The Medical and Legal Plight of Sickle Cell Patients: A Case Study of Racial Disparities in Health Care and the Potential Legal Remedies

descent. 2 SCD is also the most common genetic disease in the US, as 1 in 12 African Americans carry the autosomal recessive mutation on one allele, and 1 in 500 African Americans are born with the disease due to inheritance of two mutated alleles. 3 The sickle cell mutation causes red blood cells to "sickle" and clump when partially depleted of oxygen causing the clots and subsequent ischemia that instigate the various SCD syndromes. 4 The numerous SCD syndromes include ischemic (venous stasis) leg ulcers, avascular necrosis of the hip, shoulder, or knee, cholecystitis or gallbladder colic, priapism, headache, and gout. 5However, the lifelong and unpredictable vaso-occlusive crisis pain which most necessitates consistent management, also makes SCD treatment so problematic. 6 Opioid analgesics are the well-established treatment for SCD, and there is no ethical controversy in administering opioids to SCD patients experiencing acute pain. 7 Early intervention with fluids and opioids is very important, because aborting VOC pain can prevent extensive tissue damage. 8 Nevertheless, despite all the evidence supporting treatment with opioids, SCD patients are often refused long-term pain management or are prescribed medications with lower efficacy than opioids. 9Unfortunately, there is no quick fix to this problem because SCD patients not receiving the care they need due to numerous impeding factors.Section 1 of this paper discusses the issues driving health care disparities and inequities in patients with SCD, including issues of past and present racial bias along with the deficient evidence driving health policy.Section 2 discusses the potential legal remedies SCD patients can seek when failed by the health care though Mediterranean populations are now more likely to inherit Thalassemia than Sickle Cell Disease.See