Medical Apartheid Quotes

Physicians, patients, and ethicists must also understand that acknowledging abuse and encouraging African Americans to participate in research are compatible goals. History and today's deplorable African American health profile tell us clearly that black Americans need both more research and more vigilance.

Enslavement could not have existed and certainly could not have persisted without medical science. However, physicians were also dependent upon slavery, both for economic security and for the enslaved “clinical material” that fed the American medical research and medical training that bolstered physicians’ professional advancement.

Infant mortality of African Americans is twice that of whites, and black babies born in more racially segregated cities have higher rates of mortality. The life expectancy of African Americans is as much as six years less than that of whites.

Old measures of health not only have failed to improve significantly but have stayed the same: some have even worsened. Mainstream newspapers and magazines often report disease in an ethnocentric manner that shrouds its true cost among African Americans. For example, despite the heavy emphasis on genetic ailments among blacks, fewer than 0.5 percent of black deaths—that’s less than one death in two hundred—can be attributed to hereditary disorders such as sickle-cell anemia. A closer look at the troubling numbers reveals that blacks are dying not of exotic, incurable, poorly understood illnesses nor of genetic diseases that target only them, but rather from common ailments that are more often prevented and treated among whites than among blacks.

History of medicine courses, medical museums, and even much medical scholarship leave one unaware of the long tragic history of medical research with African Americans.

Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.

The South was a particularly unhealthy region and was home to 90 percent of American blacks, the majority of whom were enslaved until 1865.

Why Research Issues Still Matter Why do centuries of mutual distrust over medical research matter today? What does the sad history of exploitative experimentation augur for black health?

far from sharing in the bounty of American medical technology, African Americans are often bereft of high-technology care, even for life-threatening conditions such as heart disease. The

Despite its image as a disease that affects middle-aged white men, heart disease claims 50 percent more African Americans than whites and African Americans die from heart attacks at a higher rate than whites. African Americans are more likely to develop serious liver ailments such as hepatitis C, the chief cause of liver transplants. They are also more likely to die from liver disease, not because of any inherent racial susceptibility, but because blacks are less likely to receive aggressive treatment with drugs such as interferon or lifesaving liver transplants. Even

American university research centers have historically been located in inner-city areas, and accordingly, a disproportionate number of these abuses have involved experiments with African Americans.

Because race is not a biological reality, medications based upon group biological differences will work only for some African Americans. This will lead to a false sense of security, and will stymie the search for more inclusive, more efficacious, and, in a word, better treatments. We must recognize the powerful stigmatizing potential of genetic approaches to disease, especially when they are touted as the only approach.

Geography, tradition, and culture intersect to make blacks likely research subjects for new technologies, but race and economics tend to place them outside the marketplace for these same technologies when they are perfected.

But in dissecting this shameful medical apartheid, an important cause is usually neglected: the history of ethically flawed medical experimentation with African Americans. Such research has played a pivotal role in forging the fear of medicine that helps perpetuate our nation’s racial health gulf. Historically, African Americans have been subjected to exploitative, abusive involuntary experimentation at a rate far higher than other ethnic groups.

In fact, researchers who exploit African Americans were the norm for much of our nation’s history, when black patients were commonly regarded as fit subjects for nonconsensual, nontherapeutic research. This book explores the many reasons that blacks are so vulnerable, but ultimately it is because American medical researchers remain a racially homogeneous group, and I show how the racial homogeneity of American medical researchers lies at the very heart of the problem.

Almost no effective treatments existed for prevalent diseases until the eighteenth century. Until the late 1830s, the lack of effective anesthesia made the few common surgical procedures horribly painful and all others impossible. Between

The point of this chapter’s unflattering précis of nascent American medicine is not to castigate it for its primitivism, but to put blacks’ historical aversion to medical care into context, for most antebellum blacks were subjected to southern medicine. The

A closer look at the troubling numbers reveals that blacks are dying not of exotic, incurable, poorly understood illnesses nor of genetic diseases that target only them, but rather from common ailments that are more often prevented and treated among whites than among blacks. Three

In the early 1700s, this mirrored the situation in England and the rest of Europe, but medicine on the Continent began to undergo modernizing changes, although these were very slow to cross the Atlantic. Europe began to embrace public-health measures and medical advances such as widespread vaccination, scientific medical education, and the rise of the hospital, but American progress lagged behind, especially in the insular South. The

