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

by Harriet A. Washington

From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.

The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.

Genres: Nonfiction, History, Race, Science, Medicine, Social Justice, Medical

501 pages, Hardcover

First published January 9, 2007

About the author

Harriet Washington is the author of Deadly Monopolies: The Shocking Corporate Takeover of Life Itself and of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, which won the 2007 National Book Critics’ Circle Award and was named one of the year’s Best Books by Publishers’ Weekly. She has won many other awards for her work on medicine and ethics and has been a Research Fellow in Ethics at Harvard Medical School, a fellow at the Harvard School of Public Health, a Knight Fellow at Stanford University, a senior research scholar at the National Center for Bioethics at Tuskegee University and a Visiting Scholar at the DePaul University College of Law.

Reviews

[Bill · Rating 5 out of 5]

This book is incredibly hard to read in that it's so harrowing sometimes your stomach just turns as you turn the pages. However, it is masterfully written, immensely researched, and should be mandatory reading for, probably, the entire planet.

[Lori · Rating 4 out of 5]

On the bright side, hell won't run out of special places.

[Christina · Rating 5 out of 5]

This. Book. Is. Explosive.

I found this book about a year ago in the huge Barnes and Noble in Union Square. It was somewhere on the bottom shelf in the African American section. The fact that I, even if accidentally, came across this book shows my dedication to finding a good book. The title is striking, and as knowledgable as I am about Black History, the assertions laid out in this book shocked me.

Harriet Washington has written an extensively researched book that rebuts the negative assumptions made about Black Americans on how well or not they maintain their health. Almost from the moment Black Americans entered this country they have been subject to some of the most dangerous and sadistic medical experimentations, the likes of which Washington describes in detail. She sources actual medical journals and government texts. For a majority of the history of these illicit practices doctors, scientists, and politicians spoke freely about experimentations because: for much of the history of Black people being in America it was illegal for them to read - and no one ever thought they'd be able to.

The book is long.

The print is small, single spaced and every word is used with weight. The cynic in me couldn't help but think of all experimentations that went undocumented. The most inhumane experiments described I dare not recount the details here. Some of the topics that sparked the most heat during our humble book club was experimentations on female slaves that propelled modern gynecology, the sometimes theft and often times misuse of black cadavers in teaching institutions and science labs, the experimenation of known fatal chemicals on young African American children - some as young as 6 months old, and the current one-sided biochemical war going on in Black communities around the country.

Harriet Washington has written a monumental documentation of the seedy aspects of the medical world chronicling centuries of abuses on the black community that have brought many in the medical and scientic fields fame, fortune and respect. This book should be required reading for all Americans - if these things have happened within just one group, they certainly can happen to others. This book is a long read, and one that may cause you to lose sleep, but the subject matter is so important to the history of medicine and ultimately healthcare in the world as we know it.

[megs_bookrack · Rating 5 out of 5]

Let's be clear, I will not be writing a full review of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.

I simply doff my cap to the author, Harriet A. Washington, for this incredibly well-researched and detailed account of a horrific chapter in our history as a nation. And by a chapter, I mean something occurring for over 4o0-years.

Original:

Keeping my nonfiction reading on a roll here in 2021!!

Picking this one up on the recommendation of my friend, Meagan.

I'm happy she mentioned this book to me because I had never heard of it. From the synopsis it sounds like it is going to be hard to get through, but so important.

While it might not be easy to read about the exploitation and mistreatment of black people in the name of "science" ((using this word with the heaviest of sarcasm)), I do think it is important to learn about and recognize this history.

[Thomas · Rating 4 out of 5]

A powerful and long book about the history of anti-Black racism within science and medicine, mostly focused on the United States. Harriet Washington writes about atrocities spanning the period of slavery, the Tuskegee experiment, the forced sterilization of Black women, the mistreatment of incarcerated Black folks, and more. One of my major takeaways from reading this book is that research is definitely political. The more we pretend that we are “objective” the more we obscure how racism persists in science, medicine, healthcare, and related fields today. We must understand the past and take tangible action to stop and prevent white supremacy from manifesting in the present.

[Laura · Rating 3 out of 5]

Washington is a former ethics fellow at Harvard Medical School. She catalogs a shameful, centuries long tradition in American medicine of using African Americans in medical experiments. I knew vaguely that had happened, and happened in living memory, but she provides details. Gory, gory details.

