These words challenge all of us to consider what we will do, individually and collectively, to live up to Dr. Manning's hope that “Perhaps 2020 will also be remembered for the opportunity it presented for the centuries old scourge of racism to no longer be our transparent cross to bear alone. Unlike COVID-19, this pandemic of racism is not ‘unprecedented.’ We have been here before. It's time we all grieve—and act—together.”
Will we all grieve, will we all act, together?
For an organization like the American College of Physicians, it should be self-evident that we must, expanding on years of advocacy against discrimination and racism.
In 2017, ACP adopted policy on hate crimes that said “ACP opposes prejudice, discrimination, harassment and violence against individuals based on their race, ethnic origin, ancestry, gender, gender identity, nationality, primary language, socioeconomic status, sexual orientation, cultural background, age, disability, or religion” and “Hate crimes directed against individuals based on their race, ethnic origin, ancestry, gender, gender identity, nationality, primary language, socioeconomic status, sexual orientation, cultural background, age, disability, or religion are a public health issue.” Previous ACP position papers have examined racial and ethnic disparities in health care, discrimination due to sexual orientation or gender identity, and discrimination against women.
Then, on May 29, as protests against racism and police violence began to sweep the country, ACP issued a statement declaring that “The American College of Physicians is gravely concerned whenever any person is subject to discrimination, racism, harassment and violence, whether it's by police and other public authorities, or by private individuals discriminating and committing violence against others because of their race or other characteristics. It is evident that African-Americans in particular are at risk of being subjected to discrimination and violence against them because of their race, endangering them and even costing them their lives. This should never be acceptable and those responsible must be held accountable.”
ACP acknowledged that “The issue of how to ensure that policing does not result in discriminatory enforcement and violence is a multifaceted and complex one. While we caution against generalizing the egregious actions of some to all or most, a comprehensive and evidence-based approach to understanding and implementing solutions to discriminatory actions and violence against others is imperative, even as individuals who commit such acts and others with decision-making authority must be held accountable for their own actions.”
In June, the Board of Regents approved a new policy statement on racism and health that offered specific ideas to confront racism, including in law enforcement. Yet I am aware that some ACP members may think we lack the expertise, or standing, to address racism and violence in law enforcement and that it would be better if we only address discrimination in health care; some may even question whether black Americans are disproportionately subject to racism in law enforcement.
To this I say, ACP is failing to live up to its ideals and values if our policies do not clearly state that racism, violence, and brutality in policing are part of the abiding, systemic, decades- and centuries-long legacy of slavery and Jim Crow. They have been tolerated and accepted, and often facilitated and enabled, despite how many times we have seen police officers discriminate and commit brutal acts of violence against black people solely because of their color. We would be declining to stand with those in our membership and broader society who have been subjected to racism, including in law enforcement.
Our New Vision for U.S. Health Care, released this past January, envisioned a time when no person would be discriminated against based on race, ethnicity, gender, gender identity, sex, sexual orientation, country of origin, and other personal characteristics. Now, when the country is being torn apart because of racism, when national leaders are encouraging violence by law enforcement and the military against nonviolent protesters, the question for ACP and its members must be, will we do more to achieve this vision?
This is not a time to take the safe, “Let's not ruffle any feathers” course of action. ACP's May 29 statement says the College is “committed to contributing to solutions, from the standpoint of physicians and patients who see first-hand the consequences of discrimination, racism, and violence on individual and population health.” By examining systemic racism in health care, in law enforcement, and in our broader society, and proposing evidence-based solutions, ACP can help us get to the day when no person is violated, disrespected, harassed, ignored, watched, arrested, reported, denied, overlooked, impoverished, attacked, or killed because of race.
It is time to seize the moment and stand with our black neighbors, friends, and colleagues and all who are subject to discrimination. As Dr. Manning wrote, “While we won't have all the answers immediately, we recognize the peculiar intersection between the COVID-19 crisis and the tipping point of grief felt by Black people with the recent deaths of Ahmaud Arbery, Breonna Taylor, and George Floyd, and it urges us to try.”