Purpose: The purpose of this research was to (1) examine the extent that empathy and perceived patient pain affect racial biases in pain treatment and (2) attempt to reduce this racial bias via direct manipulations of the proposed mediators.
Method: Across two experiments participants (university undergraduates) viewed four videos of real patients suffering from acute pain, made treatment decisions (i.e. pain prescriptions), and provided responses indicative of emotional empathy and perceived patient pain. Experiment 1 examined the extent that empathy and perceived patient pain statistically mediated racial bias in pain treatment. Experiment 2 attempted to directly reduce racial pain treatment bias by manipulating empathy through perspective taking instructions that guided participants to imagine how the pain was affecting patients' daily lives. It was proposed that perspective taking instructions would increase empathy and thus decrease the racial pain prescription gap in comparison to a control group.
Result: Results from experiment 1 indicated that patient race had direct effects on empathy and pain treatment with participants feeling less empathy and prescribing less pain medication for African American patients. A mediation analysis confirmed that empathy was mediating the effect of race on pain prescriptions. Individual-level analyses indicated a strong positive correlation among treatment disparities, empathy disparities, and perceived patient pain disparities. Both perceiving European Americans to be suffering from more pain than African Americans, and experiencing stronger empathic reactions for European Americans pain was associated with greater racial bias in prescription behavior. Results from experiment 2 indicated that the perspective taking manipulation eliminated racial pain treatment bias. Further analysis indicate that the perspective taking manipulation was acting through both empathy and perceived patient pain.
Conclusion: Pain treatment disparities were found in a sample of individuals without medical training, suggesting that the proclivity for racially biased pain treatment exists well before medical training. Furthermore, pain treatment disparities appear to be affected by empathy and perceived patient pain, and interventions that target these processes eliminated this bias. However research that extends this paradigm to real healthcare professionals in real world medical settings is needed.
Candidate for the Lee B. Lusted Student Prize Competition