I’m glad I read this book, but I wish it had had the benefit of a hard edit. Stephen King said to authors that you have to kill your babies, and I often felt like Washington couldn’t bear to do that. The New York Times went through some of the factual assertions in the book and found them wanting, which is disappointing. http://www.nytimes.com/2007/02/18/boo....

It also would have benefited by honing down the marginal portions. For example, she tells us the story of Ebb Cade, a truck driver who was brought to a hospital near death after a terrible accident in 1945. (216). Doctors, under contract with the U.S. Atomic Energy Commissioner, she says, believed he was going to die and injected him with radioactive material so they could test how it would affect his soon-to-be-dead body. Only he didn’t die; he walked out and had very nasty side effects. Horrible story, and the specific words she attributes to the doctors are shameful. But she didn’t present particularly persuasive evidence that this project’s experimental subjects were picked on the basis of race.

I don’t think she was writing for me. I don’t know that she’s pro life, but phrases she uses like “abortion on demand” (313) are often code for that. As someone who thinks the ability to control when and if you have a child is essential for autonomy, that’s like fingernails on a chalkboard. Similarly, discussing the now mostly-discarded use of sterilization in child abuse cases, she writes:

“Forced contraception use in response to allegations of child abuse is punishment, not therapy, because it does not protect the existing children, as counseling would. It delays, not prevents, births for the duration of the Norplant ‘sentence.” In any event, preventing a child’s birth is a draconian method of protecting it from abuse.” (211).

That statement makes me roll my eyes. I haven’t seen our courts use ‘forced contraception’ out here. I’ve worked a lot of parental termination cases, and the idea that counseling protects existing children is, well, unlikely in many circumstances. More irking to me is the implication that “preventing the child’s birth” is about protecting some specific child from abuse presumes that there is some child out in the ether cued up for birth. That makes no sense to me. It implies some inchoate child has a right to be conceived.

She also lost me when she was discussing HIV. She seemed so wedded to her thesis that African Americans were the special targets of abuse by our medical establishment that she felt compelled to minimize how gay men with HIV were also treated poorly. (330-31). Both can just be terrible. I didn’t expect her to discuss the country’s shameful response to HIV when it was perceived as a disease in the gay community, but she seemed to be going out of her way to be dismissive.

Her discussion of prison experiments – including interviews with survivors – was chilling and compelling. I will remember her descriptions of a man whose skin had basically been removed piece by by for a long time. Her recap of the Tuskegee Syphilis experiment was very well done. Her discussion of grave robbing of African American cemeteries – very compelling.

An interesting follow up to The Immortal Life of Henrietta Lacks, which my group read a few months a go. A much more disciplined text, but in both, the author’s perspective was sometimes intrusive.

[Dona · Rating 5 out of 5]

I found an audio book version of this in Libby to accompany my paperback, which really made this dense, serious information much easier to read and process. Check the app to find your local library and get great books for free!

MEDICAL APARTHEID by Harriet A. Washington reveals the history of medical abuses by the white scientific establishment against black people, often USians, but in more contemporary times, such treatment has spread to other countries. Some of it is more familiar, such as the horrific Tuskegee experiment in which black sharecroppers with latent syphilis were studied for 40 years, despite the easily accessible intervention for that disease, penicillin, being developed 15 years into the experiment. But I also read hundreds of pages of cases I'd never heard of, and about how contemporary US medical researchers merely take their experiments to black populations in other countries in order to avoid all the safe measures put into place over the years to protect vulnerable populations in the US.

I want to thank Harriet A. Washington for compiling this dense tome. Her pain is evident in every sentence she writes. In her introduction, she writes about being dressed down by an academic superior in graduate school about the supposed intent and consequences of her research-- that she would merely frighten the very people she was trying to educate and help. But Washington knew what we all instinctively know about healing, and that is that wounds must be flushed out and cleaned, or they will keep festering. The truth is social astringent. It burns as it cleans and sanitizes.

I struggled very much to consume some of the details that Washinton includes in this book. Like other readers report, I felt my stomach turn. But MEDICAL APARTHEID disperses the sort of knowledge I think should be widespread. I want for every person of a certain age, and especially individuals working in any facet of healthcare, to at least attempt to read this book. It would make all of us more empathetic and understanding about our neighbors' attitudes and emotions surrounding health and healthcare.

