People often don’t even realize the subconscious preconceived notions they hold. But stereotypes can be dangerous: When you’re making a sweeping generalization about every person in a particular group, it’s likely to backfire.

This is exhibited in a new peer-reviewed article published in The New England Journal of Medicine. The study delves into how stereotypes about single people could be detrimentally impacting cancer treatment in unmarried patients.

Joan DelFattore, Ph.D., the author of the paper, discusses her experience being diagnosed with Stage IV gallbladder cancer and, through reflection and research, coming to the realization that single people are less likely than coupled people to receive more aggressive, albeit effective cancer treatment.

According to DelFattore’s extensive research, this is due to unconscious bias in the medical field. And that bias leads many doctors to assume unmarried people don’t have the necessary support to undergo the harsh side effects of life-saving treatments, like radiation therapy or surgery.

Marital status’ affect on medical care

“I had no idea that marital status might affect medical care until an oncologist, talking about what treatment to give me, asked if I have a spouse or children,” DelFattore wrote in The Washington Post. “When I said no to both, he looked genuinely concerned. But how will you manage? he asked. He then proposed to give me only one mild drug, although the standard of care was a much harsher — and more effective — combination chemotherapy. When I tried to describe my strong network of friends and extended family, he talked right over me.”

In her paper, DelFattore discusses debilitating side effects of certain treatments leading physicians to believe that patients require social support — which is undoubtably true. However, the waters get murky when DelFattore realizes that medical researchers often believe that social support and having a spouse are synonymous, completely discounting the fact that unmarried people often have solid friend groups and strong community support.

Social support

Some patients — both married and unmarried — assuredly lack the social support necessary to handle more aggressive cancer treatments. But considering that, according to the U.S. Census Bureau, 45% of U.S adults are unmarried, stereotyping nearly half the adult population is irresponsible.

Moreover, in her research, DelFattore discovered that when more aggressive treatments are not chosen in treatment plans, it’s often attributed to patient preference. However, DelFattore refutes this by citing a large study in which 1% of unmarried people with cancer turned down physician-recommended surgery, and less than 2% declined physician-recommended radiation therapy. 

Giving the green light on more aggressive treatments may not just be patient preference. More likely, unmarried people trust their doctor’s recommendations — which may be rooted in implicit bias.

Examining our biases

“The problems I’ve described here aren’t happening because doctors and health care workers are bad people,” DelFattore wrote in a PsychologyToday guest post. “They’re happening because anti-single bias is so common that it passes for normal thinking, and the solution isn’t blame, but education.”

“Anti-single bias is so common that it passes for normal thinking, and the solution isn’t blame, but education.”
–Joan DelFattore, Ph.D

This is why it’s so imperative to examine our own ingrained cultural stereotypes and hold ourselves accountable. In this case, it’s clear that failing to question social norms can be a life or death situation. “No matter how much doctors try — and I believe they do try — to treat patients, appropriately, they’re not immune to what’s in the culture,” DelFattore continued on NPR. “If you look at our culture, you see, movie after movie, where the happy ending is they get married; the unhappy ending is they don’t. Doctors are not immune to that.”

According to DelFattore, this is a crucial opportunity to raise awareness. She tells ScienceDaily that she hopes that, just as medical schools now teach about the dangers of unintentional racial and gender bias in treating patients (which undoubtedly both have a long way to go), they’ll also start discussing marital status.

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