美国国家公共电台 NPR Emergency Medical Responders Confront Racial Bias

 

RACHEL MARTIN, HOST:

There's a recent study out of Oregon that shows that race comes into play, even when it means administering lifesaving care. Specifically, this study shows black patients are 40 percent less likely to get pain medication than white people. Kristian Foden-Vencil of Oregon Public Broadcasting reports.

KRISTIAN FODEN-VENCIL, BYLINE¹: Differences in how races are treated by doctors in the ER are well-documented. Whites tend to get better care and have healthier outcomes. But until this study, it was unclear if the same was happening in an emergency in the back of an ambulance. Leslie Gregory always wondered. Now a physician assistant, Gregory got her start as one of a very few black, female EMTs. She remembers one call. The patient was down and in pain. Driving up, she could see he was black. Then one of her colleagues groaned².

LESLIE GREGORY: It was something like, oh, God. Here we go again.

FODEN-VENCIL: She worried her colleague thought that because he was black, he was acting³ out to get pain meds.

GREGORY: At the time, I remember it increased my stress as we rode up on this person because I thought, now, am I going to have to fight my colleague for more pain medication, should that arise?

FODEN-VENCIL: A group of researchers at Oregon Health and Science University decided⁴ to try to see if there was a difference in the way patients were treated on emergency calls. They looked at 100,000 medical charts of ambulance patients over three years. Black patients were less likely to receive pain medications compared to white patients, regardless of socio-economic factors like health insurance.

(SOUNDBITE OF BANG)

FODEN-VENCIL: At the end of a recent shift at American Medical Response in Portland, a row of ambulances files into the garage. Many emergency responders here bristle⁵ at the idea race plays a role in care. Jennifer Sanders has been a paramedic for 30 years.

JENNIFER SANDERS: I've never treated anybody different regardless.

FODEN-VENCIL: The very idea is distasteful, says paramedic Jason Dahlke.

JASON DAHLKE: No one I work with will explicitly⁶ and intentionally⁷ discriminate⁸ against somebody. It's not what we do. It's not the business that we're in.

FODEN-VENCIL: But Dahlke is willing to entertain the idea unconscious bias⁹ is at work in his field.

DAHLKE: Historically, it's the way this country has been. In the beginning, we had slavery and then Jim Crow and then redlining and all of this stuff that you can get lost in in, like, a large, macro scale. So yeah, it's there.

FODEN-VENCIL: So this study is given import. He mentions an older black patient he just treated. He was diabetic and complaining of extreme pain. Dahlke gave him glucose¹⁰ for low blood sugar but no pain meds. He says that's because by the time he'd stabilized¹¹ his blood sugar, they'd reached the hospital. And would he have done anything differently if the patient had been white?

DAHLKE: Consciously, absolutely not. Unconsciously, that's what studies are saying.

FODEN-VENCIL: Dahlke thinks another issue at play may be that white patients are more comfortable asking for medications than patients of color. Former EMT Leslie Gregory agrees. She says after years of discrimination, many African-Americans have their own biases¹² about the medical system. They just don't trust it.

GREGORY: How can a person of color not disrespect a system that is constantly studying and talking about these disparities but does nothing to fix it?

FODEN-VENCIL: The author of this new ambulance study, Jamie Kennel¹³, says another reason disparities loom¹⁴ so large may be that EMTs work in a stressful and time-pressured environment.

JAMIE KENNEL: In these situations, providers are much more likely to default to making decisions based on stereotypes¹⁵.

FODEN-VENCIL: So now ambulance agencies know unconscious bias may be at work. What are they doing about it? Robert McDonald with American Medical Response says he's looking at new training and a change in hiring practices.

ROBERT MCDONALD: We want to see more ethnicities represented in EMS that has historically been a white, male-dominated workforce¹⁶.

FODEN-VENCIL: The first step, though, is for emergency workers to just be aware of the role bias may play in care. For NPR News, I'm Kristian Foden-Vencil in Portland.

(SOUNDBITE OF OLDTWIG'S "DUNES")

MARTIN: This story is part of a partnership¹⁷ with NPR, Oregon Public Broadcasting and Kaiser Health News.

