African Americans and Medicine: From Slavery to Modern Times

African Americans and Medicine: From Slavery to Modern Times

Imagine being sick, but never going to a doctor because you knew they would do bad things to you, make you sicker, or even kill you. When we see doctors, we are trusting them to make the best decisions to help us. However, there was a time when doctors committed the most heinous acts against those who needed them. African American’s have been used for unethical studies and cases since the time of slavery. Some were used against their will, while others were taken advantage of by the people who were supposed to take care of them. The earlier cases of this inhumane treatment were scarcely documented, but through tales and word of mouth were passed from generation to generation. African Americans never forgot what happened to their ancestors or what could still possibly happen to them and as a result lead to the mentality that they should stay away from hospitals and doctors, furthermore creating a culture of fear surrounding institutional medicine. Unfair treatment of African Americans started during the time of slavery. In Slavery and Medicine: Enslavement and Medical Practices in Antebellum Louisiana, author Katherine Bankole describes the mentality of whites and white slave owners which dictated the treatment of slaves medically. Bankole says, “The three main areas of enslavement and medicine in the antebellum period are: theory, management, and experimentation” (Bankole 8), doctors theorized that the biology of Africans was innately inferior to that of the white race. The second area, management, involved “general health, disease, diet/nutrition, clothing, mortality, and the medical costs incurred by slaveowners.” (Bankole 8) Medical management was the most important factor that determined the success of a slave owners land. The healthier a slave was, the more he could work and produce a profit for the slave owner. This meant health care was provided at a lower cost to those who owned slaves.

References: of night doctors are again seen here where Savitt notes, “Black fear of medical schools and dissection inevitably carried over into the postbellum period, when whites, as a mean of maintaining control over freedmen, reinforced the idea of ‘night doctors’ who stole, killed, and then dissected blacks” (Savitt 340). My final thought from Savitt comes from Southern medical schools boasting about their large supplies of blacks for study material. Even after their schooling, white physicians maintained the idea of the usefulness of African Americans. African Americans continued to be used for new techniques or treatments, and doctors did not fear consequences as long as death or permanent injury did not result. “Blacks, therefore, did have reason for fearing misuse at the hands of southern white physicians.” (Savitt 341). Much advancement was made in medicine as a result of experimentation. Certain doctors received their fame off the unethical treatments of slaves and African American patients. Dr. J. Marion Sims was an American surgeon who became credited with developing the area of gynecology, and has even been called, “The Father of Gynecology.” Sims used enslaved women to try to discover a cure for the disease vesico-vaginal fistula. During Sims time, the practice of gynecology did not exist and obstetrics as well as child delivery were taught with dummies. Because enslaved women were poor, and lacked proper nutrition as well as prenatal care, they were at higher risk for developing VVF. After Sims graduated he became interested in surgery and began conducting experiments on enslaved women which resulted in the perfection of a certain surgical technique to repair the fistula. This was not Sims initial objective, but after looking after a patient one day who had fallen from a horse and had pain her pelvic area he discovered a way to better see inside the vagina which made him feel more confident in his ability to perform surgery on women with VVF. Sims used 7 enslaved women as his subjects so their consent was not necessary. His first patient was a woman named Lucy, and Sims was so sure he had discovered the proper technique for surgery he invited local doctors to come watch the surgery. Lucy had to stay in a position where she was on her knees and elbows with everyone watching, and she was not given anesthetics. Lucy was in horrible pain during and after the surgery and nearly lost her life from a blood infection she developed as a result of Sims’ experimentation. It took Sims four years to finally perfect his surgery and cure women of this disease. His first success was on a woman named Anarcha who had already received thirteen operations, all without the use of anesthetics. White women began coming to Sims after they heard of his success, but none of them could endure the pain of surgery. Among the list of unethical experiments done to African Americans, one of the most famous was the Tuskegee Study. Syphilis was a huge concern during the 1930’s in America, but not much was known at the time of the effects of advanced syphilis. The study was conducted by investigators from the United States Public Health Service on 400 African American men from Macon County, Alabama. The study was meant to last from six months to a year, but the investigators knew that the most important information would come only after the men were dead. In Experimentation on Human Beings, Susan Lederer describes the men used for the study: “The men recruited into this study were impoverished individuals; many had never seen a doctor in their entire lives” (Lederer 21). The investigators would deceive the men by offering free treatment and perform spinal punctures collecting fluid, telling them this was a treatment for the condition. The investigators wanted to make sure the men would go on not receiving treatment so they would keep them from being enlisted in military service, during World War II, because once in the military they would receive mandatory syphilis treatment. The Center for Disease control held a meeting in 1969 to discuss whether the study should continue or not. Only one professor protested the study saying the men should be receiving treatment. It was only three years later when reports of the study flooded through American media, and Americans were shocked and disgusted in the governments treatment of these vulnerable subjects that the study was closed in 1972. In light of the study as well as other unethical studies at that time, Congress adopted the National Research Act in 1974. This act required that the people must give a written consent before partaking in studies. Given the history of medical experimentation of African Americans, one is left to wonder if it has had an effect on the modern day perspective of the African American and medicine. A study conducted in 2006 by doctors, Elizabeth Jacobs, Italia Rolle, Carol Estwing Ferrans, Eric Whitaker, and Richard Warnecke, to see what trust or distrust of physicians means to African Americans. They found that the African Americans they tested had more trust based on the “interpersonal and technical competence of physicians.” While distrust stemmed from “lack of interpersonal and technical competence, perceived quest for profit and expectations of racism and experimentation during routine provision of health care.” If patients felt their physician was untrustworthy they would either keep information to themselves or lie about their medical history, change doctors, or even refuse to seek medical care. Multiple studies have shown that African Americans are more likely to distrust physicians than Caucasian Americans. One of the female patients in the study was quoted saying, “Over my period of time dealing with the medical field, I know that you do need a hell of a lot of trust in the physicians or the medical field and the institutions.” The patient goes on to say, “But I don 't know how most people are, but it reminds me of the Tuskegee Institute where they messed around and they made the brothers have the disease instead of treating them they just wanted to see how it was going to affect them. So maybe sometimes you go instead of getting treated they just want to see what it’s going to do to you and they 'll try this and try that and they may give you a sugar pill. Because it’s not like they haven 't seen anyone dead before so the only time they get affected [by dead people] is when it’s personal. So that 's why a lot of people have mistrust.” (Jacobs et al) Although there have been great medical discoveries made over the last two centuries in American medicine, the cost of these discoveries has been paid by the lives of individuals who were or deceived into partaking in these experiments. As a result, centuries later, there is still concern as to whether or not physicians are to be trusted to ethically perform their duties on patients. We owe so much of what has been established in the field of medicine to the slaves in America. Their pain and suffering paved the road to medical advancements, and their sacrifices need to be recognized as well as praised.