Medical Racism Within the American Healthcare System
“The United States government did something that was wrong — deeply, profoundly, morally wrong. It was an outrage to our commitment to integrity and equality for all our citizens. To our African American citizens, I am sorry that your federal government orchestrated a study so clearly racist. You did nothing wrong, but you were grievously wronged.”
—President Clinton’s apology for the Tuskegee Syphilis Experiment to the eight remaining survivors, May 16, 1997
One of the most horrific scandals in American medicine took place for a duration of forty years. From 1932 to 1972, the Tuskegee study created by the U.S Public Health Service and the Tuskegee Institute in Alabama allowed 400 black males to dig their graves beforehand based on unethical methods that could possibly not generate no new information about syphilis. The participants were blind sided and withheld information about their health, instead they were told they were being treated for “bad blood”. They were manipulated into participating in this vile study by being offered free medical exams, free meals, and burial insurance not knowing they had syphilis nor being treated for it. The history of health disparities and medical care in the United States also gives us insight into present-day inequalities and why racial biases continues to be a factor in medicine.
Keywords: Healthcare disparities, prejudice, racial biases, human rights
Medical Racism Within the American Healthcare System
According to Washington (as sited in Roberts, 2012) the study was designed to conform the long-held view that venereal disease acted differently in blacks than whites. Scientist believed, for example, that syphilis caused the greatest damage to the neurological system in whites but ravaged the cardiovascular system in blacks. (p. 85). In Macon County, Alabama the U.S Public Health Service (USPHS) was conducting this experiment on six hundred total of participants, only 400 of which were infected and the remaining 200 controlled. “They tricked the poor and illiterate sharecroppers into participating with false promises of treatment then let the men die so they could autopsy their bodies and examine the destruction left by the disease.” (Roberts, 2012, p.85). When penicillin became the preferred treatment for syphilis in the late 1940s, researchers prevented the men from getting existing therapies. Local physicians were deliberately not helping the sickly men, and more so focusing on racial difference in disease rather than on the human beings who were suffering from disease had tragic consequences. (Roberts, 2012).
“Whites argued that the best way to improve the condition of emancipated blacks was through either benign neglect or coercive medical intervention.” (p.85). In 1969, a committee at the federally operated Center for Disease Control decided that the study should still carry on, although a cure had been found. It was only until, 1972 when national press coverage informed the Department of Health, Education, and Welfare to halt the experiment. In 1973, Congress holds hearing and a class-action lawsuit is filed on behalf of the study participants. However, when the experiment had come to an end, Former president, Bill Clinton made an official apology and at that time there were only eight survivors. “The Syphilis Study is so frightening because if shows the inhumanity that can result from a belief in intrinsic racial difference. The study had nothing to do with treatment.” (Jones, 1981, p. 134).
“Another area of research where blacks were used as testing animals so to speak, was the experimental use of radiation. Doctors were under contract with the U.S. Atomic Energy Commission and had been waiting for a moribund patient so that they could test the effects of plutonium which is a radioactive element used in nuclear weapons and reactors.” (Golash-Boza, 2016, p. 271). Roberts states that defining disease in racial terms played an essential part in this biological strategy that was enshrined to biomedical research and practice. (p. 83). African Americans began questioning the government and health care practices involving other illnesses as well. In 1990, a survey found that ten percent of African Americans believed that the U.S. government created AIDS as a plot to exterminate blacks, and twenty percent claimed they could not rule out the possibility that this might be true (Kelley, 2008).
In the United States, racial groups are normally constructed to capture the difference in power, status, and resources however racial categorization has always been rooted in racism. It is demonstrated through the idea that inferiority is used to justify unequal treatment or discrimination of members of groups defined as inferior by individuals and societal institutions. This construct of racism enhances the understandings of racial inequalities in the health care system because the ideology of inferiority may lead to the development of negative attitudes and beliefs towards different racial groups and therefore influence the quality of health care different racial groups receive. Healthcare is an area in which many African Americans have perceived racism and suffered the detrimental health effects and consequences of this maltreatment. In fact, racism is one of the mechanisms that explains and expands racial disparities in health (Gee, 2002). Whether indirectly through environmental factors and educational and economic resources or directly through lack of care and minimal treatment of diseases, African Americans have experienced racial discrimination and racism in the field of health care and have suffered the negative effects of this disparity for centuries.