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 groaned   

v.呻吟( groan的过去式和过去分词 )；发牢骚；抱怨；受苦

参考例句：

• He groaned in anguish. 他痛苦地呻吟。
• The cart groaned under the weight of the piano. 大车在钢琴的重压下嘎吱作响。 来自《简明英汉词典》

3 acting   

n.演戏，行为，假装；adj.代理的，临时的，演出用的

参考例句：

• Ignore her,she's just acting.别理她，她只是假装的。
• During the seventies,her acting career was in eclipse.在七十年代，她的表演生涯黯然失色。

4 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

5 bristle   

v.（毛发）直立，气势汹汹，发怒；n.硬毛发

参考例句：

• It has a short stumpy tail covered with bristles.它粗短的尾巴上鬃毛浓密。
• He bristled with indignation at the suggestion that he was racist.有人暗示他是个种族主义者，他对此十分恼火。

6 explicitly   

ad.明确地，显然地

参考例句：

• The plan does not explicitly endorse the private ownership of land. 该计划没有明确地支持土地私有制。
• SARA amended section 113 to provide explicitly for a right to contribution. 《最高基金修正与再授权法案》修正了第123条，清楚地规定了分配权。 来自英汉非文学 - 环境法 - 环境法

7 intentionally   

ad.故意地，有意地

参考例句：

• I didn't say it intentionally. 我是无心说的。
• The local authority ruled that he had made himself intentionally homeless and was therefore not entitled to be rehoused. 当地政府裁定他是有意居无定所，因此没有资格再获得提供住房。

8 discriminate   

v.区别，辨别，区分；有区别地对待

参考例句：

• You must learn to discriminate between facts and opinions.你必须学会把事实和看法区分出来。
• They can discriminate hundreds of colours.他们能分辨上百种颜色。

9 bias   

n.偏见，偏心，偏袒；vt.使有偏见

参考例句：

• They are accusing the teacher of political bias in his marking.他们在指控那名教师打分数有政治偏见。
• He had a bias toward the plan.他对这项计划有偏见。

10 glucose   

n.葡萄糖

参考例句：

• I gave him an extra dose of glucose to pep him up.我给他多注射了一剂葡萄糖以增强他的活力。
• The doctor injected glucose into his patient's veins.医生将葡萄糖注入病人的静脉。

11 stabilized   

v.（使）稳定， （使）稳固( stabilize的过去式和过去分词 )

参考例句：

• The patient's condition stabilized. 患者的病情稳定下来。
• His blood pressure has stabilized. 他的血压已经稳定下来了。 来自《现代英汉综合大词典》

12 biases   

偏见( bias的名词复数 )； 偏爱； 特殊能力； 斜纹

参考例句：

• Stereotypes represent designer or researcher biases and assumptions, rather than factual data. 它代表设计师或者研究者的偏见和假设，而不是实际的数据。 来自About Face 3交互设计精髓
• The net effect of biases on international comparisons is easily summarized. 偏差对国际比较的基本影响容易概括。

13 kennel   

n.狗舍，狗窝

参考例句：

• Sporting dogs should be kept out of doors in a kennel.猎狗应该养在户外的狗窝中。
• Rescued dogs are housed in a standard kennel block.获救的狗被装在一个标准的犬舍里。

14 loom   

n.织布机，织机；v.隐现，(危险、忧虑等)迫近

参考例句：

• The old woman was weaving on her loom.那位老太太正在织布机上织布。
• The shuttle flies back and forth on the loom.织布机上梭子来回飞动。

15 stereotypes   

n.老套，模式化的见解，有老一套固定想法的人( stereotype的名词复数 )v.把…模式化，使成陈规( stereotype的第三人称单数 )

参考例句：

• Such jokes tend to reinforce racial stereotypes. 这样的笑话容易渲染种族偏见。
• It makes me sick to read over such stereotypes devoid of content. 这种空洞无物的八股调，我看了就讨厌。 来自《现代汉英综合大词典》

16 workforce   

n.劳动大军，劳动力

参考例句：

• A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
• A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。

17 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。