Few topics in medical ethics stimulate as much heated debate as the question of the proper place of religious beliefs in medical practice. Typically, this debate is orientated towards questions about the religious beliefs held by medical practitioners, and in particular the appropriate limits that ought to be placed on these beliefs shaping care in ways that might impact negatively on patients’ interests. In this issue, however, it is the religious beliefs of patients themselves, and how these beliefs ought to (...) be responded to by clinicians, that is the focus of analysis. In their Feature Article, Greenblum and Hubbard (pages 705–10) articulate a strong position in response to this issue. Their fundamental claim is that clinicians should not deliberate about religious commitments with religious patients when these patients are drawing on these commitments in the medical decision-making process. They present two main arguments in support of this claim: the public reason argument and the fiduciary argument, and they contend that the discussion of religious considerations should be compartmentalised and farmed out to another appropriately placed person, such as a member of the clergy. Stimulating six commentaries that interrogate aspects of both arguments and the authors’ practical proposal, Greenblum and Hubbard’s paper gets to the heart of the challenge of reconciling the public role of medical practitioners with the private encounters that substantiate the performance of this role. Greenblum and Hubbard’s first argument is that clinicians ought to limit their deliberations in decisions made with patients to presenting ‘considerations that any reasonable person could recognise as counting in favour of something’ (page 707). Drawing on the work of John Rawls and Robert Audi, the authors discount the place of religious reasons in …. (shrink)

Rudolf Steiner, the often undervalued, multifaceted genius of modern times, contributed much to the regeneration of culture. In addition to his philosophical teachings, he provided ideas for the development of many practical activities including education--both general and special--agriculture, medicine, economics, architecture, science, religion, and the arts. Today there are thousands of schools, clinics, farms, and many other organizations based on his ideas. Steiner's original contribution to human knowledge was based on his ability to conduct spiritual research, the investigation of (...) metaphysical dimensions of existence. With his scientific and philosophical training, he brought a new systematic discipline to the field, allowing for conscious methods and comprehensive results. A natural seer from childhood, he cultivated his spiritual vision to a high degree, enabling him to speak with authority on previously veiled mysteries of life. Topics include: true human nature as a basis for medical practice; the science of knowing; the mission of reverence; the four temperaments; the bridge between universal spirituality and the physical; the constellation of the supersensible bodies; the invisible human within us: the pathology underlying therapy; cancer and mistletoe, and aspects of psychiatry; case history questions: diagnosis and therapy; anthroposophic medicine in practice: and three case histories. (shrink)

Volume 23, Issue 3-4, November - December 2024, Page 245-250.

This article demonstrates, by use of specific theological paradigms, how medicine functions as religion. In doing so, medicine promotes anti-feminist beliefs, symbols, social memories, and churchly structures. The essay then examines the enhancement of women's health from a feminist philosophical perspective. It argues against fetishizing in health promotion to the extent that everything comes to be regarded as therapeutic. Medicine has advanced the ideology that life itself is a disease to be cured or, at best, prevented. Alternative ethics of (...) health promotion could revise this tendency of regular medicine to appropriate all of life into the medical domain, advocating that all sorts of simple daily activities are profoundly therapeutic in some way. Rather, health must be viewed as the constant attempt to re-create a female environment that is Self-defined on the boundary of an environment that is man-made. CiteULike Connotea Del.icio.us What's this? (shrink)

In ancient Greece and Rome magical and religious healing continued to be practised at the same time as a burgeoning of research and learning in the natural sciences was promoting a seemingly more rational and scientific approach to medicine. Was there, then, a dichotomy in medical treatment or was the situation more complex? This paper draws on historical textual sources as well as archaeological research in examining the question in more detail. Some early texts, such as the Egyptian papyri from (...) about 2,600 bc and the Hippocratic Corpus from the third and fourth centuries bc, contain an intriguing mixture of scientific and religious material. Archaeological evidence from, for example, sites of healing sanctuaries from ancient times, show medical prescriptions used as part of votive offerings and religious inscriptions on surgical instruments, while physicians were prominent among donators to shrines. Other archaeological finds such as the contents of rubbish tips, buried hoards, sepulchral deposits and stray artefacts from occupation levels, have also added to the archive of medical material available for discussion. The paper concludes that such intertwinings of religion and science were not only common in Roman medicine but, in fact, continue into the present time. (shrink)

