Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (Hardcover)

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Key Phrases: aberrant wars, medical apartheid, diagnosis freedom, African Americans, United States, Tuskegee Syphilis Study (more...)

Editorial Reviews

From Publishers Weekly

Starred Review. This groundbreaking study documents that the infamous Tuskegee experiments, in which black syphilitic men were studied but not treated, was simply the most publicized in a long, and continuing, history of the American medical establishment using African-Americans as unwitting or unwilling human guinea pigs. Washington, a journalist and bioethicist who has worked at Harvard Medical School and Tuskegee University, has accumulated a wealth of documentation, beginning with Thomas Jefferson exposing hundreds of slaves to an untried smallpox vaccine before using it on whites, to the 1990s, when the New York State Psychiatric Institute and Columbia University ran drug experiments on African-American and black Dominican boys to determine a genetic predisposition for "disruptive behavior." Washington is a great storyteller, and in addition to giving us an abundance of information on "scientific racism," the book, even at its most distressing, is compulsively readable. It covers a wide range of topics—the history of hospitals not charging black patients so that, after death, their bodies could be used for anatomy classes; the exhaustive research done on black prisoners throughout the 20th century—and paints a powerful and disturbing portrait of medicine, race, sex and the abuse of power. (Dec. 26)
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From The Washington Post

Reviewed by Alondra Nelson The Tuskegee Syphilis Study remains an ignominious milestone in the intertwined histories of race and medical science in U.S. society. Initiated in 1932, this tragic 40-year long public health project resulted in almost 400 impoverished and unwitting African American men in Macon County, Ala., being left untreated for syphilis. Researchers wanted to observe how the disease progressed differently in blacks in its late stages and to examine its devastating effects with postmortem dissection.

A fresh account of the Tuskegee study, including new information about the internal politics of the panel charged by the Department of Health, Education and Welfare with investigating it in 1972, lies at the center of Harriet A. Washington's courageous and poignant book. The balance of Medical Apartheid reveals, with arresting detail, that this scandal was neither the first chapter nor the last in the exploitation of black subjects in U.S. medical research. Tuskegee was, in the author's words, "the longest and most infamous -- but hardly the worst -- experimental abuse of African Americans. It has been eclipsed in both numbers and egregiousness by other abusive medical studies."

Although medical experimentation with human subjects has historically involved vulnerable groups, including children, the poor and the institutionalized, Washington enumerates how black Americans have disproportionately borne the burden of the most invasive, inhumane and perilous medical investigations, from the era of slavery to the present day. (This burden has become global in the last few decades.) In 1855, John "Fed" Brown, an escaped slave, recalled that the doctor to whom he was indentured produced painful blisters on his body in order to observe "how deep my black skin went." This study had no therapeutic value. Rather, fascination with the outward appearance of African Americans, whose differences from whites were thought to be more than skin deep, was a significant impulse driving such medical trials.

Shielding whites from excruciating experimental procedures also proved a powerful motivation. J. Marion Sims, a leading 19th-century physician and former president of the American Medical Association, developed many of his gynecological treatments through experiments on slave women who were not granted the comfort of anesthesia. Sims's legacy is Janus-faced; he was pitiless with non-consenting research subjects, yet he was among the first doctors of the modern era to emphasize women's health. Other researchers were more guilty of blind ambition than racist intent. Several African Americans, including such as Eunice Rivers, the nurse-steward of the Tuskegee study, served as liaisons between scientists and research subjects.

The infringement of black Americans' rights to their own bodies in the name of medical science continued throughout the 20th century. In 1945, Ebb Cade, an African American trucker being treated for injuries received in an accident in Tennessee, was surreptitiously placed without his consent into a radiation experiment sponsored by the U.S. Atomic Energy Commission. Black Floridians were deliberately exposed to swarms of mosquitoes carrying yellow fever and other diseases in experiments conducted by the Army and the CIA in the early 1950s. Throughout the 1950s and '60s, black inmates at Philadelphia's Holmesburg Prison were used as research subjects by a University of Pennsylvania dermatologist testing pharmaceuticals and personal hygiene products; some of these subjects report pain and disfiguration even now. During the 1960s and '70s, black boys were subjected to sometimes paralyzing neurosurgery by a University of Mississippi researcher who believed brain pathology to be the root of the children's supposed hyperactive behavior. In the 1990s, African American youths in New York were injected with Fenfluramine -- half of the deadly, discontinued weight loss drug Fen-Phen -- by Columbia researchers investigating a hypothesis about the genetic origins of violence.

