Racismin Research and Health Care

ANTH 3301: Health, Healing & EthicsCarolyn Smith-Morris, Ph.D., M.S., LPC

Medical Apartheid in History• AD 160, Roman physician Galen (129-c.199) described African

men as having oversized sexual organs, inferior intelligence• 1975, Swedish naturalist Carl von Linné (Carolus Linnaeus)

categorized Africans as Homo sapiens afer, a different species and different evolutionary track than white men

• Monogenists of the 17th and 18th centuries instead explained that characteristics were dictated by climate

• 1839, physician-scientist Samuel George Morton determined that Caucasians had the largest skulls, and therefore the largest brains, and blacks the smallest

• 1851, Louisiana’s Samuel A. Cartwright, M.D., discovered a host of imaginary “black” diseases “whose principle symptoms seemed to be a lack of enthusiasm for slavery” (Washington 2006: 36). Lecture material drawn from Medical Apartheid: The Dark History of Medical

Experimentation on Black Americans from Colonial Times to the Present by Harried A. Washington (2006, Harlem Moon).

Use of Slaves in Medical Research• Thomas Jefferson, lawyer, politician, and

scientist: • Enthusiastic researcher of vaccination• Tested his theories on his slaves• Included tests on Edward Jenner’s new

technique of vaccination (cowpox for smallpox)• Jefferson vaccinated 200 of his own and his

neighbors’ slaves, and waited for results, before injection his own family at Monticello.

Use of Slaves in Medical Research• James Marion Sims, South Carolinian doctor:

• Performed craniotomy on sick black infants to compensate for what was deemed the premature hardening of the cranial sutures;

• Un-anesthetized removal of bone segments to prevent spread of an infection.

• Botched use of obstetrical forceps, causing profound fistula.

Racism in Science

• 1906, missionary-explorer Samuel Phillips Verner brought African Pygmies to America for display at the St. Louise World’s Fair.• In exchange for a financial gift, Verner sold Ota Benga to the Bronx

Zoological Gardens.• Benga was caged with a gorilla and orangutan, given a bow and arrow,

and paraded every afternoon for show.• Show eventually closed.• He committed suicide in 1916.

Eugenics and A.A. Reproduction

Daughter of a socialist, Margaret Sanger, “is usually lauded as a powerful birth-control pioneer and as a feminist” but is described by Washington as “the most famous American populizer of eugenics” (2006: 195).

• 1920’s was researching birth patterns, published on “The Negro Number” and recruited black leaders to contribute articles in support

• W.E.B. Du Bois (NAACP founder) wrote, “The mass of ignorant Negroes still breed carelessly and disastrously….”

• 28% of blacks surveyed in the late 1960’s agreed that “encouraging blacks to use birth control is comparable to trying to eliminate this group from society”.

Granddaughter of a slave, daughter of sharecroppers, Fannie Lou Hamer sought help in 1961 for a “knot on her stomach”.

• The doctor removed her uterus, without explanation or consent.

• Became a lifelong opponent of birth control.

Genetic Perdition• Only 10% of reported sex assaults are

allegations of white women attacked by black men. • Yet most – 54% - of all convictions proven to be

unjust (through DNA evidence) involve African American men wrongfully convicted of assaulting white women. (Peter Neufeld, attorney)

• Yet relatively few inmates can afford the requisite $5k for DNA technology.

Genetic Perdition• Cardiologists James B. Herrick and Ernest

E. Irons first identified the sickle cell trait. • Affects Mediterranean, Middle Easter, and

West African people, but not South African and East Asian people.

• Failures to see or acknowledge scientific facts:• Despite broader ethnic patterns, only

African American pilots were grounded (or lost jobs);

• Ortho Pharmaceutical Company sold the so-called sickle-cell screening test, though it did not differentiate between sickle-cell carriers (heterozygote) and people with sickle-cell disease (homozygote).

Interracial Transplant• Interracial transplant (1968) from “unclaimed dead”, Bruce

Tucker• No attempt by hospital to contact• Brothers had called the hospital three times seeking information• Surgeons disregarded 24-hour waiting period (would have made

organs unusable)• Surgeons were “shielded” from liability for their work in a state

institution giving “free” care• All-white, all-male jury

Tuskegee Syphilis Study • 1932 to 1972• Penicillin widely available by early 1950’s• Multiple overt efforts to keep information about better

treatments from the study subjects

Ethics of a Social/Historical Context• Treating a hospital patient “as a corpse, though perhaps still

‘clinically’ and ‘biologically’ alive” (Lederer 150).• In 2002, waiting time for cadaveric kidney is almost x2 as long

for African Americans than for whites. A.A. also less likely to have living donors.

• The nocebo of social death• When society no longer recognizes a person’s existence as a

person• When a disease, or diseased person, is socially ostracized• When diagnosis can lead to negative health outcomes/death

• ETHICSA shared, formalized code of behavior of a group, based on ideas about right and wrong; a generic term covering several different ways of examining and understanding moral life.

• MORAL REASONINGThe thought process of identifying, evaluating, and estimating (or judging) what is right and wrong, using choice and evidence In decision-making

• NORMSBroadly accepted standards, behaviors, and vaues within a community; includes standards of action as well as moral character traits, or virtues

• PRINCIPLESGeneral moral norms judged by a community as appropriate for the guiding and evaluating of conduct;

Ethics of a Social/Historical Context (reconsidering definitions)