Rating: ⭐️⭐️⭐️⭐️⭐️
Recommend? Please read this book.
Finished: February 15 2023
Read this book if you like:
🧭 Nonfiction
🦽 Medical cases
🟰 Social justice
👩🏾 Black authors and issues

[Isil Arican · Rating 2 out of 5]

I read this book with great anticipation and really liked the first few chapters. But my enthusiasm started to decline slowly as I progressed more in the book.
Overall it is a comprehensive collection of apartheid in medicine, however the medical interpretation errors and the obvious bias of the writer as she describes things get annoying after a while.

My first turn off was regarding the vaccinations examples. She claims that vaccines are tried on African Americans first, which might be true and not ethical. However she also implies are vaccines are not effective and might even be causing autism, which is a ridiculous claim.

Then the part on birth control... her interpretation of IUDs is terrible. She claims they were designed to make African American women infertile and goes on a rampart about how they are trying to control the breeding of minorities even today. I wish she consulted a medical professional, since today IUDs are the most trusted and effective birth control methods and used by many women. She demonized the IUDs to an extend it would scare off people from using them. Shame. She seems to be not aware of the correlation of a having less children and the increased welfare of the group.

She seems to not to be able to make up her mind about the latest events, and her point of turning things around to fit her narrative is disturbing. For example, first she points out that sickle cell is perceived as an African American disease but it is not - which is true since it can be found in most mediterranean populations where malaria is prevalent. Then she bashes medical industry for not funding further research and concludes that "because it is an African American disease". Much self contradiction.

Until this point I was still at 3 stars because I learned many things but the last thing that made me drop my rating to two stars was her comment about quarantine process.
She tells a story of a tuberculosis patient who declined treatment, and was quarantined to prevent further spread. She argues about how unethical to quarantine someone just because they decline a treatment, and implies he was quarantined because of his race. The latest straw in her faulty argument is to compare a tuberculosis with alcohol abuse in a terrible slippery slope argument. Her words: "We jail people with TB today. Might we jail people with SARS tomorrow? Smokers? Alcoholics?"

In my opinion, if a person cannot differentiate a drug resistant chronic infections disease from a substance abuse from the perspective of public health prevention measures, she should not write a book about medicine. Period.

The book claims to shed a light on unethical medical practices, which it does. However her lack of understanding basic scientific and medical concepts and her conspiracy mindset shadows the rest of the arguments and makes the book lose its value.

She also claims she wrote this book to help African Americans so they would ease their fears of the medical establishment ( imo, rightfully formed fears, too). However her gross misrepresentation of medical facts and lack of understanding of preventive medical measures along with her conspiracy theories about birth control and vaccines make the opposite effect. This book would further increase those fears, with unsubstantiated claims.

I saw the NYT review after I read the book, and I agree. (http://www.nytimes.com/2007/02/18/boo...)

It is a pity that such a great opportunity is wasted. We should all learn about these horrible crimes committed in the guise of medicine, but this is not the right way to tell about them.

[Gretchen Rubin]

Gripping history, I couldn't put it down.

[Sahitya · Rating 4 out of 5]

I’ll be honest, I don’t think I can write a review for this book because it’ll make me ragey all over again. This is a very difficult book to read not only because of all the racism, bigotry and unethical exploitation of Black people for medical experimentation, but also for us to reconcile with the fact that many progresses in treatments that have been made over the years have been possible because of this exploitation. And that can be a hard pill to swallow.

But we all need to know this history upon which the world of medicine’s advances have been built on. I had only previously known about the Tuskegee Syphilis trials and a bit about how the birth control pill came to be, there are so many other things that have happened over the centuries that will horrify you. So while I don’t know what trigger warnings to mention for this book, just know that it’s worse than many bad things you can imagine but it’s important to be read and known by everyone.

[Ricky · Rating 1 out of 5]

I really wanted to like this book. As an undergraduate, I did my own research into medical racism, so of course I was drawn to potentially learning more about the abhorrent medical experimentation on black Americans.

However, the author got so many medical facts downright wrong that I'm not sure I can trust the vast majority of the research described in here.
For example:
- p. 120-121: Washington describes how anthropologists determined the age and sex of skeletons unearthed from beneath the Medical College of Georgia. She claims age can be determined from the bones of the hand and wrist - these bones are never used to determine age of skeletal remains. Further, she erroneously purports "gender" can be ascertained from the pelvic bones, flouting the basic medical (and journalistic!) distinction between biological "sex" and socially determined "gender."
- p. 154: The author speaks of deficiencies among black Americans in "...niacin, an essential amino acid." Niacin is a vitamin, not an amino acid nor even an amino acid derivative.
- (page number lost): She, at one point, refers to a "hormone" named "lutenin." There is no such hormone. It's called "lutenizing hormone" and "lutenin" is not, nor has ever been, a nickname for that.
- p. 295: When speaking about vaccination, the author touts, "...highly publicized theories link vaccination to everything from autism to sudden death..." The "highly publicized" research linking autism to vaccines has been debunked repeatedly, was based on severely flawed research, and is unsupported by a vast majority of the medical community. Despite this book's propensity for criticizing poorly designed and even malicious "scientific" studies, the author fails to recognize the original research "study" linking autism and vaccines as one of the most highly flawed in recent years.