Washington's litany of experimental misdeeds done to African Americans is more extensive than can be described here. With such damning evidence, one wonders why she felt it necessary to include examples that, while clearly offensive, do not rise to the threshold of medical experimentation. For instance, supporters of slavery, to justify the peculiar institution, cited data from the 1840 census showing that free African Americans had poorer mental and physical health than enslaved blacks. Nonetheless, taking ideological liberties with questionable statistics is not, in and of itself, an example of medical experimentation, nor was circus impresario P.T. Barnum's display of black Americans as entertainment. While demonstrating the widespread exploitation of blacks, it confuses the thrust of Washington's argument.

But Washington also sheds light on how our understanding of what constitutes medical research requires broadening in the face of new developments in genetic science. Federal and state forensic DNA databases contain a disproportionate number of samples from African Americans, for example. Because genetic samples collected for this purpose carry information about a subject's health, blacks are particularly vulnerable to the exposure of sensitive medical information. And although experimentation with human subjects is less invasive than it once was, Washington cautions that it is no less injurious. Researchers still need to be mindful of the rights of their subjects.

Given the history presented in Medical Apartheid, it is no surprise that some African Americans continue to regard the medical system with apprehension, despite more stringent safeguards enacted by the federal government in the 1970s. Washington attributes this outlook, which she calls iatrophobia, to the seeds of distrust sown in black communities by the Tuskegee scandal and a history of lesser-known mistreatment.

Washington, a visiting fellow at Chicago's DePaul University, intends that Medical Apartheid serve a socially therapeutic -- if not cathartic -- function. Laying bare these atrocities, her logic goes, will foster healing and frank but necessary conversation. Clearing the air may encourage a better informed African American public to participate in clinical trials.

Despite the author's best intentions, the scale and persistence of the "dark history" she delineates may well preclude such a development. Precisely because Washington's account of racially stratified medical exploitation is so gripping, it may be difficult for the public to muster enthusiasm to enter clinical trials, no matter their cultural background. And with the experimental research burden shifting from Americans of African descent to Africa itself (which Washington calls a "continent of subjects"), Asia, and Latin America, where some cavalier researchers are seeking more plentiful and pliant subjects, readers may be more convinced than ever of the durability of the medical color line.

Reviewed by Alondra Nelson
Copyright 2007, The Washington Post. All Rights Reserved.

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Product Details

• Hardcover: 512 pages
• Publisher: Doubleday; 1 edition (January 9, 2007)
• Language: English
• ISBN-10: 0385509936
• ISBN-13: 978-0385509930
• Product Dimensions: 9.3 x 6.3 x 1.8 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (42 customer reviews)
• Amazon.com Sales Rank: #363,636 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

9 of 9 people found the following review helpful:

5.0 out of 5 stars Frightening Look into the Minds of the Heartless, March 28, 2007

By	Richard Pugh "Will Read" (Norwalk, CA) - See all my reviews (REAL NAME)

Harriet Washington has created an extensive investigative body of work that reveals the inhumane treatment of a people unprovenly regarded as less than by those who have proved themselves to be less than. One wonders why God would grant anyone dominion over the earth and all that dwells upon it, but Medical Apartheid indentifies those who take to heart that particular verse and chapter and illustrates how they consider no one and nothing exempt from the horrors of their demonic thinking. From surgical procedures with neither consent nor notification to the withholding of treatment for the sake of science, this book reveals the price so many African-Americans have paid in the name of medical advancement-without compensation or an acknowledgment of gratitude from the medical community.

This book should be mandatory reading for all.

RCP

15 of 17 people found the following review helpful:

5.0 out of 5 stars Medical Apartheid: What You Never Learned in School, February 11, 2007

By	Janis Wiley - See all my reviews (REAL NAME)

Medical Apartheid is a must read for anyone interested in social justice issues. While Washington's work may be the catalyst for the long awaited national apology, the researched accounts of U.S. atrocities deserve and require far more. This book should become required reading in our educational institutions regardless of one's pursued field of study. The U.S. must tell the truth about its past and those it has ceremoniously honored and attempted to destroy. Harriet Washington has done just that.

16 of 19 people found the following review helpful:

5.0 out of 5 stars Medical Aparheid, March 14, 2007

By	Michael J. Carter (Asheville, NC United States) - See all my reviews (REAL NAME)

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The facts are disturbing but well documented. Ms. Washington's anaylsis is evenhanded, thorough, and scholarly. I am enjoying the book immensley.