Magazine On-line [fall 2011]
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Washington teaches students about medical injustices

Author Harriet Washington spoke about medical history and ethics for the fall convocation address September 11 in Haggin Auditorium.

medical apartheid book cover

The presentation served as an extension of the First Engagements reading, The Immortal Life of Henrietta Lacks by Rebecca Skloot, which chronicled the story of a poor African American woman’s cells being harvested without her knowledge and revolutionizing cancer study. Washington’s latest book, Medical Apartheid, tells more stories like Lacks’s involving mistreatment of African Americans in the name of medical science. She had studied Lacks in the 1990s, and when Skloot came to her about the book idea, Washington told her, “You’ve got to write this book.”

Washington said that medical science is still guilty of taking advantage of people in order to further research and make money. Only today, the victims are the uninformed—she dispelled the idea that the problem is white doctors mistreating black patients.

“The real division is not between white and black, but rather the guilty and the innocent,” she said. “It’s between people who are ready to accept this state of affairs and those who are not. The goal is to let people choose.”

She used the example of “informed consent” versus “presumed consent,” a subtle difference in language that is actually a huge difference in implications. Presumed consent means that studies may be conducted on patients without their knowledge, as long as they give implied approval. That can be as simple as holding a town hall meeting in the area the study will be conducted, and as long as there are no serious objections, it is assumed that the entire area agrees to submit to the studies. Those tend to happen in low-income communities where many people do not have access to information regarding studies’ risks. The same thing goes for trauma victims, according to the Code of Federal Regulations 21 50.23, which says that if a patient is unable to communicate, consent is assumed.

“We’re vulnerable today because of presumed consent laws,” Washington said. “Coroners can take our parts and sell them to corporations for profit. We sign many consent forms before surgery, and you may not know one form is consenting to have tissue taken. These are the kinds of issues that confront us today.”

Washington challenged students, both those who are considering medical professions and those seeking careers elsewhere, to have an open mind and to know when to challenge customs when those customs may be causing injustices.

“We as a country have to be much more acutely aware of the things that threaten us in the medical field,” she said. “I challenge you to work within your profession and respect its traditions, but more importantly to know when to question them.”

Medical Apartheid won a National Book Critics Circle Award, the 2007 PEN Oakland Award, and the 2007 American Library Association Black Caucus Nonfiction Award. Washington has been a fellow in medical ethics at the Harvard Medical School, a senior research scholar at the National Center for Bioethics at Tuskegee University, a fellow at the Harvard School of Public Health, and the recipient of a John S. Knight Fellowship at Stanford University.

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