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Medical Apartheid by Harriet A. Washington
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Medical Apartheid (2006)

by Harriet A. Washington

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After reading medical history for a few years I have become accustomed to the fact that until about 200 years ago physicians offered nothing more than comfort and false hope. Thanks to Harriet Washington’s book, “Medical apartheid : the dark history of medical experimentation on Black Americans from colonial times to the present“ I realized that many patients, even today, are still only offered false hope in spite of effective treatments being available and that their comfort, their health, is considered irrelevant against the quest for gain. As soon as scientific methods allowed for the development of effective treatments people with no power to resist became the unwilling, and often unknowing, test subjects in the competition for personal and corporate profits. Hopefully this book will do for medical research what the Rodney King video did for law enforcement.

I came to read this book for my research into early 19th century medical training. It helped me document what I suspected, anatomy classes dissected primarily black bodies. Hundreds of black bodies being robbed of their eternal slumber was as ineffective then at grabbing the attention of legislatures and law enforcement as hundreds of black bodies being gunned down in our streets is today. Having grown up in the United States I knew what to expect from the popular opinion of the WASP majority. I did not expect the persistent ignorance that is racism to be practiced by educated physicians .

Washington’s writing and research are excellent although I do have a few very minor problems with the book. When discussing the ethnic imbalance in medical studies Washington mentions a study with majority African American subjects in a majority African American city. Isn’t proportional representation what we should strive for? Perhaps there was another flaw in that study’s methodology but I did not see it mentioned in the text. When discussing African American’s over representation as subjects in prison studies the passing mention of the fact that African Americans are proportionately over represented in the prison population compared to the general population seemed to me to be understated . Although the over incarceration of minority citizens is outside the focus of the book I felt that the double discrimination could have been emphasized a bit more.

Although I feel that Washington’s professional detachment wavered during the examination of forced sterilization I am in awe of her ability to, over all, maintain her professionalism. Reading this book affected me more than any other work I can remember reading. As I said, I expected racial bigotry to be shown in antebellum selection of subjects for medical school dissection, but I was shocked at how much farther it went. I naively expected that post Mengele, post Nuremberg, post AMA, NIH and CDC ethics standards the intentional targeting of minorities and the poor would have diminished. It did not. For some reason I expected better of educated “healers”. I feel the need to go and reread John Dittmer’s “The Good Doctors” in the hope that it will restore some of my faith in the medical profession. ( )
  TLCrawford | Feb 14, 2013 |
This is such a grim book that it took me a rather long time to get through. Harriet Washington has researched the history of medical studies using people of African origin or descent from slavery times through the present. It appears to be thoroughly researched and well documented. Washington cites a need for honesty in dealing with the issue for the sake of current research efforts with African Americans -- who appear reluctant to serve as medical research subjects in even legitimate and ethical studies. She argues that such reluctance is not just fallout from the infamous Tuskegee Syphilis Study, as many white people claim, but is the result of a long-standing pattern of medical abuses toward subjects with dark skin.

Many -- no most -- of the stories here are truly ugly, the abuses blatant and obvious, the racial bias clear. Those are the most powerful (and upsetting) stories. Then there are those situations where the abuse or the bias is more subtle. In a few cases, Washington seems to tiptoe on the borders of working both sides of the issue re: the need for participation vs. the appropriateness of the studies. While this sometimes illustrated the difficulty of conducting truly fair and ethical experiments, sometimes it appeared to this reader that the author was pushing the issue in cases where the ethics were ambiguous at worst -- for instance, terminally ill prisoners who consented to highly risky procedures because they knew they would be dead in a few weeks barring a true medical miracle. Inclusion of such cases hardly seemed necessary, as there was more than enough obviously unethical material to make her point.

This is not at all a pleasant book to read, but it is a real eye-opener. ( )
1 vote tymfos | Feb 16, 2011 |
In this book, the author has compiled and analyzed a vast amount of research to make the case that racist practices toward African-American people from slavery onward, in the name of science and medicine, have created an atmosphere of distrust among African-Americans toward the medical profession. As a result of this distrust, and often fear, this group of people may not be getting proper medical care when necessary.

I won't go into a major discussion here, but I thought the author did a fine job in terms of research and presentation. I'm not a scientist, nor am I conversant enough in the topic to judge her research, but this book really opened my eyes to some less than professional and less than ethical practices. I must say that I'm not surprised -- earlier I read the book "Bad Blood" about the syphillis experiments at Tuskeegee -- but that was probably the extent of my knowledge on the topic. Washington's book makes that study seem like only the tip of the proverbial iceberg. I have to say that sometimes she was a bit repetitive, but not enough to distract from the main points of her work.

I truly hope her work does some good. I'd recommend it to people who are interested in the topic, especially people like myself who have only a limited knowledge, or to people who want to add yet another dimension to their understanding of African-American history.
  bcquinnsmom | Feb 23, 2009 |
This is a sweeping account of the long, tragic history of the abuse of African Americans in medical research. The shocking nature of the abuses described in this book, along with the sheer quantity of them, is nearly overwhelming. But Washington does much more than merely shock the reader; she helps us to understand why the black community has been so distrustful of medicine and the health care system -- which tragically worsens the health disparities between blacks and whites -- and argues that restoring that trust must begin with an honest accounting of the wrongs that have been done.

