The Dark Side of The History of Health

By Glenda Xu.

In celebration of Black History Month, UCL Bioethics and Medical Law society hosted an event led by the prestigious Dr Reuben Warren – Professor of Bioethics and Director of the National Center for Bioethics in Research and Health, Tuskegee, Alabama. This event resurfaced many of the atrocious violations that took place against African Americans since the Trans-Atlantic Slave Trade, buried deep in the history of medicine.

“We must take lessons learned from our difficult past [.. to acknowledge] current issues related to racial disparities in disease and treatment.”

– Dr Reuben Warren (6)

The Tuskegee Syphilis Study conducted from 1932 to 1972 by the United States Public Health Service was undeniably a gross violation ‘characterized by the withholding of therapy, cultural insensitivity, deception, and exploitation’ (1). This study covertly exploited over 600 African American men and their families. Participants from the ‘black belt’ of Alabama (2) were deceived into the study without any informed consent, to be given ineffective treatments and diagnostic procedures disguised to ‘treat their bad blood’ (2). Despite Penicillin becoming widely available in 1947 as a proven (2), effective treatment method for syphilis, this study lasted over 40 years. Under its pretense of the ‘benevolent act to improve the human condition through the acquisition of new knowledge’, the resulting ‘malevolence’ of the Tuskegee Syphilis study has imprinted a deep-rooted sense of mistrust of the medical system in generations of Black communities to come (1). 

“The mythical Sankofa bird flies forward while looking back with an egg in its mouth – symbolizing that whatever we have lost, forgotten, forgone or been stripped of, can be reclaimed, revived, preserved and perpetuated.”

– Dr Reuben Warren (1)

Much of our medical landscape has been built upon ‘scientific racism’ (2). The ill-treatment of Black people in the Tuskegee Syphilis study was founded by the false belief amongst medical professionals that the ‘nature of African Americans, sexual behaviour and disease’ is what makes Syphilis a ‘Negro disease’ (3). From a modern day perspective, one would presume such a poorly formed assumption no longer exists in medical practice today. However, Dr Warren highlights that the Tuskegee study is not the only, and certainly by no means will be the last, human subject research conducted that violates bioethics in Black and ethnic minorities, or lower socio-economic class communities. He reminds us that as science and medicine advances forward rapidly, we must continue to acknowledge the harrowing past in order not to ‘lose our moral bearings in the name of progress’ (4).

“We must know enough, care enough, do enough to make a change – Dr David Satcher 16th US Surgeon General”

– Dr Reuben Warren (1)

With the recent Covid-19 pandemic that has disproportionately impacted BAME communities, alongside the global outcry for George Floyd and many Black Americans, discussions surrounding structural racism entrenched in modern day society have been brought to the foreground. Bioethicists, scientists, and healthcare professionals should be called into question research methodologies and healthcare systems that overlook the historical racist origins of practice. Dr Reuben Warren enforces that: without a commitment to recognising the past, we are inevitably susceptible to allow similar injustices in the future.  

REFERENCES

  1. Warren, Reuben C. “The Dark Side of History .” Black History Month: The Dark Side of History. Black History Month: The Dark Side of History, 19 Oct. 2020, London , University College London Bioethics & Medical Law Society . 
  2. “40 Years of Human Experimentation in America: The Tuskegee Study.” Office for Science and Society, 14 May 2019, http://www.mcgill.ca/oss/article/history/40-years-human-experimentation-america-tuskegee-study. 
  3. Sargent, Joseph, director. Miss Ever’s Boys, 2015, http://www.youtube.com/watch?v=jhhZo1Vi_J4. 
  4. Centers for Disease Control and Prevention. Presidential Apology. Presidential Apology, 21 Oct. 2020, The White House, The White House.  https://www.cdc.gov/tuskegee/clintonp.htm
  5. Reverby, S M. “Tuskegee: Could It Happen Again?” Postgraduate Medical Journal, The Fellowship of Postgraduate Medicine, 1 Sept. 2001, dx.doi.org/10.1136/pmj.77.911.553.
  6. Warren, Reuben C. “Welcome from the Director.” Tuskegee University, Tuskegee University, http://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/welcome-from-the-director.