Saturday, August 21, 2021

Time to retire Black from the Boxed Warning

While some would say this is innocent terminology and has no negative connotation; why should we make ourselves aware of this phrasing and possible negative associations? I realize that many will brush this off as some libtard complaining about political correctness and fear of insulting others. After all there was the BLACK DEATH to describe bubonic plague. Are we now going to ask to rewrite history to remove the term BLACK? What is the root why we associate BLACK with more severe, harmful or disastrous outcomes?  Why is this important?  

The cautionary labeling by the FDA never was called a Black Box warning however is taught in nearly every medical and pharmacy school as being called that. The term is thrown around in usual discussion in many treatment teams to convey potential risk of harm. However it is simply a Boxed Warning (per FDA) and while the ink used in printing the package insert is typically if not always black, that is true for all sections of the insert. Do we really need to say Black to convey more serious risk, harm, or disastrous outcome? If so, why?  

The only reason I can think for a historical association of black with danger is related to dangers of the night. Throughout history of humanity it is likely that dangers exist at nighttime due to reduced vision, predictors, criminal activity as well as imagined fears and unknowns. While this is likely the root of black being associated with fear of harm, i don't think black is the most appropriate descriptor of the night time dangers either. Surely over more recent history especially in the United States fear of black is tied to white people being fearful of black individuals, which is well documented and was widely propagated throughout the South and others areas after slavery was abolished. The criminalization of being black soon became the norm in our countries unspoken and embarrassing past. As noted in social events last summer, may still be imbedded into the culture of many law enforcement agencies.  

Thus being at this cross-road in social justice, I would advocate to all clinicians to drop the BLACK from the boxed warning. Do you really need to say BLACK to make your point when describing the risk?  If so why?