By: Lamar Greene
1. Henrietta Lacks and HeLa cells
The story of Henrietta Lacks is one of the grossest examples of medical paternalism and bioethical injustice to this day. Lacks was a poor Black tobacco farmer whose cancer cells were taken by doctors at Johns Hopkins in Baltimore while she was undergoing a biopsy for cervical cancer in 1951. Her cells became the first immortal human cell line because they reproduced infinitely in the lab. Her cells were then shared freely with scientists across the world, without her consent, to develop the polio vaccine, cloning, gene mapping, in vitro fertilization, and more. While her cells have been used to create a million-dollar industry in health research, her children still live in poverty, without health insurance, and without access to many of the medical advances afforded to the world by their mother’s cells.
The “Tuskegee Study of Untreated Syphilis in the Negro Male” began in 1932 as a cross collaboration between the Public Health Service and the Tuskegee Institute. The initial purpose of the study was to record the natural history of syphilis to justify treatment programs for Black Americans. The study involved 600 Black men – 399 with syphilis and 201 without the disease – and was conducted without their informed consent. Although the Tuskegee Syphilis Experiments were projected to originally last for 6 months, it went on to last for 40 years. An Ad Hoc Advisory Panel reviewed the study in 1972 to discover that the researchers never informed the men about the study or its purpose. Furthermore, the men were never given adequate treatment for their syphilis despite penicillin becoming the standard treatment in 1947. The advisory panel revealed that the men were also never given the choice to leave the study. The study only stopped after Peter Buxtun, a US Public Health Service (PHS) employee who had filed two ethics complaints to the PHS, alerted news outlets of the study in 1972.
3. The Negro Project
Margaret Sanger, a staunch believer in Malthusian eugenics, created the controversial “Negro Project” in 1939 under the name “Birth Control Federation of America.” The Birth Control Federation of America is known today as Planned Parenthood. The aim of the program was to restrict the size of the Black population, with larger implications for complete extermination. Sanger disguised her plan under the pretense of better health and family planning. In reality, she selectively targeted low-income Black women with birth control so that they could no longer reproduce.
James Marion Sims is constantly credited as the “father of modern gynecology” for developing tools and techniques related to women’s reproductive health. Sims invented the vaginal speculum, a tool used for dilation and examination. He also pioneered a surgical technique to repair vesicovaginal fistula, a common 19th century complication of childbirth consisting of a tear between the uterus and the bladder. Sims, a southern-born slaveholder, made his discoveries through painful experimentations done on enslaved African women. He tortured enslaved African women by conducting research on their bodies without the use of anesthesia, actions of medical barbarism. Anarcha, Lucy, and Betsey are three of the women who were objectified by Sims’ experiments, where he operated on the notion that Black bodies do not experience pain. Sims is not the only doctor to have experimented on slaves, but he is a notable example.
5. Medical Stigma in Pain Management Treatment
Medical stigma in treating pain among Black patients is still very much alive today. Kelly Hoffman, a PhD student at UVA, conducted a study linking racial disparities in pain management to racial bias among White doctors. Hoffman and other researchers found that a substantial number of White medical students and residents hold false beliefs about biological differences between Black and White people, which are responsible for Black patients being undertreated for pain according to World Health Organization (WHO) guidelines. Common falsely held beliefs included the idea that Black people’s skin is thicker and Black people’s blood coagulates more quickly. These are ideas that seem to worsen as students advance in medical school and residency. Furthermore, some textbooks in the healthcare field were written with racial bias. Just last year, Pearson Education had to recall nursing textbooks because of the racial stigmas included within the texts. The textbook reported that “Blacks often report higher pain intensity than other cultures” when advising nursing students on how to evaluate patients from different racial and ethnic backgrounds.
- Armstrong, K., Ravenell, K. L., Mcmurphy, S., & Putt, M. (2007). Racial/Ethnic Differences in Physician Distrust in the United States. American Journal of Public Health, 97(7), 1283-1289. doi:10.2105/ajph.2005.080762
- Trawalter, S., Hoffman, K. M., & Waytz, A. (2012). Racial Bias in Perceptions of Others’ Pain. PLoS ONE, 7(11). doi:10.1371/journal.pone.0048546