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Venaya Binwani
Theme: Healthcare systems/Ethics and Controversy
Throughout history and even today, systemic racism continues to be a part of society and the institutions we associate ourselves with daily. It is appalling to admit that prejudice and violence still exist against black communities, especially when social attitudes and mindsets should be progressing rather than regressing. As people who have access to a platform to voice our opinions, we wanted to shed light on the systemic racism that has been embedded in healthcare and medicine over centuries, to prove that no institution is free of blame. Through this article, I am going to explore three cases of African American exploitation in biomedical research, some of which have led to medical breakthroughs that we use in modern practice today. I hope that this gives you a better understanding of the history of racism in healthcare, and makes you more aware of its presence in modern medicine.
The first of these experiments is known as the Tuskegee study of Syphilis in the Negro Male, which took place between 1932-1972. In this experiment, a group of researchers from the US public health service recruited 600 African American men to participate in a trial for Syphilis treatment. Upon recruitment, the 399 men who were infected were promised free treatment for the disease that had no definitive cure at the time, whilst the remaining 201 participants would act as a control group for the study. Despite knowing that penicillin was the recommended treatment for Syphilis at the time, the doctors prescribed them with mineral supplements and aspirin instead. As time progressed, many of these men began to develop severe complications such as blindness, due to their infection being left untreated.
By 1947, health officials had confirmed that penicillin was an effective treatment for Syphilis, however, this information was not passed on to participants and they were left in the dark about their treatment options. Due to the negligence of these healthcare professionals, 128 of these cases were fatal, the disease was passed on to 40 women, alongside 19 of their children during birth. The fact that these healthcare professionals exploited the lack of knowledge and access to treatment that these individuals had is extremely unethical and goes to show how the superiority complex of white Americans jeopardized the health of several African American people. [1]
The next case is about James Marrion Sims, presently known as the ‘father of modern gynaecology’, who invented devices and surgical techniques that physicians continue to use today. Whilst his achievements would appear commendable, the brutal history behind these developments truly epitomises the exploitation of African American individuals in the interest of biomedical research. During the early stages of his career, his patients often comprised female slaves who had experienced complications with their pregnancy, leading to persistent pain and bleeding. With the need to examine the internal organs of the reproductive tract, he developed the modern vaginal speculum which gynaecologists commonly use in pelvic examinations. He also developed a surgical technique used to repair a tear between the uterus and bladder that commonly occurred during birth (vesicovaginal fistula). However, because his patients had no autonomy over their bodies, he would often practice these techniques on them, without the use of anesthesia. At the time, the racist notion that black people could not feel pain was a shared belief amongst medical practitioners - which is ridiculous to believe given his recounts of the pain these women experienced during his surgeries. In one particular diary entry, Sim's describes that “Lucy’s (a patient) agony was extreme.”
Given this fact, it is appalling to credit a man for developing surgical procedures through the mistreatment and exploitation of black women, who couldn’t give their informed consent - which comprises the foundation of medical ethics. It makes me sick to think that parts of medical practice are associated with such a brutal history. However, it is also important to recognize the known women who were involved with these developments: Lucy, Anarcha and Betsy - whose bodies were exploited in the name of modern medicine. [4]
The final incidence I will be exploring is the case of the Crownsville state hospital, also referred to as the Hospital for the Negro Insane. This was an institution built to provide segregated mental health care for African Americans, but soon became a dumping ground for politicians, doctors and healthcare officials to isolate anyone who was perceived ‘too ill’ to mix with the rest of society. As the eugenics movement was gaining momentum at the time, it was not uncommon for a perfectly healthy individual to be admitted which resulted in severe overcrowding in the hospital. [3] To make things worse, the healthcare officials running the institution conducted a variety of horrific experiments on patients, to test inhumane methods of treatment on their patients of African American descent. Some sources say that patients with epilepsy were subject to insulin shock treatments, where patients would be injected with the hormone until their blood sugar would reach dangerously low levels that would put them in a coma. It is also reported that a procedure called pneumocephalograpy was tested. This involved drilling a hole in the patient's skull and removing the fluid surrounding the brain, to test for clearer x-ray images. [2] Unfortunately, these are only a few of the horrific experiments conducted at the hospital, which is believed to carry the bodies of 1,600 patients in unmarked graves. Whilst the building is currently abandoned, it is important to speak about such incidents in the past to respect the memory of the people who suffered at the hands of racism.[3]
From this, I hope you can see how the medical profession, which should be rooted in providing care in the best interest of patients, has not always served everyone equally. Whilst these cases may be historic, racism is sadly not in the past. To everyone reading, I urge you to educate yourselves and continue to challenge your biases, because these stories represent how prejudice and discrimination were used as a justification for abuse for exploitation.
With that being said, here is a link to a document that takes you to a collection of petitions and news articles about the Black Lives Matter Movement that you may want to engage with. Under the Microscope humbly requests its followers to educate themselves about this pressing issue and raise awareness about it.
Bibliography
Nix, E., 2017. Tuskegee Experiment: The Infamous Syphilis Study. [online] HISTORY. Available at: < https://www.history.com/news/the-infamous-40-year-tuskegee-study > [Accessed 16 August 2020].
Elshabazz-Palmer, Aqilah (2017) "Scienti c Racism: The Exploitation of African Americans," Intertext: Vol. 25 : Iss. 1 , Article 10.Available at: https://surface.syr.edu/intertext/vol25/iss1/10
Gaddy, K., 2018. A Brief History Of The Crownsville State Hospital In Maryland. [online] Culture Trip. Available at: < https://theculturetrip.com/north-america/usa/maryland/articles/a-brief-history-of-the-crownsville-state-hospital-in-maryland/ > [Accessed 16 August 2020].
4. Holland, B., 2018. The ‘Father Of Modern Gynecology’ Performed Shocking Experiments On Slaves. [online] HISTORY. Available at: < https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves > [Accessed 16 August 2020].