Overcoming the Racial Hierarchy: the History and Medical Consequences of "Caucasian".

The term Caucasian is ubiquitous in the medical field. It is used without a significant consideration of its history or medical necessity. First, the term Caucasian has racist historical origins in a beauty-based hierarchy with implied superiority. It is derived from a 1700's historical scheme which places Caucasians above the other, degenerated racial groups. Second, the pseudo-scientific justification for this hierarchy has been co-opted to legally justify discrimination against minority groups in the USA. Third, the unnecessary and incorrect application of antiquated racial identifiers negatively impacts patient care. Disentangling real, clinically meaningful genetic differences from superficial racial determinations remains an ongoing challenge. Framing patient care through Caucasian or white lens leads to the unequal care and the otherization of minority groups. Fourth, we must develop a more appropriate, racially sensitive system for patient identification in clinical practice and research. This demands intentionality, precision, and consistency.