Surgery and the Potential for Medical Abolition

The REPAIR Project was invited by the UCSF Department of Surgery to present at their weekly Grand Rounds. We are grateful for the opportunity to introduce our second year's theme, and we encourage you to read more about the topics discussed in our presentation and have provided links to resources discussed in our presentation below. 

Medicine's role in the Prison-Industrial Complex


Medical Abolition and Surgery

Medical Abolition recognizes that historical associations between Blackness, pathology, and criminality are key in the ongoing anti-Blackness we witness in medical spaces. In our Grand Rounds presentation, we explored how this plays out in surgical spaces specifically. 


Penetrating Trauma and Violent Injury

Penetrating trauma disproportionately affects Black communities:

Black patients have worse outcomes for penetrating trauma, which can only partially be attributed to findings that show Black patients are more likely to be treated at lower-resourced hospitals. 

Potential directions for action:


Pain Management

Black patients experience more pain for the same conditions

Black patients receive less pain management

  • 2298 Pediatric patients with abdominal pain: black patients were less likely to receive any analgesic (OR 0.61) or a narcotic analgesic (OR 0.38) than white patients (Johnson TJ et al, Pediatrics 2013, 132 (4) e851-e858).
  • Black patients with isolated long-bone fractures less likely than white patients (57% versus 74%, P =.01) to receive analgesics in this ED and more likely to receive no analgesic at all. (Todd KH et al 2000 Annals of Emerg Med)
  • Racial Inequality in Prescription Opioid Receipt (36% lower mean annual dose among Black patients compared to White patients) and Role of Individual Health Systems (Morden NE et al, NEJM 2021; 385(4):342-351.)

Post operative pain control

Black patients perceived to be at greater risk for future misuse/abuse of prescription opioids


Kidney Transplantation

Disparities in Living Donor Kidney Transplantation

Transplantation and Pathologization of Race

Transplant waitlist eligibility criteria affects time to referral and transplant: reliance on GFR <20 → racial coefficients increase GFR for Black patients, raising the threshold for requiring (and being eligible) for kidney transplant 

Transplant criteria often includes “social support” criteria which disproportionately excludes under-resourced and Black communities