Medical Apartheid
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''Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present'' is a 2007 book by
Harriet A. Washington Harriet A. Washington is an American writer and medical ethicist. She is the author of the book ''Medical Apartheid'', which won the 2007 National Book Critics Circle Award for Nonfiction. She has also written books on environmental racism and the ...
. It is a history of
medical experimentation Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
on
African Americans African Americans (also referred to as Black Americans and Afro-Americans) are an ethnic group consisting of Americans with partial or total ancestry from sub-Saharan Africa. The term "African American" generally denotes descendants of ens ...
. From the era of
slavery Slavery and enslavement are both the state and the condition of being a slave—someone forbidden to quit one's service for an enslaver, and who is treated by the enslaver as property. Slavery typically involves slaves being made to perf ...
to the present day, this book presents the first detailed account of black Americans' abuse as unwitting subjects of medical experimentation.


Synopsis

''Medical Apartheid'' traces the complex history of medical experimentation on Black Americans in the United States since the middle of the eighteenth century. Harriet Washington argues that "diverse forms of
racial discrimination Racial discrimination is any discrimination against any individual on the basis of their skin color, race or ethnic origin.Individuals can discriminate by refusing to do business with, socialize with, or share resources with people of a certain g ...
have shaped both the relationship between white physicians and black patients and the attitude of the latter towards modern medicine in general".Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present
''Social History of Medicine'' (2007) 20 (3): 620-621.
The book is divided into three parts: the first is about the cultural memory of medical experimentation; the second examines recent cases of medical abuse and research; while the last addresses the complex relationship between racism and medicine. Some topics discussed are well-known, such as the
Tuskegee syphilis experiment The Tuskegee Study of Untreated Syphilis in the Negro Male (informally referred to as the Tuskegee Experiment or Tuskegee Syphilis Study) was a study conducted between 1932 and 1972 by the United States Public Health Service (PHS) and the Cente ...
(193272), in which African Americans with the disease were intentionally denied treatment (without being told) in order to allow the progression of the disease so it could be observed in all stages, but other episodes are less well known to the general public. The book also mentions cases of
medical experimentation in Africa African countries have been sites for clinical trials by large pharmaceutical companies, raising human rights concerns.Washington, Harriet A. ''Medical Apartheid'', Anchor Books 2006 p390 Incidents of unethical experimentation, clinical trials lacki ...
and their links to African-American cases.


Topics covered


James Marion Sims

James Marion Sims James Marion Sims (January 25, 1813November 13, 1883) was an American physician in the field of surgery. His most famous work was the development of a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstr ...
, born in Hanging Rock,
South Carolina )''Animis opibusque parati'' ( for, , Latin, Prepared in mind and resources, links=no) , anthem = " Carolina";" South Carolina On My Mind" , Former = Province of South Carolina , seat = Columbia , LargestCity = Charleston , LargestMetro = ...
, was widely considered to be the "father of
gynecology Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined are ...
". Washington uses her book to expose Sims by detailing the misdiagnosis of the medical conditions which his patients suffered from during his medical training and the mistreatment of black slave women that led to his medical breakthrough. In the beginning of its excerpt on Sims, the book details how he would blame the wrong parties for diseases and infections, such as neonatal tetanus. Neonatal
tetanus Tetanus, also known as lockjaw, is a bacterial infection caused by ''Clostridium tetani'', and is characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually ...
is a bacterial disease which is caused by animal manure and it grows in wounds such as umbilical stumps. Instead of blaming the slave owners for not providing proper and clean living areas for these slaves to live in, Sims blamed slave women's supposed laziness as the cause of their diseases. Washington also mentioned the exploitation of black slave bodies when she talked about the mistreatment of black infants during the 1800s. Sims used their bodies for tetany experiments. Sims determined through his research that the cause of tetany in the babies was a result of the movement of skull bones during birth. In order to test his theory, he took a black baby and, using a shoemaker's tools, opened the baby's brain based on his belief that black babies' skulls grew faster than the skulls of white babies, preventing their brains from growing or developing. Most of the babies died and he blamed their deaths on their supposed lack of intelligence. The most infamous example of Sims' medical malpractice was his research on vesicovaginal fistulas. Sims acquired four female slaves and used their bodies in order to find a cure for the complication of childbirth. Sims put the slave women through painful surgeries without giving any of them anesthesia and he was eventually able to find the cure. As Washington said in the book, "he claimed that his procedures were 'not painful enough to justify the trouble and risk of attending the administration,' but this claim rings hollow when one learns that Sims always administered anesthesia when he performed the perfected surgery to repair the vaginas of white women in Montgomery a few years later. Sims also cited the popular belief that blacks did not feel pain in the same way as whites." (7) Despite this, he received much fame and attention for his breakthrough. Because of his use of black women, Sims was eventually able to help white women who experienced vesicovaginal fistulas, but black women still did not have access to these treatments and many of them died from the same disease that the slave women helped to cure. Along with not giving them
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
, he mistreated the women, making them completely undress, then kneel on their hands and knees while doctors examined their
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
s.


Awards

''Medical Apartheid'' won the 2007 National Book Critics Circle Award for Nonfiction. Harriet Washington has been a fellow in ethics at the
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
(HMS), a fellow at the Harvard School of Public Health, and a senior research scholar at the National Center for Bioethics at
Tuskegee University Tuskegee University (Tuskegee or TU), formerly known as the Tuskegee Institute, is a private, historically black land-grant university in Tuskegee, Alabama. It was founded on Independence Day in 1881 by the state legislature. The campus was d ...
.Medical Apartheid
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See also

* ''
The Plutonium Files ''The Plutonium Files: America's Secret Medical Experiments in the Cold War'' is a 1999 book by Eileen Welsome. It is a history of United States government-engineered radiation experiments on unwitting Americans, based on the Pulitzer Prize– ...
'' * ''
Acres of Skin ''Acres of Skin: Human Experiments at Holmesburg Prison'' is a 1998 book by Allen Hornblum. The book documents clinical non-therapeutic medical experiments on prison inmates at Holmesburg Prison in Philadelphia from 1951 to 1974, conducted under ...
'' *
List of medical ethics cases Some cases have been remarkable for starting broad discussion and for setting precedent in medical ethics Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical eth ...
* Compulsory sterilization in the United States *
Medical racism in the United States Medical racism in the United States encompasses discriminatory and targeted medical practices and misrepresentations in medical teachings driven by biases based on characteristics of patients' race and ethnicity. In American history, it has impact ...
* Unethical human experimentation in the United States


References

{{reflist, 2 2007 non-fiction books American history books History books about medicine 21st-century history books Books about African-American history Human subject research in the United States Medical books National Book Critics Circle Award-winning works Human rights abuses in the United States Race and health in the United States Doubleday (publisher) books J. Marion Sims