Zinhle Mncube (University of Johannesburg) - Racial categories are widely used in biomedicine. Epidemiologists stratify health outcomes according to racial categories. Pharmaceutical companies develop so-called ‘race-based medicines’ targeted at people of specific racial categories. In clinical practice, doctors consider an individual’s race in testing for certain diseases and for prescribing treatment. Critics of the use of racial categories in biomedicine argue that: (i) race is a non-scientific concept; (ii) racial categories are a bad proxy for genetic variation in human population groups; (iii) the use of racial categories in medicine essentializes and reifies race; and (iv) the use of racial categories can engender bad consequences for patients (for example, it is possible that a treatment held for “white” patients could work on a “black” patient. However, the argument goes, if racial categories are used in the prescribing of drugs, the black patient might not get the treatment that would work for her). My aim in this paper is to address the following epistemological question: is the use of self-identified racial categories as a proxy for differences in medically-relevant risk factors (genetic, and/or social and environmental) warranted in biomedicine? That is, is there warrant for this use of racial categories if the goal is to elucidate the risk factors involved in differences in therapeutic drug response and treatment between people? My claim is that there is an evidential basis for including self-identified racial categories in biomedicine — although crude, racial categories can provide valuable information about variation in the genetic, social and environmental risk factors involved in therapeutic drug response and treatment. I argue that the use of self-identified racial categories is warranted in biomedical research and practice, because, in relevant cases, it works.