The author initially seems to have a impressive vocabulary. However, this is quickly overshadowed by the needless redundancy which weighs down nearly every page of this book. I understand the need to hammer in the point that black individuals were and continue to be exploited within the medical field. However, it is unnecessary to say this five times in a row in slightly different ways every several paragraphs. The truth in this point would much more effectively be driven in with actual facts and historical illustrations.

Washington also makes the mistake of juxtaposing medical studies from vastly different decades and eras. There is no chronology to any of the chapters and the author carelessly jumps between references from the 1950's and those from the 1990's and 2000's.

Finally, citations are few and far between, perhaps given only two to three times on a page.

Overall, this book had great potential, but given the downfalls I listed here, I had to stop reading before the final section. I felt as if I couldn't effectively and accurately learn about this subject when Washington's research is full of so many holes, inconsistencies, and errors.

[Aubrey · Rating 5 out of 5]

In 1915, Dr. Harry J. Haiselden heralded the first wave of U.S. eugenics when he gained fame and wealth by exploiting the evil legacy of the black mother...On November 12, 1915, he announced to newspapers that he allowed the ailing but viable newborn of his patient Anna Bollinger to die in Chicago's German-American Hospital because he would have gone through life as defective. Between 1915 and 1918, Haiselden killed five other babies, drawing fawning attention from the press each time. Practicing negative eugenics very publicly, Haiselden encouraged parents and other pediatricians to follow his example by killing or allowing the deaths of the "genetically inferior." Parents began openly to recruit doctors to kill their children who were born with birth defects, and doctors came forward with their own proud confessions of infanticide....When he decided to make a film to popularize his eugenic ideals, starring himself, it became a hit, making him a wealthy movie star. The film was The Black Stork. It begins with the story of a white, wealthy, well-born slave owner who, in a moment of inebriation, is seduced by his "vile, filthy" black servant.

When I was a child, I was gaslit with such implications that since I wasn’t being physically/sexually abused in an obvious manner, I had nothing to complain about. Protest against this of any sort was met with the insistence that of course they had to treat me badly in order to prepare me for the “real world”, as I certainly couldn’t expect to survive in the “real world” if I felt entitled to people treating me humanely, regardless of my circumstances of age, intelligence, physical constitution, and personal appearance. Well. Here is this “real world” everyone’s been talking about, albeit more sordid and strange and terrifyingly consistent than the average parent would wield in front of their children’s faces when it came totalitarian pedagogy. The fact that my childhood imaginings that once kept me in line pale in the face of such truths is a boon rather than a disappointment, for it’s given me an ironclad constitution for research and bred-in-the-bone ethics that trusts the ideologies on top as far as it can throw their idolaters. I don't give a fuck how comfortable the status quo makes you. You either dislike being a cannibal, or you don't, and pulling a Cronus isn't going to save you forever.

Black bodies on anatomists' tables, black[ people's] skeletons hanging in doctors' offices, and the widespread display of purloined black body parts constituted the same kind of warning to African Americans as did the bodies of lynched men and women left hanging on trees where black[ people] would be sure to see them, or cut up as souvenirs of racial violence.

In January of 2013, I made the decision to never conduct scientific research for money. Bear in mind this was from the perspective from Bioengineering, not the pre-med track, so I have no idea what kind of ethical bearings those who wish to become doctors get in the course of their university education. However, the beauty of the pre-med is the applicability from a wide variety of majors, thus making it possible for an English major to self-study in the requisite scientific courses and do well enough on the MCAT to get into medical school. After that, how much of that grueling education is medicine, and how much of it is ethics? The reason of all the people I knew for making the pre-med way was money, money, money, so if their classroom doesn't make an explicit effort to make it clear that medicine with compromised ethics is a monster that only the sadists excuse, all they'll come out with is money, money, money, and the power to wield that money in and below and around the laws that bind their creed. The US may have a streak of anti-intellectualism, but I'll let you make the decision whether that's worse than medical researchers kidnapping homeless people and foster children and HIV babies for deals with the devil that were never about "the greater good."

