Under-treatment of Pain in Black Patients: A Historical Overview, Case-based Analysis, and Legalities as Explored Through the Tenets of Critical Race Theory

Abstract

Pain, also called the “fifth vital sign” is an important topic in healthcare settings. It requires urgent attention and treatment to minimize agony and discomfort. Unfortunately, multiple clinical studies conducted over the last few decades have repeatedly shown disparately inferior pain management in Black patients in medical settings when compared to White patients with similar pain levels. This Article utilizes Critical Race Theory to examine the understudied issue of under-treatment of pain in Black patients. It discusses the story of a real patient, Jacqui, who was under the medical care of the author. It examines her unfortunate experiences with poor pain management throughout different stages of her life, including a blood disorder as a child with, a traumatic arm fracture as a teen, during childbirth, and finally, later in life with advanced cancer. Three points are addressed in this Article: first, a discussion of Jacqui’s
experiences, and an analysis of those experiences through the available clinical data. This Article reveals the extent to which Black patient’s pain is undertreated, and how it led Black patients to mistrust our healthcare system. Second, the Article explores malpractice based legal analyses to these issues based on federal and state legislation. Third, various proposals to correct various systemic
discrepancies in medical-education and clinical settings to minimize such racial biases in pain management are discussed. It concludes by talking about the final part of Jacqui’s clinical journey.