At the same time, medical experts of every persuasion agree that African Americans share the most deplorable health profile in the nation by far, one that resembles that of Third World countries. When Dr. Harold Freedman observed that the health status of Harlem men resembles that of Bangladeshis more closely than that of their Manhattan neighbors, he did not exaggerate. Twice as many African American babies as babies of other ethnic groups die before their first birthday. One and half times as many African American adults as white adults die every year. Blacks have dramatically higher rates of nearly every cancer, of AIDS, of heart disease, of diabetes, of liver disease, of infectious diseases, and they even suffer from higher rates of accidental death, homicide, and mental illness. Before they die young in droves from eminently preventable diseases, African Americans also suffer far more devastating but equally preventable disease complications, such as blindness, confinement to wheelchairs, and limb loss.

involved experiments with African Americans. These subjects were given experimental vaccines known to have unacceptably high lethality, were enrolled in experiments without their consent or knowledge, were subjected to surreptitious surgical and medical procedures while unconscious, injected with toxic substances, deliberately monitored rather than treated for deadly ailments, excluded from lifesaving treatments, or secretly farmed for sera or tissues that were used to perfect technologies such as infectious-disease tests.

I challenge us to change, because as Charles Darwin once observed, “It is not the strongest species that will survive, nor the most intelligent, but the one most responsive to change.

the preamble of the National Sickle Cell Anemia Control Act, enacted in 1972 to foster sickle-cell research, screening, counseling, and education, is untrue: “Two million Americans suffer from sickle cell disease.” Actually, 2 million people were healthy carriers22 and fewer than 100,000 Americans suffered from sickle-cell anemia. The erroneous claim coupled with its constantly reinforced perception of sickle-cell disease as a black disorder left Americans with the mistaken impression that a good portion—one in twelve—of African Americans suffered from sickle-cell anemia.

The vaccine debate encapsulates more than a scientific disagreement; it also reflects the lingering iatrophobia from the exploitative abuse of African American children. This abuse has had a chilling effect on lifesaving research because parents are withholding their permission from positive as well as abusive research. History has shown them how difficult it is to distinguish between the two.

The health of thirty million African Americans is continually imperiled, partly because many eschew effective care rather than risk the tender mercies of government-sponsored medicine. Although many studies and abuses contributed to this iatrophobia, Tuskegee remains the iconic symbol of racialized medical abuse.

Two other slave women peer around a sheet, apparently hung for modesty’s sake, in a childlike display of curiosity. This innocuous tableau could hardly differ more from the gruesome reality in which each surgical scene was a violent struggle between the slaves and physicians and each woman’s body was a bloodied battleground.

Betsey’s voice has been silenced by history, but as one reads Sims’s biographers and his own memoirs, a haughty, self-absorbed researcher emerges, a man who bought black women slaves and addicted them to morphine in order to perform dozens of exquisitely painful, distressingly intimate vaginal surgeries. Not until he had experimented with his surgeries on Betsey and her fellow slaves for years did Sims essay to cure white women.

Whatever his true cure rate, Sim's silver sutures did help to end a real medical tragedy for many women, and some excuse the abuse of enslaved women on this basis. This essentially utilitarian argument presents an ethical balance sheet, with the savage medical abuse of captive women on one hand and countless women saved from painful invalidism on the other. However, such an argument ignores the ethical concept of social justice, and these experiments violated this essential value because the suffering and the benefits have been distributed in an unfair way, leading to distributive injustice.

ENTERED 2021 FEELING a general sense of disenchantment. I was in my second year at Birzeit University, studying law, but the Covid-19 pandemic meant all my classes were online. Even though I was already living at home with my family in Nabi Saleh, a ten-minute drive from Birzeit, I missed the daily buzz and excitement of campus life. I yearned to be learning in an actual classroom, instead of my bedroom. But there was no telling when things would return to normal. At the same time, Israel was receiving global praise for leading the world in vaccinating its population, including settlers like the ones living across the road from our village. But not us. Despite its international obligations as an occupying power, Israel did not initially provide vaccines to the millions of Palestinians living under its occupation, a grotesque display of medical apartheid, and something that only added to my mounting frustration.

Harriet A. Washington in her groundbreaking book Medical Apartheid,

Three times as many African Americans were diagnosed with diabetes in 1993 as in 1963.

Mental ailments are destroying blacks, as well: Black women suffer the highest rates of stress and major depression in the nation and suicide rates soared 200 percent among young black men within just twenty years.

fact, the first legally proven fatality from domestic bioterrorism was the 1973 murder of West Oakland school superintendent Dr. Marcus A. Foster, an African American, who was felled by a cyanide-tipped bullet from the arsenal of the Symbionese Liberation Army.22

One way to transform a system is to add new forces that are working toward our goal. Such forces were added when Leo Robinson and the dockworkers sent food and medical supplies to anti-apartheid groups, or when the “Sun City” artists donated their proceeds. Invisible forces can also be against us, though, in which case improvement comes from subtracting them. We can divest from apartheid. We can speak up to dismantle racism.