This unique collection of writings by physicians and other health care providers looks at various topics in the arts and humanities, showing a side of the medical profession rarely seen. In this reversal of the usual practice of humanists looking at medicine, the writers here discuss such areas as 'The Physician as Creative Reader,' 'Religion in the Life of the Physician,' 'The Surgeon as Sculptor,' 'The Physician in the Arms Race,' among others.

Hui medicine is originated from Muslim medicine through Silk Road. This medicine is a unique Chinese traditional medicine system formed by the integration of traditional Islamic Arabia medicine and traditional Chinese medicine. This ethnic medicine is Sinicization of Islamic culture. It is also the cream of ancient Eastern and Western traditional medicine of China. Religion is very important for the Islamic faith population such as Hui nationality. Although Halal food, restaurants and schools are everywhere in Qinghai Xining city, there (...) are not reports about the medical practice in the Muslim faith population. In this article, the in-patients are from Qinghai Kangle Hospital which is Hui medicine special hospital located in Hui majorities area in Qinghai Chengdong area. The data had been collected from January 1, 2020 to June 30, 2023 of COVID-19 period. This hospital served both Muslim and non-Muslim patients, and the medical doctors nurses and staffs are also come from Muslim and non-Muslim background, the education background is Western medicine and Traditional Chinese Medicine. Our results showed that there are no significant difference between the Muslim-believers and non Muslim-believers in their medical practice. The religion may not be important among the inpatients who served with Chinese Hui Medicine in Kangle Hospital. (shrink)

The main purpose of this article is to explore, from an ethical perspective, one particular branch of what is today called “spiritual medicine”: namely, prayer therapy. Several landmark studies in the literature will be thoroughly examined, respectively the classical study of Byrd (1988), the replica of Harris et al. (1999), and the controversial study of Leibovici (2001). Beginning with these studies and the related controversies surrounding them, the religious features and ethical consequences of prayer therapy are investigated. The ethical aspects (...) of prayer therapy – the informed consent issue, the issue of respecting bioethical principles, and the issue of medical competence in offering such techniques – are thoroughly addressed. Finally, an alternative way of framing the prayer therapy discussion is offered, in the context of public-private dichotomy. (shrink)

In this article, I defend the view that conscience exemption clauses for medical practitioners (doctors, nurses, technicians, pharmacists) should be limited by patient protection clauses. This view was also defended by Mark Wicclair, in his book on conscience exemptions in medicine (Cambridge UP, 2011). In this article, I defend Wicclair’s view by supplementing it with Hegelian ethical theory and feminist critical theory. Conscience exemptions are important to support as a matter of human rights. They support an individual’s right to protect (...) their deepest value-commitments. A true understanding of conscience is dialectical, however, and it requires patient protection clauses because they, too, protect individuals in their deepest value-commitments. In this article, I show that the defense of patient protection clauses is historically supported by the theory of “conscience [Gewissen]” developed by G.W.F. Hegel in the nineteenth century (mostly in the Phenomenology of Spirit (1807)). (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by bringing (...) medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

The connections of Medicine and Religion are thoroughly documented in the primitive societies, and it comes as no surprise to see them together. Here we describe the true story of a Portuguese physician of the late 19th century whose image today is venerated in such a way as to compare him to a saint and to bestow upon him miraculous powers of healing. We propose that modern day physicians can learn from the example of this man that the role (...) of doctor encompasses not only scientific and technical mastery but, most of all, piety, humanity and compassion. (shrink)

