End of the Day, Jávea

Reaching for an End to Bias

Jessica Nordell describes something like a quest in her new book, The End of Bias.

“When I began this book, I thought I was writing a work of science. My plan was to read, study, synthesize the best evidence, and share what I found. The journey would be straightforward; it would be scientific and outward-facing – as if, when we study the world, we are not always in some way, seeking ourselves. Instead, what I discovered broke me open.”

She started with hoping to find scientific truth about human bias. She ends with the hope that humans can overcome it and make that progress last.

Inescapable Harm from Implicit Bias

Bias makes its way into every facet of our existence. Some people are explicit about it. They aim to harm people who are different from them because of race, gender, size, or any number of other dimensions.

But more often – and perhaps more devastatingly – it comes in subtle implicit little cuts. Fear of a black man. Questions that raise doubts about ideas advanced by a woman. Assumptions about the health of a large person.

The overwhelming harm of such implicit bias and reasons to hope for ending it are the focus of Nordell’s fine book.

Implicit Bias in Healthcare

One of the most pernicious contexts for bias is healthcare. Recently, Skip Murray offered us a glimpse of how implicit weight bias in healthcare unfolds:

“I don’t like going to the doctor to begin with. I’m really tired of ‘pop some pills, don’t do nicotine, and lose some weight.’ I’m a very modest person. Super uncomfortable with showing my body.

“I was having health issues and they were trying to eliminate possibilities. First up: blood pressure. The nurse puts the cuff on my arm and it doesn’t work. She grabs a different one, apologizes it’s smaller, but the big one isn’t working.

“Why not go get a bigger one? So, she uses the smaller one and it was so tight it bruised my arm. Next up: EKG, she digs in a drawer in the room and pulls out a gown, says sorry, there aren’t any bigger ones in here.

“Why not go get a bigger one? That one was so tight, I could barely get my arms in it. And I couldn’t hold it shut (had to be open in the front) because it wasn’t big enough. I was so embarrassed.

“The shame was so intense, I couldn’t even advocate for myself and request things the right size. How can a nurse care so little about how things too small made me feel? And our clinic wonders why I don’t come in more often. Why would I?”

This kind of ritualized humiliation requires no explicit insults. The whole experience is thoroughly demeaning without a harsh word spoken. Human narratives such as this tell us exactly what pervasive, implicit bias is all about and the harm it does. In a setting meant to improve our health, systemic bias inflicts harm instead.

How-To Change Our Hearts

Nordell has written a very different sort of how-to book. She says that what is required to end bias is a change of heart, challenging us to think differently about ourselves and everyone around us. We can begin with a greater awareness of our own biases. That awareness prepares us to “unwind harmful and unexamined patterns of thinking, practice seeing one another and ourselves with new eyes, and build cultures to support this transformation.”

Thus, she says we can build processes into our institutions and organizations that reduce the role of bias every day. She describes how this has worked in different settings. These narratives make for a book that is both hopeful, credible, and rewarding to read. Her book points the way to a better existence through the end of bias.

Click here, here, and here for more about this fine book.

End of the Day, Jávea; painting by Joaquín Sorolla / WikiArt

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October 23, 2021