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Medical Apartheid author Harriet Washington details history of racism in medicine

Diversity Campus Read discussion centers on how to learn from the past to address discrimination and systemic barriers in health care

The UMass Chan Medical School 2022 Diversity Campus Read concluded on Wednesday, Feb. 9, with author Harriet Washington presenting virtual talks about her book, Medical Apartheid, to an audience of UMass Chan learners, faculty and staff.

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Harriet Washington

A medical ethicist, editor and author, Washington spoke with students about medicine’s tumultuous relationship with the Black community and how it has perpetuated and benefited from anti-Black racism.

“It’s important for medical education to acknowledge that a lot of what we teach and disseminate as the history of medicine is not only inaccurate, but carefully curated to malign the humanity and experiences of people of color, to African Americans in this country,” Washington said. “We are talking about propaganda that has been held in common for a long time by very influential people, but it does not change the fact that it is fictitious. It is based on the presentation of longstanding biases that have been used to distort the experiences of African Americans. We have to reckon with that history before we can talk about changing things.” 

Washington said her motivation for this work came from not seeing Black women doctors growing up and wanting to speak to and on behalf of people who have been historically voiceless.  

In her talk, “Medicine and the Curation of History: Addressing an Untrustworthy Healthcare System,” Washington took listeners on a journey through 400 years of American history, strategically beginning with the Nuremberg trials, which Washington called “the beginning of global dialogue about medical ethics and the history of medicine.”

At these trials, Holocaust atrocities, which included the use and abuse of medicine as a means for genocide, enslavement and torture, were agreed upon by medical professionals as horrid crimes against humanity.

“But we’d forgotten what had happened in our own country, a very close parallel,” said Washington.

Washington noted that the ideologies rooted in the historical and present-day practice of medicine are rooted in medical mythology.

“Academics and scholars know that myths may not be factually true, but it is true in the sense that it tells you something about a culture’s thoughts and values,” she said.

Medical myths that grounded the thoughts and values of American culture were that Black people were a distinct species with flawed but hardy bodies; that their intelligence was lower, with childlike judgment; and that they were to be blamed for their own illnesses, to name a few. Performative technological experiments that made what Washington called “illogical, but bright and shiny pronouncements about race” and the invention of imaginary “Black diseases” further created a white vs. Black chasm and enforced laws that denied Black people civil and social liberties.

Washington said these historical patterns have informed today’s approach to racially disparate diseases and affirmed the sentiments of the Institute of Medicine’s 2002 publication “Unequal Treatment” which states that “racial and ethnic disparities in health care occur in the context of a broader historic and contemporary social and economic inequality and evidence of persistent racial and ethnic discrimination in many sectors of American life.” 

In the context of medical discourse, Washington said, “Rarely does race do anything besides simply redefining or reshaping stereotypes and assumptions.”

Removing race from medical discourse does not translate to ignoring race and its relation to how care is given, she said. Rather, the lesson Washington wants her audience to learn is that race is not biological and therefore it should not take the lead in how care is offered.

“We’re working very hard as a campus community to be more diverse, to be more culturally aware, to try to eliminate health care disparities and to be much more intentional about efforts and understanding of race and its effects on the care that we give to our patients,” said Chancellor Michael F. Collins.

“As we move toward being a more anti-racist campus, it is important that we learn from our past and address racism, discrimination and other systemic barriers within the health care system so that we can promote health equity and inclusiveness,” said Marlina Duncan, EdD, vice chancellor for diversity and inclusion.

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UMass Chan Medical School creates affinity groups to support faculty and staff of color