The one major criticism I have of the book is, in describing some of the more recent episodes, its tendency to understate the role of socioeconomic class discrimination in order to continue pressing the issue of race. To be sure, class discrimination has meant that blacks have been overrepresented, there is a meaningful distinction to make between medical abuses motivated by racism and/or racist medical theory, and medical abuses that disproportionately affect blacks by taking advantage of the vulnerability of people in poverty. But this is a relatively small criticism of what is a powerful and important book that should be read by anyone concerned with social justice and ethical research. ( )
  JFBallenger | Jan 15, 2009 |
This is an overwhelming but highly worthwhile book. I would recommend it to anyone interested in the history of medicine, racism in America, or just good non-fiction. Harriet Washington attempts a very ambitious project and draws on a huge number of medical studies/records and personal narratives of those who participated in them, either as subjects or experimenters, and those who analyzed these studies. Her overall purpose is to explore and expose the role of racism in the history of American medicine and to restore the experiences and voices of black Americans - most of whom were unwilling or unwitting participants - to this history.

The title, which some may find hyperbolic, is an apt description of the history that Washington uncovers, as black and white Americans have truly existed in separate spheres where medical experimentation and medical care was concerned. Although she begins her story in antebellum America, describing medical experimentation on slaves and free blacks, her examination of studies conducted in the last 10 to 20 years demonstrates that, although the situation has certainly improved, the exploitation of disadvantaged blacks for the benefit of scientific "advancement" is far a thing of the past. Despite this history of abuse, Washington ends her book with a plea for more participation by blacks in clinical studies, arguing that - with strict control of such studies and improvements in study design and ethical constraints - these studies offer blacks an invaluable opportunity to improve their health, which has suffered throughout history due to precisely the kind of medical experimentation that she details in her book.

Washington's book is divided into a number of "themes" that emerged throughout the history of medical research on black Americans, most of which are manifested to a greater or lesser extent in different periods, so the chapters do tend to follow a rough historical progression from the plantation to the present. These themes include: (1) the display of black bodies, whether in surgical theaters or circus "freak shows" like the Worlds' Fair; (2) the misappropriation of black bodies by science, including grave robbing in order to procure bodies for medical school dissection instruction & use of individuals as experimental subjects without their consent - informed or otherwise, as in the practice of the "Mississippi appendectomy," the practice of sterilizing black women through hysterectomy or other means during the course of other surgical procedures; (3) the use of the least powerful among American blacks - slaves, sharecroppers, the poor or homeless, soldiers, children, prisoners, and the already-ill; and (4) the use of black experimental subjects to develop & perfect treatments that tended to benefit white and/or wealthy Americans.

The use of American blacks to develop treatments for whites is particularly interesting given the fact that most of the history of experimentation on black Americans has tended to promote and reinforce the belief in an inherent racial difference between blacks and whites; additionally, blacks were not simply different, they were inferior to whites - more prone to disease, less intelligent, hyper-sexual, less evolutionarily advanced. Even traits found primarily among blacks that indicated superior immunity to certain diseases were rephrased as "inferior susceptibility" to those diseases. Despite the belief that blacks and whites were completely different "species," black bodies provided the testing ground for many medical treatments and devices that were later used on whites.

A further theme that runs throughout Washington's book, but is only made explicit in the later chapters focusing on contemporary American studies of urban blacks, is the assumption that all pathologies found in American blacks, whether physical, psychological, or social in nature, were the result of genetics. Social explanations - poverty, lack of opportunity, violent environments, etc - that might contribute to criminal behavior amongst urban black youth were dismissed in favor of claims that they were inherently condemned by faulty brain chemistry, leading to attempts to predict criminal behavior among younger siblings of boys already in the juvenile justice system by measuring the younger boys' levels of neurotransmitters thought to be linked to aggression. Lobotomies were practiced and promoted in the 1960s as a cure-all for urban riots, in total dismissal of the reality that discontent among urban blacks in the 1960s might reflect genuinely oppressive social conditions, rather than mental illness or some other deviancy that needed to be stamped out.

Despite this history of abuses, many of which occurred as recently as the 1990s, Washington does feel that - with strict controls & improved ethics - it is vitally important for American blacks to participate in clinical trials and to not fear the American medical system, because this fear causes communities to avoid truly beneficial therapies. She feels that, by clearing the air and addressing the issue of exploitation of black Americans by the scientific and medical communities throughout history, she paves the way for this participation. I don't know if I agree with that, however, because after reading this book, even I - an educated, upper-middle class white woman - felt highly paranoid about the safety of a lot of drugs and supposedly "safe" medical interventions. Still, a great book - very highly recommended, even though it is quite emotionally draining. ( )
2 vote fannyprice | Apr 22, 2008 |
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Amazon.com Product Description (ISBN 076791547X, Paperback)

National Book Critics Circle Award Winner (Nonfiction)
PEN/Oakland Award Winner
BCALA Nonfiction Award Winner
Gustavus Meyers Award Winner


From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.
The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.

(retrieved from Amazon Mon, 30 Sep 2013 13:39:38 -0400)

(see all 2 descriptions)

The first comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between Africans and Western medical researchers and the racist pseudoscience that resulted, it details the way both slaves and freedmen were used in hospitals for experiments conducted without a hint of informed consent--a tradition that continues today within some black populations. It shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and a view that they were biologically inferior, oversexed, and unfit for adult responsibilities. New details about the government's Tuskegee experiment are revealed, as are similar, less well-known medical atrocities conducted by the government, the armed forces, and private institutions. This book reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit.--From publisher description.… (more)

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