' stereotyping ?), which will require that we ask difficult questions such as 'Why?'. Testing for sickle-cell disease, for example, in my humble opinion should be racially discriminatory. My overriding aim would be to minimise harm and disadvantage, and in Nadeem Moghal's cited case one must remember that the child's needs should be paramount, despite the apparent racism of its parents !

I would hope to be prepared to break bad laws (eg: UK Slavery, Nazi Germany, Apartheid South Africa). When my letter is read in context, and its questions not read as if they were answers, I do hope Derek will agree we are both striving for the same thing - an end to all unfairness and unreasonable intolerance in our society.

I thought Nadeem Moghal's piece, and the discussion which followed was a very helpful contribution to that cause.

Competing interests: No competing interests

05 March 2014
L Sam Lewis
GP Trainer
NHS
Surgery, Newport, Pembrokeshire