Physician and other healthcare organizations panned the Supreme Court’s decision last week striking down the use of affirmative action policies in college admissions.
The decision “is a direct blow to people of color across the United States, who are already at risk of poor health outcomes,” Molly Meegan, JD, general counsel and chief legal officer of the American College of Obstetricians and Gynecologists (ACOG), said in a statement. “We know that racial diversity in healthcare literally saves lives: research and experience have shown time and time again that disparities in health outcomes decrease when patients are treated by health care professionals who have learned and worked alongside colleagues of different racial and ethnic backgrounds.”
“The best way to ensure diversity in the medical workforce is through holistic considerations of medical school candidates that take into account race, ethnicity, and the lived experiences that each candidate could bring to their career as a physician because of their background,” she added.
Meegan was referring to the high court’s 6-3 decision on June 29 in the case of Students for Fair Admissions, Inc. v. President and Fellows of Harvard College, in which a group of Asian students asserted that the affirmative action policies used by the admissions departments of Harvard and the University of North Carolina (UNC) were illegal under the Equal Protection Clause of the 14th Amendment to the Constitution.
“Because Harvard’s and UNC’s admissions programs lack sufficiently focused and measurable objectives warranting the use of race, unavoidably employ race in a negative manner, involve racial stereotyping, and lack meaningful end points, those admissions programs cannot be reconciled with the guarantees of the Equal Protection Clause,” Chief Justice John Roberts Jr. wrote; he was joined by justices Samuel Alito Jr., Clarence Thomas, Brett Kavanaugh, Neil Gorsuch, and Amy Coney Barrett. “Many universities have for too long wrongly concluded that the touchstone of an individual’s identity is not challenges bested, skills built, or lessons learned, but the color of their skin. This nation’s constitutional history does not tolerate that choice.”
But the justices did give colleges and universities an alternative: “At the same time, nothing prohibits universities from considering an applicant’s discussion of how race affected the applicant’s life, so long as that discussion is concretely tied to a quality of character or unique ability that the particular applicant can contribute to the university.”
The court’s remaining three justices disagreed. With its decision, “this court … rolls back decades of precedent and momentous progress,” wrote Justice Sonia Sotomayor, who was joined in dissent by justices Elena Kagan and Ketanji Brown Jackson. “It holds that race can no longer be used in a limited way in college admissions to achieve such critical benefits. In so holding, the court cements a superficial rule of colorblindness as a constitutional principle in an endemically segregated society where race has always mattered and continues to matter. The court subverts the constitutional guarantee of equal protection by further entrenching racial inequality in education, the very foundation of our democratic government and pluralistic society.”
Like ACOG, the American Medical Association (AMA) also panned the decision, with AMA President Jesse Ehrenfeld, MD, saying the ruling “undermines decades of progress centered on the educational value of diversity, and will reverse gains made in the battle against health inequities.”
“This ruling … will translate into a less diverse physician workforce,” he said in a statement. “Diversity is vital to healthcare, and this court ruling deals a serious blow to our goal of increasing medical career opportunities for historically marginalized and minoritized people.”
The ruling “undermines policy that was producing positive results and improving the health of our patients, as well as making all physicians better practitioners,” Ehrenfeld concluded. “This ruling is bad for healthcare, bad for medicine, and undermines the health of our nation.”
The American Academy of Family Physicians (AAFP) also weighed in. “The lack of a diverse physician workforce has significant implications for public health,” AAFP President Tochi Iroku-Malize, MD, MPH, said in a statement posted on Twitter. “The AAFP remains committed to advocating for equitable representation and opportunities in medicine and ensuring individuals from underrepresented communities can pursue a career in family medicine.”
Omar Atiq, MD, president of the American College of Physicians (ACP), said in a statement that his organization was “disappointed” by the decision; he noted that “a diverse physician workforce should include individuals of all races, including Indigenous, Black, Latinx, Asian American, Native Hawaiian, Pacific Islander, and other persons affected by discrimination to better reflect the population for whom we care.”
“Considering race as one of the many determining factors used when considering an individual’s admission to an education program can be an important way to combat the harm that systemic racism and discrimination has in the United States,” said Atiq.
Another disappointed organization was the Association of American Medical Colleges (AAMC), which represents the nation’s medical schools. “We are deeply disappointed with the Supreme Court’s decision to dismantle its longstanding precedent in the 2003 case, Grutter v. Bollinger, which had recognized student body diversity as a compelling interest permitting the limited consideration of race in admissions,” AAMC president and CEO David Skorton, MD, and AAMC chief legal officer Frank Trinity, JD, said in a joint statement. “Today’s decision demonstrates a lack of understanding of the critical benefits of racial and ethnic diversity in educational settings and a failure to recognize the urgent need to address health inequities in our country.”
The AAMC said its members “will work together to adapt following today’s court decision without compromising these goals.” The organization did not respond by press time to a query about what actions it was planning to take.
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Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow
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