Academic Review 2024

30 ST EDWARD’S, OXFORD

that a healthcare professional’s judgement is both situational and valid due to their knowledge. Patient safety is affected by the halo and horn effect. The cognitive bias known as halo effect is the judgement of an individual formed and influenced by a single characteristic (Neugaard, 2016). In a healthcare context the halo effect is positive as it means the healthcare provider has observed a patient’s positive trait meaning they will view them in a positive way (Imperial College London, n.d.). This “desirable” trait can lead to better care and reduced discrimination. The opposite of the halo effect is the horn effect which can also impact healthcare and patient safety. If a patient has a trait which the healthcare provider perceives as negative, then this means that they will be viewed in a negative way. The patient may be treated badly because of this “negative” trait. This can lead, for example, to their pain being dismissed or a doctor not listening to them as they have been deemed as unintelligent. Their diagnosis could possibly be affected because of this (Nisbett & Wilson, 1977). The halo and horn effects are examples of how people can be categorised as in-group or out-group causing positive or negative perception. society. Residential schools were federally funded but run by Christian churches. (Hanson, Gamez, & Manuel, 2020). On behalf of the Indigenous people who were medically experimented on without their knowledge and consent a class action lawsuit was filed against the Canadian government in 2018. The class action lawsuit accused the government of inadequate medical care which they provided at “Indian hospitals” (racially segregated hospitals set up for First Nations and Inuit people in Canada (Lux, 2017). This type of discrimination was caused by explicit bias. SEGREGATED HOSPITALS IN CANADA Even though these hospitals provided healthcare it was discriminatory and at a lower standard compared to other Canadian hospitals. In the 1960s David Melting Tallow spent three years in an “Indian Hospital”. When he was 16, he underwent lung resection while awake, even though the treatment

cortex involved in the processing of conflict) but activity in the nucleus accumbens (involved in the expectation of reward) lowers (Agarwal, 2020). The release of dopamine in the nucleus accumbens (Dfarhud, Malmir, & Khanahmadi, 2014) shows how implicit bias is linked to the reward system in the brain. Therefore, people choose the route where they will receive rewards leading to the affirmation of their current beliefs instead of adapting them. A professor of psychology at Princeton called Susan Pike said that prejudice can be described as ‘emotional biases that can lead to discrimination which can alter our instincts about people and situations’ (Agarwal, 2020). Instincts play a big role in healthcare. Nurses must decide if after a procedure they should let a patient rest or wake them up for tests. They use instincts which can be impacted by the racial biases which a nurse holds. Clinical instinct has been justified by the law for example in the case of Mueller v. Auker in the US (Patel, 2014). The court ruled that even though the parents were against their child getting tested the doctor’s clinical instinct was vital and a ‘well recognized and accepted feature of medical emergency practice’ (Patel, 2014). This case shows The terms used to describe Indigenous people in this paragraph may be found as offensive to some but most are accepted by the Indigenous community. The term “Indian” is only used to refer to hospitals and an act created by the Canadian government. It creates monolithic identity as it is often not the correct self-definition of Indigenous people and has roots in the colonial era (Bird, 1999). First Nations is an umbrella term which describes Ojibway, Dene, Metis and Cree people (Marks, 2014). Preferred terms are those that are from the language of the Indigenous people as they are more authentic and represent them better. I use umbrella terms like First Nations because all Nations faced discrimination. The Canadian parliament passed the “Indian Act” in 1876 (Voce, Cecco, & Micheal, 2021). This act led to Indigenous children being separated from their families and forcibly sent to residential schools with the purpose of assimilation into Euro-Canadian The history of discrimination in healthcare towards people of colour (POCs) and women