The denial of racism is racism itself

Responses to a recent CMAJ issue, dedicated to Black health and anti-Black racism in health care, indicated that some physicians hold a view that racism does not exist in Canada, based on their own observations. Such responses are not uncommon in discussions of racism in medicine. However, we must reflect on why some physicians think their own biased interpretations of what they have seen are a superior form of evidence to inquests, investigations, reports and peer-reviewed published literature.

Racism in health care in Canada is documented in many places, including the In Plain Sight report,¹ the Joyce Echaquan inquest,² survey findings on the experience of Black nurses in Ontario³ and published research reports showing inequitable health care for Indigenous Peoples.⁴ A meta-analysis that evaluated different types of colour-blind ideologies and their effects found that power-evasion colour-blindness (i.e., the denial, minimization and distortion of the existence of institutional racism) was associated with increased anti-Black racism.⁵ It serves as a barrier to the disruption of systemic racism, thus reinforcing and restabilizing the status quo system of advantaged white access to power, money, resources and opportunity.

We must apply principles of evidence-based medicine and ethical responsibilities to name and take action on racism in Canadian health care.