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Allowing patients to choose the ethnicity of attending doctors is institutional racism

BMJ 2014; 348 doi: (Published 04 February 2014) Cite this as: BMJ 2014;348:g265
  1. Nadeem Moghal, associate medical director, George Eliot Hospital, College Street, Nuneaton, Warwickshire CV10 7DJ, UK
  1. nemoghal{at}

Nadeem Moghal reflects on a case in which a hospital accepted the request of the parents of a patient that care should be delivered by only a white doctor

On 22 April 1993 the black teenager Stephen Lawrence was murdered by a gang of people, some of whom were finally convicted in 2012. The deficiencies in the police investigation led to the Stephen Lawrence Inquiry, known widely as the Macpherson report, which defined the phrase “institutional racism” as “the collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.”1

This concept continues to be debated, particularly by police services, the focus of the Macpherson report. The definition is intricate, nuanced, and an advance in our understanding of our society. It is relevant to every organisation, private and public. It is a definition against which individual and organisational behaviours can be tested and healthcare services are no exception. NHS organisations …

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