BioMed
Harriet A. Washington traces medical experiments on Black Americans, from slavery-era surgery to prison research, and explains the lasting distrust they caused.
When a third party owns or controls a patient, a doctor's apparent concern for that patient's health can serve the owner instead. The owner wants a working body and the physician wants research material, and both goals can run directly against what the patient needs.
According to the book, slavery depended on doctors to keep enslaved people working, and doctors depended on slavery for income and for bodies to train and experiment on. Each system propped up the other, so the profession's own advancement was bound up in the abuse.
A group's distrust of medicine rarely traces back to a single famous scandal. It builds up over generations of repeated abuses, many of them never widely known. Blaming one notorious study hides how long and wide the pattern ran.
The book's answer to a history of exploitation is not to stay away from medicine. It argues that communities should take an active part in research on the diseases that hit them hardest, while keeping watch for abuse.
People with good historical reasons to distrust doctors go to hospitals less and volunteer for research less, even when they carry the heaviest burden of disease. So past exploitation keeps damaging health long after the abuses themselves end, by keeping people away from the care and studies that could help them.
Theories that cast a group as biologically inferior give doctors a scientific-sounding excuse to experiment on them and treat them badly. The claimed difference, such as feeling less pain or being unfit for adult responsibility, becomes a reason to deny consent, anesthesia, and decent care.
Treatments developed by experimenting on a powerless group are often given first, or only, to a more privileged group. The book's main example is a surgery reportedly perfected on enslaved women without anesthesia, which was later done with anesthesia on white women while Black women kept dying of the condition.
Some hospitals did not charge Black patients so that their bodies could be used for dissection after death. Black remains were also robbed from graves, autopsied without permission, and sold to medical schools and public shows. The poor paid for their medical care with their bodies after death.
People with little power to refuse, such as the enslaved, prisoners, and the poor in hospitals, keep ending up as research material. Over the twentieth century, researchers ran large numbers of experiments on Black prisoners, often without the subjects' knowledge or real agreement.