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

In the 2007 nonfiction book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, medical researcher Harriet A. Washington describes the long history of American medical experiments on African Americans. Although certain of these abuses are well-known, such as the Tuskegee Syphilis Study, a comprehensive history that describes the long-standing pattern of exploitative practices has not been written. By uncovering how American medicine has been built upon the abuse of black people, Washington hopes to repair relations between doctors and African Americans, thereby bridging the gap between the health profiles of white and black people in the United States. This nonfiction text was published in 2006 and won the National Book Critics Circle Award for General Nonfiction.

Part 1 of Medical Apartheid focuses on the historic treatment of African Americans. Washington argues that blacks have been unfairly treated by American doctors since the birth of the United States. In Chapter 1, Washington describes the general culture of health care in the Antebellum South, exploring how medical treatment of slaves rested solely in the hands of slaveowners. In order to justify the institution of slavery, a number of scientists claim that black people naturally lack physical and mental prowess and require the supervision of white slaveowners to survive—a set of beliefs known as “scientific racism” (32). Chapter 2 explores how Southern surgeons develop medical advances through abusive experimentation on slaves. James Marion Sims helps to pioneer modern gynecology by repeatedly operating on a group of female slaves, without consent or anesthetics. In Chapter 3, Washington focuses on sideshow exhibitions of black people, arguing that such displays help to popularize the theories of scientific racism.

In Chapters 4 through 6, Washington explores how the bourgeoning 19th-century movement of teaching hospitals principally rely on black bodies to train physicians. Many doctors learn how to operate by practicing needless surgeries on African Americans, and cadavers are robbed from black cemeteries to provide material for dissections and autopsies. Part 1 closes with Chapter 7’s exploration of the infamous Tuskegee Syphilis Study. In the study, the US Public Health Service allows a group of syphilitic poor black men to go untreated so that scientists can observe the long-term effects of syphilis. Rather than treat the study as an isolated instance of medical abuse, Washington argues that it is part of a continuous pattern of the medical establishment’s neglect of black people.

In Part 2, Washington focuses on a variety of 20th-century instances of abuse. The chapters are grouped thematically around “vulnerable subjects” (19) who are particularly susceptible to abuse, such as children and prisoners. Chapter 8 focuses on the history of birth-control programs targeting African Americans. Washington argues that such programs must be understood in relation to the early 20th-century eugenics movement, which sought to reduce the reproduction of African American communities due to racist beliefs that black people are genetically unfit. In Chapter 9, Washington describes a number of radiation experiments performed upon black bodies, often without the patient’s knowledge. Chapter 10’s discussion of prison experiments similarly focuses on a lack of informed consent. Scientists such as Dr. Albert M. Kligman perform dangerous experiments upon black prisoners, employing tactics of manipulation and coercion to get the prisoners to agree to be research subjects. Chapter 11 focuses on experiments on black children, many of which treat black children as naturally aggressive “born criminals” (277).

Washington uses Part 3 to describe a number of ways cutting-edge developments in medicine may impact African Americans. While advances in DNA testing have freed a number of falsely imprisoned black people, Washington notes that the growth of governmental genetic databases may grant the police new means to unfairly target black people. Washington describes a number of experimental medical devices, such as an artificial heart and artificial blood, that are disproportionately tested and refined on black subjects. Although African Americans may play a central role in developing these devices, they are often unable to afford the very same devices the moment they are approved for the marketplace. Finally, Washington explores the history of bioterrorism targeting black populations, from the CIA’s MK-NAOIMI program to apartheid South Africa’s attempts to develop a biological chemical weapon that only affects black Africans.

In Medical Apartheid’s Epilogue, Washington explores the contemporary climate of medical research. In Washington’s view, most present-day medical experiments are ethically sound. Washington encourages African Americans to participate in medical research as a necessity for improving the health profile of blacks, although she warns that one must still be thorough in investigating any potential experiments. Washington concludes her Epilogue with a number of suggestions for ensuring medical experiments remain free of abuse. These include “ban[ning] exceptions to informed consent” (403) and requiring medical researchers to follow the same standard of ethical conduct whether experimenting in the United States or in Africa.