This essentially utilitarian argument presents an ethical balance sheet, with the savage medical abuse of captive women on one hand and countless women saved from painful invalidism on the other.
However, such an argument ignores the ethical concept of social justice, and these experiments violated this essential value because the suffering and benefits have been distributed in an unfair way, leading to distributive injustice. In this case, the most powerless group, which is also a racially distinct group and a captive group, is the group upon which doctors inflicted harm "for the grater good." Another, privileged group enjoys the benefits but shares near the pain nor the risks. Thus the moral unacceptability is clear.

It'd be so easy to turn this into a critique of capitalism. Money needs to be made, so the slaves will be cannibalized to serve the masters. Money needs to be made, so the impoverished need be to cannibalized to serve the masters. Money needs to be made, so the imprisoned should be cannibalized to serve the masters. Money needs to be made, so citizens of third world countries are available to be cannibalized to serve the masters. People who demand I offer them a workable alternative to capitalism think themselves entitled to putting responsibility for a think tank effort onto single person in response to my desire that human sacrifices no longer be rendered acceptable. In response to them, I question their religion, because the only thing saving belief from extinction is some measure of social humanity. In response to them, I question their knowledge of science, for the majority of studies were not only human experimentation, but were riddled with so many scientific flaws that reliance on the conclusive results would more likely than not leave those would-be benefactors dead. In response, I question their faith that the horrors detailed in these pages will never happen to them by way of skin color, or economic security, or intelligence, or sanity. The beauty of eugenics and capitalism is both are hierarchies that always require a bottom tier, and exterminating that bottom for the sake of a better top will only push those middle liners down, a new generation become an antithesis to the concept of those worthy of survival.

Via Operation Paperclip, the U.S. government supplied American hospitals and clinics with seven hundred Nazi scientists.

A common apology for experimental abuse insists that we should not apply present-day medical ethics to the medical behaviors of yesterday, which were governed by less enlightened medical standards fro everyone, not just African Americans. However, ethical strictures did govern the behavior of nineteenth-century physicians. Before the mid-twentieth century, these binding ethical standards were not enforced by federal laws, but consisted of medical oaths, professional codes, and rules governing clinical conduct within medical schools, hospitals, and other institutions. These rules were carefully adhered to in cases of white patients but were routinely broken for African Americans.

Yale Law School ethicist Jay Katz, M.D., avers that in the eyes of many American researchers [the Nuremberg Code] was "a good code for barbarians but an unnecessary code for ordinary physicians."

Beginning this, I quipped about a curiosity to discover from whence the Nazis drew their inspiration. Ending this, I'm tired, cause it's all right there, laid out in spades. History always makes everything a hell of a lot more complicated, because more often than not, the argument you're making only exists because of its history of abuse. People say fear of autism is the only reason anti-vaccinators have and I, looking at the CIA experimentation funded at home and abroad say no, that's not right. Others say Planned Parenthood is only capable of doing good with its proving for abortion and I, looking at its eugenicist creator and original goals of involuntary sterilization say no, that's not right either. The human population is burgeoning, but that doesn't mean we ignore the pockets that have been carved out for purposes of genocide or the military industrial complexes that require three earths to sustain their current rate of consumption. Medical advances are nice, but if you're willing to be treated by people who would gleefully forget the difference between therapy and research if they didn't live in fear of hoards amateur journalists descending on hospitals and scientific centers, camera phones and Wikipedia articles at ready, you're just a meal that's currently off limits.

Medical theories of criminality are important because medicine has long claimed a special provenance over criminality. The very frequent reference to a prison as a site of rehabilitation and treatment is the sine qua non of modern penology.

Leaving aside for a moment the egregious social fallout of selecting only black and Hispanic boys, this racial selection also created serious scientific error. When only one ethnicity is considered in an experiment to elicit general information about a heterogeneous population, an unacknowledged set of socioeconomic variables are introduced.

Silence governs those risk factors that cannot be laid to a blame-the-victim paradigm that emphasizes patients' high-risk behaviors.

