Another Feeble Argument for “Affirmative Action”
People who are in favor of continuing America’s obsession with group proportionality keep advancing arguments that it’s imperative for our institutions to “mirror” society. That is to say, it’s good if a group of people is composed of individuals so that it has roughly the same percentages of people “representing” blacks and Hispanics and women and Aleutian Islanders and so on as we find in America at large. Conversely, it’s presumptively bad if a group doesn’t have the right percentages of our social and ethnic blocs.
Recently I came across a new piece in this genre, published in the prestigious New England Journal of Medicine. The authors of “Affirmative Action in the Balance” contend that medical schools need to be free to choose their student bodies using racial preferences, and they’re worried that the Supreme Court might rule against the use of such preferences in Fisher v. Texas. Here is the keystone of the argument: “Future generations of physicians need to mirror the society they serve, and this will not happen unless medical schools are permitted to pursue holistic admission policies that consider race and ethnic group….” The notion that group proportionality is vital is widespread, at least among liberal intellectuals. Recall that Bill Clinton declared that he was determined to have “a Cabinet that looks like America” and therefore made a point of having “representation” by women and minorities. It made for nice political rhetoric, but American women were not any better off just because Janet Reno was the Attorney General, and blacks were not any better off just because Ron Brown was the Secretary of Commerce.
But what about the medical profession? Wouldn’t it be problematic if too many doctors were white and male, too few female or minority? Not at all. Each doctor serves his or her own patients and does so not as a “representative” of any ethnic or other sort of group, but as an individual who has particular knowledge and skill. A patient probably knows nothing about the overall group composition of the medical profession in the nation and only cares about the capability of the physician who treats him. The doctor’s ancestry has no more to do with that than does his political affiliation, his musical preferences, his religion, or anything else. From a public policy standpoint, we should want the system that maximizes the number of highly capable people who enter medical school. We should not worry about getting overall percentages of students to “mirror” society. Furthermore, racial preferences can do almost nothing to alter the percentages of individuals who enter the medical profession. They don’t cause any more students in “underrepresented” groups to take the MCAT and apply to medical schools. All they do is slightly redistribute where they go to medical school and in a few marginal cases, lead to the admission of a “minority” applicant rather than another student. (That was the case in Bakke, but the authors fail to mention that the favored minority student, Patrick Chavis, turned out to be a disastrously bad doctor.)
One more argument the authors advance is that physicians need to have “cultural competence” in their dealings with patients. That may be true in some instances where the patient comes from a very different culture than the physician, but the solution for that problem, to the extent that it exists, is not to try to make the medical profession as a whole “mirror” society, but to provide the necessary cultural training for those physicians who might be apt to have to deal with such patients. If a clinic in the Miami area, for example, treats many Haitians, it should make sure that the doctors who work there are familiar with Haitian language and customs that might be relevant in diagnosing and treating illness. That makes sense, whereas an effort at getting the “right” percentage of black students, almost none of whom will know anything about Haitians, into medical school, does not.
The country needs to get over the diversity mania and focus on individual characteristics, just as Reverend Martin Luther King, Jr. suggested back in 1963.