Implicit bias in healthcare Implicit bias significantly affects how healthcare professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of which can adversely impact health outcomes. Addressing Historical perspective Although the earliest evidence of the practice of dentistry dates back to the Indus valley civilization (American Dental Education Association [ADEA], n.d.) and the Egyptian era (American Dental Association, n.d.a), dental education did not become formalized until the early part of the 19th century (ADEA, n.d.). At that time, both dental practitioners and the public began to recognize the importance of properly training those providing dental care and dentistry, and dentistry began its transition from a craft vocation to a learned profession (Taylor, 1922). An exploration of the history of medical and dental ethics is important to an understanding of the concept of professionalism as it relates to dentistry. Medical ethics has its foundation in ancient Greece around the fifth century BCE (Muacevic and Adler, 2018). The physician Hippocrates, recognized as the founding father of medicine, espoused ethical ideals that still hold true in medical practice today.
implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
EVOLUTION OF HEALTHCARE ETHICS
From the time of Hippocrates to the third century in the Common Era, evidence can be found in literature regarding the incorporation of ethical standards into the practice of medicine. The earliest known document about medical ethics is an ancient text titled Epidemics I (Jonsen, 2000). Although this text, written in the time of Hippocrates and credited to him by scholars, is mostly clinical in nature, one statement stands out: “As to diseases, make a habit of two things – to help and not to harm” (Hippocrates, trans. 1923, p. 165). Oath is another text from this time period. It is widely attributed to Hippocrates, although debate exists in contemporary historical literature concerning its authorship The Hippocratic Oath is a part of the collection of works known as the Hippocratic Corpus which was composed over hundreds of years so Hippocrates could not have authored them all (Bad Ancient, 2020). This famous document is commonly known as the Hippocratic Oath . Text Box 1 contains the classic version of this oath.
Text Box 1: The Hippocratic Oath: Classic Version The Oath of Hippocrates I SWEAR by Apollo the physician and Æsculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment: • I will keep this Oath and this stipulation – to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction. • I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. • I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. • I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. • I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad. • I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot. Note . From Oath of Hippocrates. (1910). In Harvard classics (Vol. 38). Boston, MA: P.F. Collier and Son. Retrieved from http://www.cirp.org/library/ ethics/hippocrates/.
The Hippocratic Oath provides medical practitioners with a framework for the ethical practice of medicine by professing a set of obligations to which physicians are bound. As is evident from the language of the oath, Hippocrates believed that the practice of medicine was both an art and a privilege and that patients had rights of their own. Dentistry has adopted many of the ideals of the Hippocratic Oath into its current professional codes of ethics as well as
the oaths that dental and hygiene students take upon their graduation from dental school. However, to fully understand the history of medical – and subsequently dental – ethics, it is necessary to explore other historical events. The years between 1940 and 1985 mark an important period in the development of medical and dental ethics worldwide. The atrocities that occurred in the concentration camps during World War II sparked this era of change. The Nazis designed
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