[This is Part 5 of “Wholly Pro-Life”, a 6-part series on what a consistent pro-life ethic requires across the full span of human life and condition.]

Half the Room Believed Something False

In 2016, researchers surveyed 222 white medical students and residents and found that roughly half of them endorsed at least one false belief about biological differences between Black and white people. These were not vague impressions, but specific, testable claims: participants believed Black people’s skin is thicker, that their nerve endings are less sensitive, and that their blood coagulates more quickly than white people’s. The trainees who held these beliefs rated a Black patient’s pain as lower than a white patient’s given an identical clinical scenario, and made less accurate treatment recommendations as a result.^[1]

This is racial bias in pain assessment, documented in a controlled study rather than argued from anecdote or inferred from outcome statistics after the fact. But the more useful question the study raises isn’t whether disparity exists. It’s what has to be true in someone’s head for that disparity to happen at all, apparently without any of them noticing. A belief did that. It was not a slur, not an intention to harm, not anything a person holding it would recognize in themselves as hatred, just a quiet, assumed belief about whose body works the way bodies are supposed to work, and whose report of pain can be trusted at face value.

What This Article Is Not Arguing

Before going further, a distinction has to be drawn clearly, because without it this article risks being misread as denying something obviously true. People really do experience and report pain differently from one another. Nerve density varies between individuals. Prior injury and trauma change how a body registers new pain. Culture and upbringing shape how openly someone expresses discomfort, and even a person’s own history with being believed or dismissed can change how insistently they describe what they feel. None of that is in dispute, and none of it is patterned by race in any way medicine has actually found, despite more than a century of attempts to prove otherwise.

That kind of variation asks something specific of a caregiver: pay closer attention to the person in front of you, because you cannot assume in advance how they will experience what is happening to their body. A good clinician has always had to set aside easy assumptions and actually listen to the individual patient’s own account, since no chart or category can substitute for that. What the Hoffman study documents is the opposite move entirely. “Black people’s skin is thicker” is not an observation about the particular patient in the room, drawn from attentive listening. It is a categorical claim about an entire race, invented rather than measured, that gives a caregiver permission to trust that patient’s own testimony less before they have even finished describing what they feel.

That is the actual line, and it is worth stating plainly so it cannot be missed. Individual variation asks a caregiver to pay closer attention to the person actually present, while racial essentialism does the opposite, granting permission to pay less before that person has even said a word. This article is about the second one, not the first, and nothing here should be read as suggesting real, individual, person-specific variation in pain experience is somehow suspect or unwelcome.

Documented Racial Bias in Pain

Hoffman and her colleagues ran two studies. The first documented these beliefs among white laypeople generally and found that people who endorsed them rated a Black person’s pain as lower than a white person’s, given the exact same description of an injury. The second moved into the medical context specifically, surveying actual medical students and residents, people already trained or in training to treat real patients in real emergency rooms and clinics. Roughly half endorsed at least one of the false beliefs tested. Those who did consistently rated Black patients’ pain lower and recommended less accurate treatment for the person in pain than their peers who did not hold these beliefs, even when shown the same clinical vignette with only the patient’s race changed.

What makes the finding harder to dismiss than a single anecdote or a single bad actor is who these participants were. Many were not people who scored high on general measures of racial prejudice when tested separately. The belief did not require an otherwise bigoted person to carry it, and it did not travel together with other markers of open racial animus the researchers also measured. It operated on its own, quietly, alongside a sincere and probably genuine rejection of stereotyping in every other area these students would have named if asked directly whether they held racist views.

Hoffman herself has noted that these particular beliefs are not new inventions dreamed up by a handful of confused medical trainees. Claims about Black bodies being built to endure more than white bodies, needing less relief, feeling less      were used historically to justify slavery, to defend forcing people to labor beyond what would have broken someone assumed to be made of ordinary human material. The theological and pseudo-scientific dressing has changed considerably since then. The underlying claim, that this group’s body is fundamentally other and built different, has simply moved into a new institutional home: not a plantation owner’s self-justification, but a hospital intake form and a clinician’s unexamined assumption.

