Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present was published in 2006 by Harriet A. Washington. It is a history of medical experimentation on African Americans. From the era of slavery to the present day, this book presents the first detailed account of black Americans' abuse as unwitting subjects of medical experimentation. Medical Apartheid won the 2007 National Book Critics Circle Award for Non-fiction. Washington's work helped lead to the American Medical Association's apology to the nation's black physicians in 2008 and the removal of the James Marion Sims statue from Central Park in 2018.
Synopsis Medical Apartheid traces the complex history of medical experimentation on Black Americans in the United States since the middle of the eighteenth century. Harriet Washington argues that "diverse forms of racial discrimination have shaped both the relationship between white physicians and black patients and the attitude of the latter towards modern medicine in general". The book is divided into three parts: the first is about the role of African Americans in early American medicine and the cultural memory of medical experimentation; the second covers the twentieth century with a focus on vulnerable research subjects, while the last examines recent cases of medical abuse and research. Some topics discussed are well-known, such as the Tuskegee syphilis experiment, but other episodes are less well known to the general public. In the epilogue, Washington mentions cases of medical experimentation in Africa and their links to African-American cases. She also provides recommendations for moving forward, including repairing the system of institutional review boards, banning exceptions to informed consent, requiring researchers to receive education in the ethics of biomedical research, and requiring researchers to follow the same research standards at home and abroad.
Topics covered
Part 1: A troubling tradition In Part 1 of the book, Washington discusses scientific racism and its intersection with unethical medical testing during slavery and afterwards. She describes how enslaved and free African Americans were exploited and mistreated by doctors and used in medical experiments.
James Marion Sims One of the most infamous examples Washington describes is James Marion Sims, a doctor from South Carolina often considered the "father of gynecology". Washington details the misdiagnosis of the medical conditions his patients suffered from during his medical training and the mistreatment of black enslaved women that led to his medical breakthrough. Washington describes how Sims used black infants for tetany experiments. Sims determined through his research that the cause of tetany in the babies was a result of the movement of skull bones during birth. To test his theory, he took a black baby and, using a shoemaker's tools, opened the baby's brain based on his belief that black babies' skulls grew faster than the skulls of white babies, preventing their brains from growing or developing. Most of the babies died and he blamed their deaths on their supposed lack of intelligence. The most infamous example of Sims' medical malpractice was his research on vesicovaginal fistulas, a complication of childbirth. Sims acquired four enslaved women and used their bodies to find a cure. Sims mistreated the women, including by making them completely undress (despite modesty standards of the time) while he and other doctors examined them. He also put the women through painful surgeries without giving them anesthesia and Washington writes, "he claimed that his procedures were 'not painful enough to justify the trouble and risk of attending the administration,' but this claim rings hollow when one learns that Sims always administered anesthesia when he performed the perfected surgery to repair the vaginas of white women in Montgomery a few years later. Sims also cited the popular belief that blacks did not feel pain in the same way as whites." Despite this, he received much fame and attention for his breakthrough. Because of his experiments on black women, Sims was eventually able to help white women who experienced vesicovaginal fistulas, but black women still did not have access to these treatments and many of them died from the same disease that the enslaved women helped to cure.
Exhibiting of African Americans Washington discusses cases of Africans and African Americans exhibited in human zoos and freak shows, including famous and lesser known cases. Washington argues that "[a]round 1840, entrepreneurs realized that a market hungered for black exotica, and they took a leaf from the physicians' book by displaying blacks as medical curiosities", and that these displays were "a dramatic argument for the alien inferiority of black bodies". Cases Washington describes include:
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