It’s never a good time to be a baby who’s been exposed to drugs. But the brilliant antiracist minds at Mass General Brigham have somehow found a way to make that situation even more risky. Early this month, the Massachusetts healthcare network announced its latest gambit in the fight against racial disparity in medicine: no longer reporting instances of abuse in cases of fetal drug exposure.
The rationale for this baffling new policy? The DEI-rich language of ‘health equity.’ As per Mass General’s announcement, “Black pregnant people are more likely to be drug tested and to be reported to child welfare systems than white pregnant people.” The decision was further portrayed as “the latest step in our efforts to address long-standing inequities in substance use disorder care.” But will it?
As the updated policy reads:
First, the new policy requires written consent for toxicology testing of any pregnant individual or infant outside of emergent situations. At the same time, it limits toxicology testing to circumstances where results will change the medical management of the pregnant person or infant.
The policy also notes that an abuse/neglect report to state child welfare agencies in Massachusetts and New Hampshire after delivery should be filed only if there is reasonable cause to believe that the infant is suffering or at imminent risk of suffering physical or emotional injury and that ‘substance exposure’ alone, including treatment with methadone or buprenorphine for opioid use disorder, does not require a report of abuse or neglect in the absence of protective concerns for the infant.
Under Brigham’s no-report policies, black babies exposed to drugs can be passed over for potentially life-saving care if their mothers refuse help. How is erecting new barriers to treatment for these children a step toward any serious concept of justice?
As psychiatrist Sally Satel notes, the new policy would reduce not only the amount of reporting involved in the Boston system, but strip healthcare providers of the ability to meaningfully intervene in cases where a baby’s health appears compromised.
This is hardly the first time Brigham’s chosen to mix racial politicking with its patient care. The Brigham and Women’s Hospital, as part of its United Against Racism campaign, recently introduced a program where patient admissions to cardiac units would weigh the race of the patient, as a supposed ‘righting of the scale’ against historic health disparities.
Let’s be clear here: these practices, while perhaps palatable to the modern advocates of equity, cannot be conscionable to modern advocates of justice. Brigham has made its stand: prioritizing marginalized patient populations in a bid to right historical wrongs. Yet the obvious problem remains: Such policies attempt to right historical wrongs by risking modern ones.
The system may purport to advance ‘health equity,’ but it runs a real risk of hurting innocent children. We must evaluate these systems based on what they do, not merely on what they purport to do. To do otherwise is to adopt an uncritical perspective on equity that cedes legitimacy to unserious and dangerous solutions.
We are sometimes asked, in the name of charity and good faith, to pretend that arguments over DEI and equity-based policies are low-stakes questions. We’re told that the real diversity argument is between “validating the feelings and lived experience of people of color” or “propping up white supremacy with our complicit silence.” I’ve written at length about how this isn’t the case, but the actions and results of the DEI movement speak far louder than its critics’ most pointed words.
For a further example, let’s take a closer look at Brigham’s cardiology policy. Brigham alerted physicians when a black or “Latinx” patient presented with heart failure to “educate the clinician about the fact that, historically, this population has had inequitable access to specialized cardiology care and offer a recommendation to consider changing admission.” It’s not an override of a clinician’s judgment or even a treatment prescription, meaning that it’s actually a relatively impotent policy in the aggregate. By any modern standard of DEI, it doesn’t even qualify as intersectional. But that’s actually the point — the policies that work aren’t the ones being dreamed up for ‘health equity’ brownie points.
Intersectionality, particularly in medicine, only works at the most basic level: the differentiation of the individual patient. The only morally serious option is for healthcare providers to evaluate patients based on individual history and symptoms — and avoid the kind of DEI-esque language of ‘health equity’ that makes observers and patients alike start raising questions about what forces are actually driving the boat over at Mass General Brigham.
That practical and rhetorical vision isn’t what modern DEI proponents want you to sign up for. Accepting their view of equity, in this case, means systems that risk passing over treatment for innocent children. Is that equity? It’s certainly not equality, it’s certainly not justice, and it’s not what anyone really wants for the future of American healthcare: we can’t validate people’s lived experiences if they die as babies in a maternity ward.
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Isaac Willour is an award-winning journalist focusing on race, culture, and American conservatism, as well as a corporate relations analyst at Bowyer Research. His work on race & DEI has been featured at outlets including National Review, USA Today, C-SPAN, and the Daily Wire. He is a member of the Young Voices contributor program, and can be found on Twitter @IsaacWillour.
The views expressed in this piece are those of the author and do not necessarily represent those of the Daily Wire.