Nursing Textbook Criticized for ‘Racist’ Passage About How Cultural Groups Handle Pain

A passage from a textbook for nurses that describes different racial groups’ reactions to pain surfaced on social media earlier this week, leading many to denounce the passage as “racist” and causing the book’s publisher to apologize and remove the passage from publication.

Facebook user Onyx Moore first published a photo of the passage, from the textbook “Nursing: A Concept-Based Approach to Learning,” on her Facebook page on Monday. The passage lists six groups and their “cultural differences” relating to pain. Some of the points made in the passage include:

Arabs/Muslims: Pain is considered a test of faith. Muslim clients must endure pain as a sign of faith in return for forgiveness and mercy.

Asians: Chinese clients may not ask for medication because they do not want to take the nurse away from a more important task.

Blacks: Blacks often report a higher pain intensity than other cultures.

Jews: Jews may be vocal and demanding of assistance.

Hispanics: Hispanics may believe that pain is a form of punishment and that suffering must be endured if they are to enter heaven.

Native Americans: Native Americans may prefer to receive medications that have been blessed by a tribal shaman.

An outcry followed, with many turning to social media to express their outrage at the passage.

Jewish. Diagnosed chronic pain disorder at 6. Probably 1/5 of people who meet me know I have it. Am I demanding assistance?! @pearson ????????????????

— Arielle Calvo (@ArielleCalvo) October 20, 2017

As a Native American, I pick the pain scale # under the most stoic face: 4. I received this sacred number when they took out my gallbladder. https://t.co/fyeWmlXDdA

— Elissa Washuta (@elissawashuta) October 18, 2017

Hi yes; this Catholic (part) Hispanic believes whole heartily in pain killers. Praying didn’t help my exploded cyst, but morphine did. https://t.co/tmjvBkKlUu

— Churro (@Risa_amor) October 19, 2017

Most of those points don't make a lick of sense. Sure, I get cultures are different, but pain isn't. Are we to assume if an Asian is stabbed that this textbook would expect them to stay quiet and not ask for help??? https://t.co/gqUWgxSbUV

— Fire Blast (@_Fire_Blast_) October 17, 2017

Some people were less critical, saying the passage could help nurses understand cultural differences.

The purpose of this is to have providers at least be aware that there are different cultural perspectives on pain and sickness.

— savage kind (@Bogarten420) October 20, 2017

In response to the backlash, Pearson, the book’s publisher, announced on Wednesday that the content would be removed from publication.

We apologize for the offense this has caused and appreciate the concern and feedback we have received.

— Pearson (@pearson) October 18, 2017

Pearson also released a statement further responding to the controversy:

While differences in cultural attitudes towards pain are an important topic in medical programs, we presented this information in an inappropriate manner. We apologize for the offense this has caused and we have removed the material in question from current versions of the book, electronic versions of the book and future editions of this. In addition, we now are actively reviewing all of our nursing curriculum products to identify and remove any remaining instances of this inappropriate content that might appear in other titles.