Footnotes: Racism in medicine

As long as we live in an unequal society, science and medicine will always have a long way to go. #BlackLivesMatter

This is racism in medical history.

It’s been 12 days of protests since George Floyd died. This is a second in comparison to more than four centuries of subjugation. But it’s not just thanks to the police and military. Science and medicine were not exceptions.

While doing this ‘Graphic Design Is Not My Passion‘ project, I better understood how we are raised to blindly accept or ignore immoral and unethical practices. We keep these unconscious biases because of tradition, because of outdated laws, because of our privilege, and because of the strength of those who wish to keep the status quo.

We now take for granted the existence of ethical review boards and medical privacy laws. But these came with high costs.

Carl Linnaeus and the legacy of scientific racism

Carl Linnaeus helped justify and spread the ideas of racial typology and European superiority with his 1735 work. Systema Naturae led to centuries of scientific racism. He is known as the Father of Modern Taxonomy.

Nosce te ipsum. Linnaeus presented the genus Homo and the varieties americanus, asiaticus, afer, and europaeus, each with their inherent characteristics. Afer was written as “niger, phelgmaticus, laxus”. Black, phlegmatic, lazy.

By the time of Charles Darwin 100 years later, scientific society would be agreed in dividing humanity into distinct races, supporting progressive evolution towards the European ideal, and justifying gender roles based on sexual selection.

The first major document to challenge social racial typology was the 1950 UNESCO Statement on Race and Racial Prejudice, driven by post-war outrage.  

Anarcha, on the treatment of slaves and consent

Anarcha was one of the enslaved American women who underwent a series of experimental surgical operations without anesthesia from 1845 to 1859, under Dr. J. Marion Sims. He was later known as the Father of Modern Gynecology.

Anarcha was subjected to 30 experimental surgeries for fistula repair.

Dr. J. Marion Sims’ work on gynecological surgery had significant impact on modern medicine; some of his suture techniques are still used today.

This was before the concept of ‘informed consent’ and before the widespread use of anesthesia, which was first used in 1846. Other physicians who also operated on enslaved men and women include Dr. Ephraim McDowell (considered a founder of abdominal surgery and ovariotomy) and Dr. Crawford Long (pioneer in anesthesia use).

“Therapeutic experimentation” on American slaves could have been the only compassionate act available to doctors in a slaveholding society, aside from outright revolution. 

The immortal cell line of Henrietta Lacks

She was diagnosed with cancer. A tissue sample taken 1951 without her consent became HeLa, the first immortal human cell line. This changed medical research, led to a billion-dollar industry, and didn’t benefit her family until 1975. Her name was Henrietta Lacks.

Twenty years after her death, her impoverished family belatedly found out about her cells being used for research and profiteering.

The doctor who cultured her cells was named Dr. George Gey. After Lacks’ death, Gey still had further HeLa samples taken from her body. The practice of asking consent in the use of tissue samples, of maintaining privacy in publishing genetic information, and of compensating patients in commercial use would still be an issue up until 2013, when European Molecular Biology Laboratory scientists sequenced the entire genome of HeLa cells and published the information without the family’s consent.

Medical and research ethics in the Tuskegee Study

Told only that they had “bad blood”, hundreds of black men became part of the 1932-1972 government study on the natural course of syphilis. Despite the advent of penicillin, none of them received treatment. Children also became infected. This was the Tuskegee Study.

The study involved two black professionals (Dr. Dibble and Nurse Rivers); black medical students were also rotated into the study by the the late 1940s.

The research question asked whether untreated syphilis caused cardiovascular damage more often than neurological damage, and if the natural course had significant difference between white and black men. The research subjects were not told that syphilis was sexually transmissible.

The American Congress later established the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1974.

Ernest Hendon, the last living participant of the Tuskegee Study, died in 2004.

This post only features four examples of racism in medicine history. There are countless more, including the use of blackface, segregation, and racial IQ studies. Today, African Americans still face racism in pain assessment and treatment, in opportunities within medical professions, and in access to health care.

As long as we live in an unequal society, science and medicine will always have a long way to go. #BlackLivesMatter

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