The kind of shifts that would fulfill the adage of learning from history in order to avoid the doom of repeating it would require reparations for slavery and holistically ethical learning and all sorts of things that will never happen so long as society defends to death its playing to the tune of your money or your life. Those with scientific training that hide behind the excuse that the public who volunteers as subject material will never understand it aren't scientists, but piss poor socioeconomic abusers who aren't qualified enough to perform research due to a lack of ability in being able to explain every aspect to all and sundry. All and all, this work is an exact reason why the willful pretense that there is no confluence between science and the arts will forever entail that children are trained from the cradle to be sadists, because what is consent? What is worth? What can history tell us about why "the world" is acceptably wielded as some vague juggernaut to scare people into line, up until the point someone deconstructs "the world" and attempts to publish their findings of things more nightmarish and more unquestioned than the metaphor itself?

South Africa's systematic murders via biological agents are important to this book because so many of the scientists involved in crafting South Africa's racist bioterror were Americans. In fact, the science of the apartheid could not have existed without the avid participation and guidance of a handful of American scientific renegades.

During World War II, prisoners had been commonly used as research subjects, and after the war, the United States was the only nation in the world continuing to legally use prisoners in clinical trials.

People who aren't African Americans or Africans or in anyway associated with the concept of "black" can afford to read this because the process doesn't dehumanize via proxy for 500+ pages, especially in the case of those who gulped down The Immortal Life of Henrietta Lacks and all its white author glory. There are instances of broad spectrum eugenics involving mental illness and poverty that touch upon other demographics, but intersectionality is the goal of this work, and you can't have that without black women. If you can't do it because you have a weak stomach, don't become a doctor. If you won't do it because it doesn't interest you, don't go to a doctor. It's alright for medicine to cost more than the human beings it sacrificed to better itself can afford, but for it to cost a recognition of those human beings? Absurd. Wouldn't you agree?

...[W]hen the desperately ill are confronted with extreme measures and heroic experimental ventures, they risk confusing research with therapy, and so do their doctors. Patients rarely understand that physicians conducting the research are primarily interested in the research, not an individual patient's survival and quality of life.

It is not necessary to waive informed consent in order to provide the unconscious with treatment: Laws already exist that permit doctors to offer the best-available treatment to patients who are comatose, unconscious, underage, or in other ways unable to consent to treatment. But these laws do not extend to experimentation, and rightly so.

"We now know, where we could only surmise before, that we have contributed to their ailments and shortened their lives."
-Oliver Clarence Wenger, M.D., U.S. Public Health Service, 1950

[Shelley · Rating 5 out of 5]

It is very rare that I give a book 5 stars but this one earned it. This was a deeply disturbing and chilling book. Normally I do not read this type of book because I do not have time to invest in it but I took time this time. It was well researched and presented an awful picture of how so many people were injured and killed in the name of science and in order to justify medical testing and experimentation. I have studied this topic in the past in regards to early settlers in the deep south, primarily the creole and cajun slaves in Louisiana and the tortures they endured at the hands of their French owners. This book only reinforced the stories I had already found and added more credibility to the truth that so many people try to shovel under the rug. Good book.

[Alan · Rating 5 out of 5]

This book is mandatory reading.

[Nancy Oakes · Rating 4 out of 5]

In this book, the author has compiled and analyzed a vast amount of research to make the case that racist practices toward African-American people from slavery onward, in the name of science and medicine, have created an atmosphere of distrust among African-Americans toward the medical profession. As a result of this distrust, and often fear, this group of people may not be getting proper medical care when necessary.

I won't go into a major discussion here, but I thought the author did a fine job in terms of research and presentation. I'm not a scientist, nor am I conversant enough in the topic to judge her research, but this book really opened my eyes to some less than professional and less than ethical practices. I must say that I'm not surprised -- earlier I read the book "Bad Blood" about the syphillis experiments at Tuskeegee -- but that was probably the extent of my knowledge on the topic. Washington's book makes that study seem like only the tip of the proverbial iceberg. I have to say that sometimes she was a bit repetitive, but not enough to distract from the main points of her work.

I truly hope her work does some good. I'd recommend it to people who are interested in the topic, especially people like myself who have only a limited knowledge, or to people who want to add yet another dimension to their understanding of African-American history.

[Carolyn Fitzpatrick · Rating 4 out of 5]

This was the most disturbing history book that I've read in a looong time. First it discusses the horrible medical experiments conducted on slaves in antebellum days, some of which make those Nazi experiments look like nothing at all. Then it moves into the experiments and graverobbing that free African Americans were more vulnerable to, due to poverty and racism. Then it wraps up with the examples of racist medical practices in the modern day plus medical abuses practiced in prisons, which are disproportionately populated by African Americans. Not a fun read by any means but an interesting side of American History that I had only been partially aware of previously.