Othering Without Hatred

Othering does not require hatred. It only requires believing, quietly and often sincerely, that another group’s embodied experience differs from your own in a way that makes their testimony about their own suffering less trustworthy than it would otherwise be.

This is what makes this form of othering more durable than open bigotry, and much harder to see coming, whether in a hospital or anywhere else. A person who believes “Black skin is thicker” does not experience that belief as contempt. It does not feel, from the inside, hatred of anyone in particular. It feels like a fact they picked up somewhere along the way, filed away without much scrutiny, and now apply without ever examining where it came from or whether it holds up. A medical student who holds this belief can walk out of that exam room and genuinely believe he treated his patient fairly, because the discount he applied to her reported pain did not register to him as a discount at all. It registered as accurate calibration, the same way any of his other clinical judgments would.

This is, underneath the clinical language, a theological claim wearing a scientific coat: a hierarchy of embodied credibility, where some bodies’ reports of their own suffering are taken at face value and others require independent verification before they count as reliable. Systems can build this same move without anyone administering them ever having to state a value judgment out loud, and without a single person involved ever consciously deciding that one group’s shared image-bearing status matters less than another’s. This series has already found the same quiet sorting at work in who counts as trying hard enough to deserve help – a category doing the deciding so no individual administering it ever has to. Here the category is biological rather than economic, and the setting is a clinic rather than a caseworker’s desk, but the shape of the sin is identical: a system that lets everyone involved feel they never judged anyone, because a belief did the judging quietly, upstream of any single decision anyone can point to and call discrimination.

None of this requires the participants in Hoffman’s study, or anyone who unknowingly shares their assumptions, to be monsters. That is the point, and why this deserves more careful attention than open bigotry, not less.

One Body, One Origin

Scripture does not leave room for this hierarchy, and it does not merely soften it around the edges – it removes the ground it would need to stand on entirely. Genesis 1:27 places the whole of humanity, without further qualification, inside a single act of creation: “So God created man in his own image, in the image of God he created him; male and female he created them.” The passage grants one image and one act to all of humanity, with no biological subcategories, no tiers of embodied credibility built into the account of how any of us came to exist, and no asterisk attached to any group’s claim on that image.

Paul makes the same point directly against exactly the kind of reasoning this article has been describing, centuries before anyone dressed it in the language of nerve density and skin thickness. Speaking to a Greek audience steeped in their own assumptions about which peoples were civilized and which were barbarian, assumptions every bit as confident as any modern biological myth, he says God “made from one man every nation of mankind to live on all the face of the earth” (Acts 17:26). Paul traces one origin for every nation, without exception – no group made of different stuff than another, no matter how thoroughly a culture, ancient or modern, has convinced itself otherwise.

A body reporting pain is a body doing exactly what an image-bearing body does when it is genuinely hurting. There is no image-bearer whose report of their own suffering was built to require a discount, and no biological finding has ever actually shown otherwise – only false beliefs invented, generation after generation, to make the discount feel scientific rather than assumed. This is the same claim this series opened with: that every human being carries God’s image without further qualification, at every stage of life and, it turns out, regardless of what a culture has decided a particular body is capable of enduring without complaint.

Distance Is Where the Lie Survives

If individual variation is real, what actually breaks a false categorical belief once someone already holds it? Not correct information alone, delivered in the abstract. A medical student can be shown Hoffman’s own data, told plainly that these beliefs are false, and still feel the old assumption quietly reassert itself the next time he is tired, rushed, or facing another chart instead of another face. Statistics correct the mind for as long as the statistics are in view. They do not, by themselves, reach the place where the original belief actually lives.

