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Embedding racialised differences into prescribing: the case of UK hypertension guidelines

Smart, A and Weiner, K (2015) Embedding racialised differences into prescribing: the case of UK hypertension guidelines. In: ESA 2015 - 12th Conference of the European Sociological Association: Differences, Inequalities and Sociological Imagination, 25-28 August 2015, Czech Technical University, Prague, Czech Republic.

Abstract

In 2002, US psychiatrist Dr Sally Satel courted controversy by arguing in a New York Times magazine article that physicians should take into account a patient’s race when they prescribed medicine. For many observers, her viewpoint contradicted the long-standing consensus that race was a biologically meaningless form of categorisation, and ignored concerns about the socially sensitive nature of making racialised judgements in healthcare. However, in 2006, the UK’s foremost authority on prescribing practices, the National Institute for Health and Care Excellence (NICE), issued a set of treatment guidelines for hypertension that stipulated a treatment pathway for ‘black patients of African or Caribbean decent’. In 2014, the US Joint Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) followed suit, over- turning its 2003 race-blind policy. These developments raise difficult questions, not least for health care systems, policymakers and practitioners. This paper reports on research investigating the development of the NICE hypertension prescribing guideline, based on documentary analysis and interviews with key UK experts. We consider the discussions that surrounded its development, the types of evidence used to support the guideline, and ideas about its implementation. We analyse the intersections between different knowledge claims (about pharmacological evidence, tacit clinical experience and underlying assumptions about difference) to reflect on how racial categories are ascribed and how uncertainties about ‘mixedness’ are addressed. We will also discuss the implications of such guidance for evidence-based clinical practice and for policy debates about inclusion and equality.

Item Type: Conference or Workshop Item (Paper)
Divisions: College of Liberal Arts
Date Deposited: 30 Nov 2015 15:08
Last Modified: 29 Apr 2016 14:11
URI: http://researchspace.bathspa.ac.uk/id/eprint/6824
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