Against the Reification of Race in Bioethics: Anti-Racism without Racial Realism

The three target articles constitute a powerful and persuasive call for actively anti-racist bioethics and biomedicine.All three articles reject race as a biological category.Nevertheless, they share a common commitment to racial classification.At one point, Ruqaiijah Yearby writes that "social race, like biological race, is an illusion created to establish racial hierarchy," but mostly she writes about "races" as though they were not an illusion, but a reality.In this commentary I critique the racial realism of the target articles.I argue that the biomedical fight against racism is best served by a form of anti-realist reconstructionism about race, which says that there are no races, only racialized groups-groups misunderstood to be races.Note that I do not defend the color blindness that Clarence H. Braddock (2020) persuasively rejects.Because of the role of skin color in racialization and racism, color blindness is a misguided goal.One can reject color blindness, though, without accepting racial realism.Before I get to my main argument, I want to briefly discuss race as a biological category.I agree with the authors that race is a biological illusion, and have argued this elsewhere (Hochman 2016; 2019b).However, both Braddock and Yearby over-extend the argument against biological race.Braddock writes that "an individual who is Black is as different from the next person who is labeled as Black as they are from another person who is labeled as white" (Braddock 2020, see also Yearby 2020).However, as David Witherspoon and colleagues explain, "the answer to the question 'How often is a pair of individuals from one population genetically more dissimilar than two individuals chosen from two different populations?' depends on the number of polymorphisms used to define that dissimilarity and the populations being compared" (Witherspoon et al. 2007, 351).Depending on these variables, sometime there are more genetic similarities within racialized populations than between them, a fact that is compatible with the finding that most human genetic diversity resides within any given racialized group (Witherspoon et al. 2007).Overstating the case against biological race provides ammunition to those who accuse biological race skeptics of misunderstanding the science (Hochman 2016).It is also important that "race" is replaced with other categories, such as 'racialized group' and 'ancestry.'Rather than "race," Yearby suggests that biomedically relevant factors include "neighborhood; education; occupation; job; health insurance coverage; income; wealth; health behaviors; experiencing racism; gender identification; disability status; and age" (2020).I agree, but "experiencing racism" doesn't tell us precisely how an individual is racialized, and it isn't a proxy for a range of diseases that are correlated with ancestry.Think of the Italian who travels through life without experiencing racism, but who has sickle cell disease.Biomedicine offers strong support for anti-realism about biological race (Msimang 2020).However, the more fine-grained category of ancestry ought to be adopted, and the category of the racialized group ought to replace "race."Now to the racial realism of the target articles.What, if anything, justifies this stance?For Yearby, racism requires the existence of races.She describes racism as "a social system where the racial group in power creates a racial hierarchy in which other racial groups are deemed inferior" (2020).However, racism requires the existence of groups believed to be races, not actual races.Braddock alludes to "a strong body of evidence that supports the notion that race is not a biologic category or construct but rather a sociological and experiential construct" (2020).But surely 'race' is a biological category, just one that fails to refer.And while we cannot understand society or identity