Precision medicine (PM) aims to revolutionise healthcare, but little is known about the role religion and spirituality might play in the ethical discourse about PM. This Perspective reports the outcomes of a knowledge exchange fora with religious authorities in Singapore about data sharing for PM. While the exchange did not identify any foundational religious objections to PM, ethical concerns were raised about the possibility for private industry to profiteer from social resources and the potential for genetic discrimination by private (...) health insurers. According to religious authorities in Singapore, sharing PM data with private industry will require a clear public benefit and robust data governance that incorporates principles of transparency, accountability and oversight. (shrink)

What do medicine and war have to do with each other? This question is explored through the writings of James Childress, whose early contributions to just war theory illuminate his work in bioethics. By considering the conceptual influences of just war theory on Childress’s bioethics, the contributions and limits of his approach can be set in relief through normative engagement with certain areas of medicine. In particular, Childress’s just-war-inspired bioethics befits the practice of surgery; but oncology, as a medical analogue (...) to total warfare, requires significant transformation in order to be disciplined by Childress’s approach. Childress offers a coherent schema for navigating moral conflict in a fallen world, but he does not provide a substantive account of the peaceable end toward which medicine as just war aims. (shrink)

A THEOLOGICAL BIOETHICS NEEDS, FIRST, A THEOLOGICAL POLITICS. THE thesis of this essay rests on the claim that the contours of a theological politics are found in the nature of sacramental practices. More specifically, a theological politics of medicine is found in the sacramental practice of anointing of the sick. Anointing provides a radically theological hermeneutic—a theologically robust vision for interpreting medicine that, if enacted, can powerfully make real God's work in the world. Such a vision is embodied in one (...) particular twentieth-century exemplar—the organization called Partners In Health and its cofounder, Paul Farmer. Farmer and PIH, I argue, live the theologic and theological politics of medicine embodied in the practice of anointing. What is more, they show—against those who would accuse such an approach of being naively idealistic—that such a theological politics is possible, powerful, and can even change the world. (shrink)

Volume 23, Issue 3-4, November - December 2024, Page 251-263.

Background Medical Assistance in Dying in Canada came into effect in 2016 with the passing of Bill C-14. As patient interest and requests for MAID continue to evolve in Canada, it is important to understand the attitudes of future providers and the factors that may influence their participation. Attitudes towards physician hastened death in general and the specific provision of MAID are unknown among Canadian residents. This study examined residents’ attitudes towards PHD and MAID, and identified factors that may influence (...) their decision to participate in PHD and provide MAID. Methods A cross-sectional survey was adapted from prior established surveys on MAID to reflect the Canadian setting. All Canadian family medicine programs were invited to participate. The survey was distributed between December 2016 and April 2017. Analysis of the results included descriptive statistics to characterize the survey participants and multivariable logistic regressions to identify factors that may influence residents’ attitudes towards PHD and MAID. Results Overall, 247 residents from 6 family medicine training programs in Canada participated. While residents were most willing to participate in treatment withdrawal, active participation in PHD and MAID by prescription of a lethal drug and lethal injection were less acceptable. Logistic regressions identified religion as a consistent and significant factor impacting residents’ willingness to participate in PHD and MAID. Residents who were not strictly practicing a religion were more likely to be willing to participate in PHD and MAID. Increased clinical exposure to death and dying crudely correlated with increased willingness to participate in PHD and MAID, but when examined in multivariable models, only a few activities had a statistically significant association. Other significant factors included the residents’ sex and location of training. Conclusions Residents are hesitant to provide MAID themselves, with religious faith being a major factor impacting their decision. (shrink)

