Fast Company: Pulse oximeters are racist

June 3, 2022

By Tim Worstall

Fast Company manages to get a part of medical treatment either wrong, or the wrong way around – that’s up to you to decide. Their headline reads, “Pulse oximeters are racist, and that likely cost lives during COVID-19.”

The correct answer – and as above, we have a choice here – is either that this is nonsense, since racism depends upon intent and as pulse oximeters are objects, they cannot have intent. Or, our alternative answer, pulse oximeters don’t distinguish between people of different races and therefore are not racist enough.

Which is very different from the assertion here:

“But pulse oximeter readings are notoriously racist, routinely overestimating the amount of oxygen inside Black and Hispanic bodies.”

A pulse oximeter is trying to measure oxygen in the blood. It does so by shining light through the skin, seeing how it changes as it comes out the other side then calculating. We can obviously see that skin color might change such readings, possibly not to the benefit of people with certain skin tones. But we’d not normally say that the machine is being racist – that accusation always has the meaning of there being intent. As machines don’t have reason therefore they can’t have intent. To call the machine racist is like saying that the lamp itself is as reflections from different skin colors are, well, different colors.

The other possible explanation is that we should indeed treat people equally. But there are times when race really does matter – like when shining light through skins of different colors. So treating people exactly equally, with the same machine, using the same calculations, is between less than optimal and wrong if we do so. That is, we are not taking account of racial differences here, are treating people too equally and so are not being racist enough.

Either the machine is simply a machine and cannot be racist, or the difficulty is that we are not treating people of different races in the different ways that they need to be treated – we are being color blind and so non-racist as to be wrong.

Fast Company tries to look at the online business world, the tech world. It has a significant presence in that sector of the media and gains some 6 million visits a month from having that. The readership trends to those who work in those industries.

The actual solution to this problem of the pulse oximeters is that several types are made, the calculations concerning the connection between light being shone though skin and oxygen in the blood are redone and they encapsulated in different versions. We then use different versions on Black, Hispanic and White patients. The solution is to treat those of different physical attributes differently, to distinguish on the basis of race. That is, there really are times when to be entirely color blind and offer wholly equal treatment isn’t the right thing to be doing. But it’s still not racist to be that way now, is it?


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