[l · Rating 2 out of 5]

http://www.nytimes.com/2007/02/18/boo...

I haven't checked Washington's sources obviously but the NYT assessment seems accurate to me. This was a very disappointing read - tbh, books like this are why I'm hesitant to read those 'this year's feted nonfiction' lists. So many works of popular nonfiction have this awful journalistic tone (sensationalizing, decontextualizing) which makes me question everything that they say and unfortunately this is one of them.

In regards to the lack of context, for example, if you're talking about medicine and rights then you should canvass (to some degree!) the development of health law as it relates to informed consent, battery, medical research, mature minors etc. I was incredibly irritated by Washington's recap of a case wherein a mother sued a surgeon after he did a procedure on her 15 year old son without her knowledge and initially lost via the mature minor rule as her son had consented. This decision was reversed as it was determined that the surgery was not in the child's best interests and that he was unclear as to the risks involved in the procedure, but Washington doesn't discuss the mature minor rule/the best interests test or the justifications for these tests. Instead, Washington presents mature minor consent as a way of letting evil doctors off the hook for their illegitimate experiments on coerced black children. Washington also actually says that children are incapable of consent because they cannot understand medical procedures, weigh risks etc, which is an appallingly ignorant thing for someone who has studied medical ethics to say, imo. There are other issues of course, but children's autonomy in medical decision-making is one of my soapbox issues. Maybe I would have given the book 3 stars but for the 'children can never consent because you can bribe a six year old with a toy' nonsense. But maybe not, it's reflective of this book's complete lack of nuance tbh.

[Dave · Rating 3 out of 5]

Washington's book is more encyclopedic than argumentative, though she makes overtures in both directions. Medical Apartheid is an exhaustive look at how prejudice has played out in the sphere of medicine and healing, exclusively focusing on Western medicine's dark interaction with the subjected and forgotten enslaved and poor. She also attempts to establish causation between a current African American iatrophobia (fear of medicine) and the many abuses of African Americans at the hands of American medicine, and her strategy is the well-intentioned but somewhat tiring beat-the-reader-over-the-head approach.

It's sad that there is so much evidence to support Washington's claim. However, as the book goes on, Washington's zeal to incorporate further weight to the burden of proof causes her to grasp at reductive arguments and split hairs. For me, this shift began with her examination of experimentation on prison populations. Washington downplays experimentation that occurred before African Americans made up the shockingly disproportionate percent of the prison population, asserting a black and white racial narrative in the place of the more complex narrative of American incarceration (though race certainly plays a part).

In a subject that is so rife with unquestionable evidence in support of her claim, I was disappointed that Washington resorted to juking stats and leaving out complicating details.

[Michelle · Rating 5 out of 5]

52 Weeks of Women of Color
2020 PopSugar Challenge ~ "Read a book by or about a woman in STEM"

This book had me raging. Medical Apartheid is a detailed account of the atrocities that African Americans have faced at the hands of the medical profession and the scientific community. Most of us are familiar with the government funded Tuskegee Syphilis experiment but many do not realize how extensive and pervasive these egregious practices are currently. In today's world children of color are more likely to be targeted for studies of a non-therapeutic nature. Men of color are rounded up for random DNA fingerprinting, infringing upon their legal and personal rights. The poor are exploited as a free resource for experimentation when they enter emergency rooms for care. Black employees are unknowingly tested for hereditary and social diseases. Their DNA profiles are then used to discriminate against them.

This does not even touch upon all that is covered in this book. Although Ron Butler does a fantastic job narrating this book, I would behoove you to get a physical copy. There was so much information here that I felt I should be highlighting and taking notes on. I found this hard to do in the audio format. For me Medical Apartheid is a book that I need to own. It is the type of book that you come back to time and again, each time gleaning more information.

[Meagan · Rating 5 out of 5]

2021 PopSugar Challenge
A book from your TBR list you meant to read last year but didn't

non-fiction book 2/12 for the year

[Jess Owens · Rating 5 out of 5]

Review: https://youtu.be/7EH3t2vrViE

[Becky · Rating 5 out of 5]

A few days ago I saw a NY Times article about Sandra Lindsay, who was the first person in the US to receive the Covid vaccine outside of a clinical trial a year ago, and her thoughts on that, and I was like... OK, cool. After reading this book though, that article takes on a much more portentous meaning, considering that Sandra Lindsay is Black.