Critically exploring medical thought in a cultural milieu with no discernible influence from the European Enlightenment, _Being Human_ reveals an otherwise unnoticed intersection of early modern sensibilities and religious values in traditional Tibetan medicine. It further studies the adaptation of Buddhist concepts and values to medical concerns and suggests important dimensions of Buddhism's role in the development of Asian and global civilization. Through its unique focus and sophisticated reading of source materials,_ Being Human_ adds a crucial chapter in the larger (...) historiography of science and religion. The book opens with the bold achievements in Tibetan medical illustration, commentary, and institution building during the period of the Fifth Dalai Lama and his regent, Desi Sangye Gyatso, then looks back to the work of earlier thinkers, tracing a strategically astute dialectic between scriptural and empirical authority on questions of history and the nature of human anatomy. It follows key differences between medicine and Buddhism in attitudes toward gender and sex and the moral character of the physician, who had to serve both the patient's and the practitioner's well-being. _Being Human_ ultimately finds that Tibetan medical scholars absorbed ethical and epistemological categories from Buddhism yet shied away from ideal systems and absolutes, instead embracing the imperfectability of the human condition. (shrink)

Mission hospitals founded by American Board missionaries in the late Ottoman period set an unusual example within the broader framework of Ottoman provincial healthcare services. These hospitals provided free health services to many poor and needy patients irrespective of their ethnic and religious origins: most importantly, they had access to Muslims, unlike typical Catholic and Protestant missionary institutions which were only able to operate among the non-Muslim population of the empire. By these means, mission hospitals managed to gain the sympathy (...) of both the local population and Ottoman local officials. This study will focus on the historiography of mission hospitals and the fundamental debates surrounding these institutions under the rubric of two main headings. First, the study will set out a short historiography of mission hospitals, their typical modus operandi and the audiences they reached out to in technical terms. Then, from a theoretical perspective, the study will shed light on the underlying motivations of these mission hospitals along with Ottoman governmental attitudes toward these institutions. (shrink)

Since ancient times, tattoos were a form of expressing spiritual trends or a life style. Our country does not have a very complex culture regarding tattoos or persons who practice this kind of art and thus for their bearers the majority of existing tattoos lack a special meaning. In forensic science, by conducting physical, traumatic expertise or by postponing the punishment, we find, a lot of times, persons in detention for different criminal acts, and the examination of these is necessary. (...) According to this retrospective study, we noticed an increased frequency of biblical tattoos in the case of convicts from the prisons that belong to Forensic Institute of Medicine from Cluj. We will try to find explanations in the forensic literature for the marks they have and if these have a special meaning for them, and also for the circumstances in which these were made. We will also present the church’s point of view regarding these practices. (shrink)

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)

In Jeffrey P. Bishop's The Anticipatory Corpse it is argued that the dead body has become epistemologically normative in contemporary medicine. In order to regain the communal bonds necessary for the responsive encounter with the other, medicine is in need of living traditions. This leads Bishop to question whether only theology can save medicine. The present essay takes up on this question with a reply from a Bonhoefferian anthropology, arguing for the embodied human being as being-there-with-others and shows how this (...) is Christologically shaped. The broader aim of the essay is to contribute to the debate on embodiment in theological bioethics. The essay maintains a normative understanding of the corporeal reality of what it means to be human and yet argues that this must always be understood in connection with the responsive relation to the other. (shrink)

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)

Religion and medicine -- Theology and medical ethics -- The profession and its integrity -- Life and its sanctity -- Health and healing -- Death and its (in)dignity -- Nature and its mastery -- Care of patients and their suffering -- Respect for persons and their agency -- Contraception -- Technological reproduction -- Genetic control -- Abortion -- Choosing death and letting die -- Care of neonates -- The physician-patient relationship: advise and consent -- Psychiatric care: professional commitments and (...) social responsibilities -- Research and experimentation -- Allocation and distribution.; This collection includes a wide range of contemporary theological essays dealing with medicine ethics, as well as some material from Scripture and from classical theologians. It contains the work of Catholics and Protestants, "liberals" and "evangelicals," as well as some contemporary essays not written by Christian theologians but of great importance for theological reflection. Together the essays provide a rich introduction to theological reflection on medical ethics and a convincing demonstration of the contribution theology can make to the consideration of issues in medical ethics. (shrink)