What breaks a categorical belief is something more specific: sustained contact with an actual, known, particular person the belief cannot survive looking at directly. This is not a psychological theory borrowed from outside Scripture. It is the pattern Scripture itself keeps using whenever it wants to dismantle a category someone has built between “us” and “them.”

Consider Ruth. To an Israelite audience, a Moabite woman was not a neutral category – Moab carried a long, specific history of hostility toward Israel, and the law itself restricted how fully a Moabite could be received into the assembly (Deut. 23:3). Ruth does not overcome that history through an argument. She overcomes it by showing up in Boaz’s field, gleaning among his workers, until he cannot relate to her as “the Moabite” any longer without also relating to her as Ruth – loyal to Naomi, working from dawn, known by name (Ruth 2). The category survives at a distance. It could not survive Boaz actually watching her work.

Paul gives Philemon the same kind of contact to reckon with, more directly still. Onesimus was a slave, a category Philemon had every cultural and legal reason to relate to at arm’s length. Paul will not let him keep that distance. He asks Philemon to receive Onesimus back “no longer as a slave, but… a beloved brother” (Philemon 1:16) – not a general statement about how slaves as a class ought to be treated, but a demand rooted in one particular, named man Philemon could no longer file safely under an abstraction, because Paul has made sure he knows exactly who is coming home.

Othering survives at a distance and dies in the particular. A belief about “an entire race” is far harder to sustain against one actual person’s actual testimony, held right in front of you, than against a category encountered only in a lecture hall, a textbook, or a statistic on a page. This does not mean proximity alone guarantees a changed heart – Boaz still had to choose to see Ruth rightly, and Philemon still had to choose to receive Onesimus as Paul asked rather than simply tolerate his return. But it does mean the false belief has nowhere left to hide once a particular person is standing where the category used to be.

Conclusion: Whose Testimony Gets Believed

This series began by asking whose voice a legal process was built to hear and whose was left structurally unrepresented, whatever the medical facts of the case turned out to be. This article has asked a sharper, more intimate version of that same question: whose reported pain gets believed by default, and on what unexamined grounds someone decides in advance, often without realizing they have decided anything, that it does not need to be.

The gospel’s answer has not changed shape across any of these installments, only the terrain it has been tested against. The same image, the same origin, and the same act of creation stands behind every body that has ever reported what it feels, in a hospital room or anywhere else. No hierarchy of credibility built into any of it, no matter how sincerely, or how quietly, one gets constructed anyway by people who would be genuinely surprised to learn they were building it. The remedy this series keeps returning to is not a better policy or a more careful category, but the same insistence, tested again here: every body in front of you carries the image intact, and its testimony about itself deserves to be heard as such.

Questions for Reflection

• Where might you be discounting someone’s account of their own experience based on an assumption you have never actually examined?
• Does it change how you think about prejudice to learn it can operate this quietly, without anyone involved feeling hatred?
• What would it look like to notice a categorical belief operating in you before it shapes a decision, rather than after?
• Who in your life is still a category to you rather than a known, particular person?
• How does “one origin, every nation” (Acts 17:26) sit alongside assumptions you have inherited without choosing them?

Prayer Points

• Ask God to reveal any belief you hold about a group of people that you have never actually tested against a real, known person.
• Pray for medical professionals and caregivers, that they would recognize bias operating beneath their own good intentions.
• Ask the Lord to bring particular people, not categories, into your path where your own assumptions run deepest.
• Pray for The Gospel Lens as this series nears its close, that this installment would be received as an invitation to examine quiet belief rather than an accusation.

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[1]Kelly M. Hoffman, Sophie Trawalter, Jordan R. Axt, and M. Norman Oliver, “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites,” Proceedings of the National Academy of Sciences 113, no. 16 (2016): 4296-4301, https://www.pnas.org/doi/10.1073/pnas.1516047113. Full text also available via PubMed Central: https://pmc.ncbi.nlm.nih.gov/articles/PMC4843483/. Accessed August 26, 2026.