• care systems
• communication
• ethics

Bagel slicing can be hazardous, so though I’d always emphasised safety, it wasn’t entirely surprising when my daughter cut her finger, requiring a trip to urgent care. Our 23-year-old daughter was adopted in China at 14 months, so what did surprise me was the first question from the nurse, addressed to me in the suburban waiting room: ‘does she speak English?’ Having seen my reactions to similar questions posed to my Chinese-American wife, my daughter gave me the ‘don’t say anything, Dad’ look. While I have had perhaps more than my rightful share of indignation when my wife (who was born in New York) is asked ‘where are you really from’, as a white man, I have never experienced this kind of microaggression (or macroaggression) directly. Sadly, inured to these questions, my wife generally responds with a ‘happens all the time’ sense of resignation.

I wrote a letter to the chief executive officer (CEO) of the hospital, thanking him for the good medical care, but noting what I believed to be unconscious bias. There is ample evidence that there is systemic bias in the healthcare system, and that this bias can lead to adverse outcomes. The UK NHS Midlands Leadership Academy has prepared an extensive toolkit to help deal with unconscious bias,1 and the Public Health Agency of Canada issued a report …