Against the common assumption that modern medicine is altogether secular and scientific, this article argues that the practice of medicine manifests characteristic features of religion. This exposition is predicated upon a delineation of the phenomenological characteristics of religion and upon a critical analysis of the ways scientific medicine does or does not manifest these characteristics. Insofar as medical practice is unknowingly religious, that practice can cause harm and delusion. An acknowledgment that scientific medicine embodies features of religion (...) is a beginning point for scholarly reflection, criticism, and research from a variety of academic perspectives. (shrink)

Principles-based biomedical ethics has been a dominant paradigm for the teaching and practice of biomedical ethics for over three decades. Attractive in its conceptual and linguistic simplicity, it has also been criticized for its lack of moral content and justification and its lack of attention to relationships. This book identifies the modernist and postmodernist worldviews and philosophical roots of principlism that ground the moral minimalism of its common morality premise. Building on previous work by prominent Christian bioethicists, an alternative covenantal (...) ethical framework is presented in our contemporary context. Relationships constitute the core of medicine, and understanding the ethical meaning of those relationships is important in providing competent and empathic care. While the notion of covenant is articulated through the richness of meaning taught in the Christian Scriptures, covenantal commitment is also appreciated in Islamic, Jewish, and even pagan traditions as well. In a world of increasing medical knowledge and consequent complexity of care, such commitment can help to resist enticements toward the pursuit of self-interest. It can also improve relationships among caregivers, each of whose specific expertise must be woven into a matrix of care that constitutes optimal medical practice for each vulnerable and needy patient. (shrink)

The essays assembled in this volume reflect my long-standing interest in moral philosophy and my conviction that the idea of a medical ethics as something ...

Volume 24, Issue 11, November 2024, Page 1-3.

This article is an interpretation of Kant’s Conflict of the Faculties as a mature work where the philosopher put the transcendental philosophy into practice. We will explain the conflict between theology, law, medicine, and philosophy and show how it can be reduced to the question: how are the synth..

Science and religion are incommensurable: one cannot use centimeters to measure volume. Science's proper cognate is theology. Science and theology are human activities that are basically conceptual (partly fallible) frameworks for explaining experience. Religion and technology, by contrast, involve and control or limit human practice and experience: they involve “sensate” reality—people and things. The study of the interaction of these four terms (or any two) must use the terms more precisely.Science as practiced today has become scientism, another theology. (...) Technology is, without any doubt, the world's most powerful and fastest growing religion.Minor squabbles among theologies, including science, must continue, but it is the tensions between technology and the established religions that will define this century. Battles on three fronts are already clear: the environment, globalization, and economic gaps. But whole–person healing, the replacement for high–tech reductionist modern medicine, is the most significant, because it will undermine science, which has hitched its wagon to this falling star.The end of fundamental science is upon us, because it has been so successful. Science will be increasingly applications–driven, and it will be judged by results. Here, it has met its nemesis in wholeperson healing that incorporates integrative medicine. Scientists must now reconsider their role in society. It will not be easy to accept a humbler position. Moreover, the vague allusions to spirituality by scientists need a more authentic commitment to praxis in lifestyle. (shrink)

Adolescence is an important yet vulnerable period of transition from childhood to adulthood. An increasing number of studies support the traditional Catholic view, which sees teens as prone to making poor decisions when influ­enced by emotions or peer pressure but capable of thriving when guided by parents and religion. However, newer policies of medical societies undermine the traditional supports of family and faith with a permissive approach toward sexual exploration. To counter this unhealthy trend, which seems to be based (...) more on postmodern ideology than robust science, Catholic physicians should become experts in adolescent behavior and sexual health. Physicians should be sensitive to opposing viewpoints but participate only in treatments which are ethical and beneficial for their patients. Specifically, Catholic physicians must avoid contraceptives, abortion, and “gender-affirming” therapies. By using good science and emulating the models of service, Socratic dialogue, and accompaniment, physicians can guide adolescents toward a virtuous, healthy adulthood. (shrink)

Volume 24, Issue 12, December 2024, Page 6-7.

