Drug Toxicity and My Dad’s Ethnicity

My Korean-American father experienced a severe drug eruption after receiving allopurinol for gout. Although commonly used as a first-line medication in the United States, in South Korea, allopurinol is only prescribed after human leukocyte antigen (HLA) testing due to the high frequency of an HLA allele associated with allopurinol-induced severe cutaneous adverse reactions. Given the complexity of the discourse around engaging race and ethnicity in medical practice, my father's experience led me to contemplate the current context of eliminating race from clinical decision making to address historical and ongoing injustices. Upon this reflection, I advocate for the separation of race and ethnicity to appropriately consider ethnicity when it may support quality and safety of care for all patients.