Discrimination vs. Justification

2015-0704 Discrimination vs Justice

According to an article published by Reuters, “older, poorer and less educated patients may have lower odds of receiving a prescription for clot-busting drugs” to help prevent additional strokes after the initial one.

The findings are based on a study by Swedish researchers involving approximately 12,000 first-time stroke patients who also had a heart rhythm disorder known as atrial fibrillation —  a disorder that raises the risk of stroke. Researchers found “only 36 percent of those in the study were prescribed anticoagulant drugs when they left the hospital.” However, the truth looks much worse when you sort the data by age — “only 11 percent of patients” older than 90 and “29 percent of people in their 80s received the drugs, compared with 61 percent of adults under age 70.”

Sorting  data also reveals “roughly 30 percent of the poorest patients and people without a high school education got the medicine, compared to 48 percent of college-educated patients and 46 percent of the richest stroke survivors.”


Some elderly people tend to fall and suffer injuries more easily than younger people. Since falls and injuries may result in bleeding, and anticoagulant  medication makes it difficult to stop bleeding, some doctors are reluctant to prescribe this type of medication to elderly patients, even after a stroke.

Physicians might also find it too risky to give anticoagulant drugs to less educated people out of concern that these patients might not take the medicine as prescribed.

My Opinion

While the rationale for withholding anticoagulant prescription from some elderly patients may be based on sound reasoning, I am not convinced the rationale explains the substantial gap in service between younger and older patients. The explanation used to justify the huge gap between poor and wealthy patients is complete nonsense in my opinion. It seems to me the wealthier and more educated patients are more likely to ignore instructions because they “know what they need more than the doctor.” On the other hand, the less wealthy and less educated are more likely to be thankful for the help and pay close attention to the instructions.

To read the complete Reuters article, click here.

Click here to read another Beyond Adversity post.



  1. When you are sick it is very difficult to advocate for yourself. When there is this type of added discrimination your chances of getting the best medical information is complex to say the least. My dad was a stroke patient caused by A Fib, so this story hit close to home. There is such a need to improve this type of discrimination!

    1. Cheryl, you and I recognize this as discrimination, but unfortunately many people, either consciously or subconsciously, believe the action is justified. How could we prove this is discrimination?

  2. Yes, complete nonsense. Physicians not prescribing potentially lifesaving medicine because of concern patients might not take it? Doesn’t make any sense. It would be informative if Reuters provided info on the cost to patients and reimbursement to physicians for anticoagulants, broken down by patient age and income level.

    1. Howard, like you, I also notice omissions that could have made an article better. Sometimes the omissions both me and sometimes I recognize there is a time to be perfect and a time to be done. When the deadline arrives, it is time to be done.

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