American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

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From the Board of Governors Diversity Pillar: An Introduction to Common Terms of Diversity, Equity and Inclusion 

by the ACS Board of Governors Diversity Pillar: Communication/Advocacy Subcommittee 

“If you cannot define it, you are not part of the conversation.” 

—Shannon Marie Foster, MD, FACS  

In the realm of medicine and surgery, a common vocabulary and agreed-upon shared terminology allows the ready exchange of ideas that can cross practice, geographic, language and cultural barriers. 

As such, it is in the evaluation of who we are and who we want to be as humans relating to other humans that we must come to understand the language of diversity, equity and inclusion. If we do not speak with the same shared vocabulary, we cannot truly participate in the conversation.  

Racism is defined as a belief or doctrine that inherent differences among the various human racial groups determine cultural or individual achievement, usually involving the idea that one’s own race is superior and has the right to dominate others or that a particular racial group is inferior to others. Racism may be the belief of one, of many or of the ruling/political group in power. If the latter, the term institutional racism is applied and can be defined as a policy or system of law/government that is associated with this racist belief system and favors members of the dominant racial or ethnic group or has neutral effect on their life experiences while discriminating against or harming members of other groups. When accepted, this standard serves to preserve the social status, economic advantage or political power of the dominant group. Alternatively, anti-racist belief and action rejects supremacy of one group over another and enacts doctrine and policy, which recognizes the presence of racism in society and actively combats prejudice and discrimination to promote racial justice.  

As concepts of self-identification and the labeling of “others” permeates every part of our life—home and office, work and play for the young and the old—we can either deny or ally. Othership is the means by which we divide and classify groups as different and needing rules and policies different from those of the accepted “normal” or “standard”—often ourselves. Allyship is an active choice to advocate and support those who define themselves differently—race, religion, nationality and gender identity are some common examples—and ensure no separate rules or standards exist.  

There are two ways to go about allyship. Performative allyship can be defined as that performed to demonstrate and increase social capital and an individual’s or group’s moral compass without true action or, worse, to the detriment of the movement by stealing and misdirecting attention and messaging. Real allyshipsolidarity—is based in constant education and can be defined as intentional union or fellowship with a marginalized, underrepresented or discriminated-against group to act, aid and promote at the discretion of the group itself as an accessory, not a scene stealer.  

Conversations using these shared and understood terms and ideas will allow change that is transformative (radical, all-encompassing and embraced as the base of thought, character and condition), rather than transactional (an enforcement of new rules, guidelines or measures as a mere path to conducting business as usual). In our departments, our homes, and our communities, let us make changes like those we have all striven for in the quality measures of better patient outcomes. As we know, the conversations leading to quality change are hard and may be met with resistance, but at their base they are inspirational and motivational, not accusatory or punitive. Accordingly, the same must be true for our culture.  

No matter our age, beliefs, lifestyle or location, let us make sure that we can all join the conversation. 

(There are an overwhelming number of resource and reference materials available for further reading on each of these subjects—please start your research effort by typing any one of these bolded terms into Wikipedia or your institutional medical library and follow your interest.)