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Martin and colleagues’ study—“The impact of skin tone on performance of pulse oximeters used by NHS England COVID Oximetry @home scheme: measurement and diagnostic accuracy study”—tackles an issue of major clinical and ethical importance: differential accuracy of pulse oximetry across populations.1 The framing of the title, however, merits reconsideration. To state that “skin tone” has an “impact” on device performance risks implying biological agency in what is, in fact, a technological and regulatory limitation.