美国医学会（观点）：仅从高胆红素血症指南中删除种族是不够的

Viewpoint

October 17, 2022

Removing Race From Hyperbilirubinemia Guidelines Is Not Enough

Sharon Ostfeld-Johns, MD1,2; Elena Aragona, MD1; Louis Hart, MD1,3

Author Affiliations

JAMA Pediatr. Published online October 17, 2022. doi:10.1001/jamapediatrics.2022.3865

The 2004 update to the American Academy of Pediatrics (AAP) guideline for management of hyperbilirubinemia included Black race as a factor associated with “decreased risk of significant jaundice” and East Asian race as a “major risk factor” for the development of severe hyperbilirubinemia.1 The 2009 update and clarification did not explicitly remove Black race and continued to list East Asian race as an “important risk factor for severe hyperbilirubinemia.”2 In their 2022 perspective,3 the AAP Board Committee on Equity and the Board of Directors denounced race-based medicine and advised its elimination from all clinical decision-making tools. The hyperbilirubinemia guideline4 has just been updated for 2022, and race has been removed. We would argue that moving toward race-conscious medicine requires more than simply removing previous harms; it requires an explanation of how those harms came to be and an explicit plan for how racism can and must be expunged from our clinical work.