Over 76% of respondents to a British Medical Association survey in 2021 had experienced racism in their workplace on at least one occasion in the previous two years. In the first of the EAPC’s Racism in Palliative Care blog series, Dr Gurpreet Gupta issues an invitation – to lean in, to ask questions, to learn and to challenge the ‘status quo’.
Woke! I can almost see eyes rolling on the other side of the screen reading the word. An innocuous four-letter word that has become increasingly controversial to use. That outrage alone has certainly made it easier to lean away from challenging discussions.
But to be politically and socially aware (which is the actual definition of ‘woke’), especially in relation to racial injustice, surely is to be encouraged? As you read on, I invite you to lean into the discomfort and do what we do best in palliative care- start having the conversations, listen with curiosity and engage in meaningful action… because racism remains pervasive in our society and medicine. Over 76% of respondents to a British Medical Association survey in 2021 experienced racism in their workplace on at least one occasion in the last two years.
In the aftermath of George Floyd’s murder and the rising Black Lives Matter movement, healthcare organisations in the United Kingdom (U.K.) were slow to respond or demonstrate commitment to anti-racism. This, and the inescapable inequalities highlighted by the COVID-19 pandemic, led to formation of the Association for Palliative Medicine’s Race Equity Committee and the essential question whether we as a palliative care community are aware of these problems within our systems? The Race Equity Committee went looking.
In 2022, the committee conducted a survey of the U.K. palliative care workforce, exploring experiences of racial prejudice/discrimination in the workplace. We had 1352 respondents and results are undergoing review, however the early analysis confirms that there is work to do. 39% of respondents answered ‘yes’ to experiencing racism directly in the workplace. Worryingly, approximately 2% of respondents experienced racism from executive team members and 9% directly from patients. The harm and impact of such attitudes, especially from senior leadership cannot be overlooked. How truly widespread these attitudes are remains unknown.
Patients do not shed discriminatory attitudes and behaviours at the doors of our institutions and neither do some of our professional colleagues. The expression of racial prejudices cumulatively contributes to moral distress and burnout (1) with subsequent impact on patient outcomes. As Ibram X. Kendi says, being ‘not racist’ is not enough, we must be actively anti-racist (2).
Working within the anti-racism sphere has not been easy, so why am I still here and inviting you in? Power and privilege. I am acutely aware that being of a middle-class British born Sikh Panjabi background affords me privilege. In the U.K. at least, it allows me to be perceived as part of a ‘model minority’ (a minority group stereotypically viewed as being more successful than other groups and often better accepted by the majority population) (3) and therefore I can adopt adjacency to white centred spaces more easily than many of my Black colleagues. As a result, I carry a greater sense of responsibility to challenge racism and inequity when I see it, but I still have blind spots and continue to learn.
Desmond Tutu once said, ‘If you are neutral in situations of injustice, you have chosen the side of the oppressor.’
Let us not adopt the stasis of neutrality.
Let us learn together, let us act together.
In the upcoming series of EAPC blogs on ‘Racism in Palliative Care’, you will hear from eminent global voices such as Professor Merryn Gott, Professor of Health Sciences, University of Auckland and Dr Maurice C. Scott, Jr., Assistant Professor, Department of Medicine, University of Colorado School of Medicine, alongside others. The series will provide an opportunity to explore how power and privilege serve to embed inequities. But it will also offer the space, if utilised effectively, to learn how we can work together to enable correction of the imbalances and provide safer, equitable spaces for both healthcare staff and the patients we serve.
1) Kimani Paul-Emile, Alexander K. Smith, Bernard Lo, and Alicia Fernández, Dealing with Racist Patients, NEJM, 354: 708-711 (2016).
2) Ibram X. Kendi TED talk, ‘The difference between being “not racist” and antiracist’, 2020.
3) Partial definition from Dictionary.com.
Links and resources
- Read the editorial on Racism and Palliative Care in Palliative Medicine here.
- Listen to The Changemaker podcast, hosted by Marie Beecham, a Diversity, Equity, & Inclusion Advocate.
- Race Equality Foundation, a U.K. charity tackling racial inequality in public services. Click here to see health and care reports and projects.
- Find out more about the U.K. National Health Service Workforce Race Equality Standard here.
- Listen to Dr Jamilla Hussain on the Hospice U.K. Dying Matters podcast discussing Racism in Palliative Care here.
About the author
Dr Gurpreet Gupta is a palliative medicine consultant working at St Luke’s Hospice in North West London. She has a particular interest in staff wellbeing and racial equity. Gurpreet is a founding member and deputy chair of the Association for Palliative Medicine’s Race Equity Committee. She spoke last year at the Palliative Care Congress on the ‘Challenges of Working in the Anti-Racism sphere’. Twitter: @ggupta.
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