Maybe, in an ideal world. But not in the world we live in.

People of color have suffered from health care disparities over the whole history of our nation, usually in the form of lack of access or undertreatment. A 2017 study found that in New York City, African-Americans were significantly underrepresented in the best hospitals, even after controlling for insurance coverage.

African-Americans, including children, are more often undertreated for pain compared with their white counterparts. While 74 percent of white patients with bone fractures in an Atlanta emergency room received pain medications, 57 percent of African-Americans did. African-American children with an appendicitis were 44 percent as likely to receive opioid medications for pain, a cornerstone of care, as white children. Such inequities, the manifestations of implicit bias and institutional racism, are only the tip of the iceberg.

But there is a sadly ironic twist when it comes to disparities in dying. Although African-Americans are deprived of proper treatment for much of their lives, at the end they suffer from too much of it. They are more likely than white people to die attached to machines, their deaths stretched out, their suffering prolonged.

Why is this? Like so many difficult problems in medicine, it’s complicated, and of course it varies from case to case. As a white physician who cares primarily for African-American patients in Oakland, I have noticed two recurring themes in my work. On the patient side, there is often powerful distrust of the health care system, a fear that we doctors — who are mostly white — will deprive them in their time of need. On my side, there is my own guilt, my fear of being perceived as racist or somehow embodying an oppression I am often blind to. When these factors collide, doing more can be a temporary salve.

When my patient’s son questioned my motives, my first instinct was to backpedal, to persuade him that I wasn’t trying to kill his father. I wanted to say, “Why don’t we just err on the side of putting in the trach and keeping him alive?”

But then I caught myself, remembering what his father had asked for. “I understand why you are asking,” I said. “Please believe me when I say I just want to get your father the care that he wants.” With this reassurance, he sighed, thanked me and walked back into the room.

We disconnected the ventilator that afternoon. My patient died peacefully, his son singing beside him.