This book situates biomedicine within American culture and argues that the very organization and practice of medicine are themselves cultural. It demonstrates the symbolic construction of clinical reality within American biomedicine and shows how biomedicine never leaves the realm of the personal.

Justifying the existence of professional ethics in medicine is usually connected with the traditions of a profession and with a humanistic dimension of these ethics, pointing at the same time to their culture-forming character. With such an attitude, professional ethics is treated as a part of all mankind’s output, and its teaching turns out to be an important element of preparation for taking part in culture. Taking into account the cultural meaning of professional ethics, one should notice that all discussions (...) about the character of relations of medicine and ethics exceed the very health care system. The dilemma outlined in the article deals with the problem whether the existence of medical ethics requires external regulations or is this also a creation of the very representatives of medicine and only they can formulate it. If the latter is to be assumed, ethics in medicine would have to be independent of other detailed ethics and it would not need to be included in any other more general theory. In the first solution, medical ethics is becoming a part of general ethics and, therefore, it would be justified to include it in a more general theory – bioethics. The authors indicate that professional ethics does not limit freedom of the staff but gives a special opportunity to use it. Records constituting its contents are mostly standardized by a professional group which sets criteria of recruitment on its own and general duties resting on their members. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, that of the (...) common good as a goal in medicine. (shrink)

The question, "Is medicine a social science?" can be understood in three different ways. One interpretation suggests that medicine is merely a social science, which is obviously false. Another interpretation is that medicine might be in part a social science. The third interpretation of the question is, "Is the social scientific dimension of medicine very important?" Three claims are considered about the social scientific dimension of medicine. Although these claims are shown to be untrue, they nevertheless call attention to neglected (...) aspects of medicine. CiteULike Connotea Del.icio.us What's this? (shrink)

America’s COVID-19 pandemic has both devastated and disparately harmed minority communities. How can the allocation of scarce treatments for COVID-19 and similar public health threats fairly and legally respond to these racial disparities? Some have proposed that members of racial groups who have been especially hard-hit by the pandemic should receive priority for scarce treatments. Others have worried that this prioritization misidentifies racial disparities as reflecting biological differences rather than structural racism, or that it will generate mistrust among groups who (...) have previously been harmed by medical research. Still others complain that such prioritization would be fundamentally unjust. I argue that, to pass muster under current law, policymaking in this area must recognize a crucial distinction: prioritizing minority communities, such as hard-hit neighborhoods, without regard to individual race is typically legal, but prioritizing individuals on the basis of their racial identity faces is likely not. I also explain how prioritization on the basis of Native American status is allowable and legally distinct from prioritization on the basis of individual race. -/- In Part II, I provide a brief overview of current and proposed COVID-19 treatments and identify documented or likely scarcities and disparities in access. In Part III, I argue that randomly allocating scarce medical interventions, as some propose, will not effectively address disparities: it both permits unnecessary deaths and concentrates those deaths among people who are more exposed to infection. In Part IV, I explain why using individual-level racial classifications in allocation is precluded by current Supreme Court precedent. Addressing disparities will require focusing on factors other than race, or potentially considering race at an aggregate rather than individual level. I also argue that policies prioritizing members of Native American tribes can succeed legally even where policies based on race would not. In Part V, I examine two complementary strategies to narrow racial disparities. One would prioritize individuals who live in disadvantaged geographic areas or work in hard-hit occupations, potentially alongside race-sensitive aggregate metrics like neighborhood segregation. These approaches, like the policies school districts adopted after the Supreme Court rejected individualized racial classifications in education, would narrow disparities without classifying individuals by race. The other strategy would address the starkly disparate racial impact of deaths early in life by limiting the use of age-based exclusions from vaccine or treatment access that explicitly deprioritize the prevention of early deaths and so disparately exclude minorities, and by considering policies that prioritize the prevention of early deaths. (shrink)