I have a whole new perspective on (valid) hesitancy when it comes to emergency authorizations, medical trials, medical research, and medical ethics (or the lack thereof for MOST of US history) after reading this book. The meticulously researched cases outlined here show that the US medical industry (and the Nazis) didn't give too many shits about the lives or bodies of those that were deemed to be throwaways in society. They'd use, abuse, lie, manipulate, coerce, and worse to experiment on people... because they could. Stringent laws to protect against those practices were only implemented not too many years before my birth. These types of practices were still going on in the 1970s. Of course, they were unethical long before that, but ethics are easily ignored when the justification of SCIENCE is invoked, and when medical experimental mutilation, torture, and death results in the kind of knowledge that leads to worldwide recognition and having your name go down in history for the discovery of such and such drug or procedure... over the bodies of the unwitting, unprotected, and vulnerable people who were used to get there. Real impressive resumes, for monsters.

I digress. To be the first person to do anything risky is courageous. To be the first to take an emergency authorized vaccine, as a Black woman, after the looooong history of how Black bodies were stolen and used for medical research against their knowledge or consent... that takes balls. Even if the only horror story she may be aware of is the Tuskegee syphilis study, which is the most commonly known and cited ethical clusterfuck, it was still brave as fuck of her to step up to the front of the line and offer her arm.

So, I can understand that hesitancy. Pfizer doesn't come out of this book looking like any type of hero, that's for damn sure. It left a really bad taste in my mouth knowing the shit they endorsed and funded and did in the name of "science".

But I still received 2 shots of the Pfizer vaccine plus a booster. And I will continue to get them as long as necessary. I still take medications and regularly rely on the knowledge gleaned from unethically obtained medical research, etc. I wish that wasn't the case, but this is the situation we have now, and we can only move forward and do better - with better laws and regulations and oversight and APPLIED ethics.

That being said - if your reason for being anti-vax now is because Jenny McCarthy or Fox News told you not to trust them... Get your damn shots. Your reason is invalid.

One last note... Harriet Washington cites the brilliant work of neurosurgeon Ben Carson in this book. I really, REALLY wonder what she says about him now.

[akemi]

This is the first book I've had to stop reading for the sake of my mental health. I feel myself becoming bitter and angry, and I do not want to be here. I can't do any good from this space. Props to others who can get through this, because it's very much worth reading. Trigger warning though, there's a lot of physical and sexual violence.

Medical Apartheid relays stories of black bodies opened up, modified, tortured, sometimes once before being disposed of, other times periodically for years on end, from the 1700s to now. It's grim. C-sections, gynecology, eye surgery, amputations: these experiments began on nonconsenting slaves without anesthesia. Medical history is a history of torturers, rapists, and child experimenters. In America, black bodies were used; in Britain, lower class children, sex workers, the disabled. Across both countries, experiments on the marginalised and the poor were used to buttress the health of the elites. These elites received treatment once it was perfected. There were doctors who even drew their procedures in textbooks as done on white women, effacing the historical injustices they'd committed on black bodies.

Worth reading alongside Fanon's Black Skin, White Masks, which provides a phenomenological account of racism, and Hurley's The Gothic Body: Sexuality, Materialism, and Degeneration at the Fin de Siècle, which gives a very good overview of degeneration and how it emerged out of evolutionism.

I'm going to now read about communes, mutual aid, and other life-affirming things.

[Janine · Rating 2 out of 5]

I really wanted to like this book. It is such an important topic and there needs to be well-written, well-researched literature on racism in medicine and role it has played in healthcare disparities. (There are some out there!) Sadly, this book is not it.

The book basically follows the logic that doctors perform medical research --> medical research needs test subjects --> test subjects have always been the most vulnerable populations --> Blacks are included in these vulnerable populations --> therefore, medical researchers are racist. It then tries to back up these claims by giving an endless number of examples, some incredibly shocking and horrific (involuntary surgeries on chattel slaves, the Tuskegee experiment, grave robbing for medical schools, Henrietta Lacks), and others that are examples of a single incident of one Black person being experimented on with little to no evidence that race was a factor in choosing this person. Medical experimentation on disenfranchised populations, such as those in concentration camps (leading to the Nuremberg Trials), chattel slaves, Native Americans, intellectually disabled children, the elderly, prisoners, the military, the uninsured, and lower socioeconomic groups is well known throughout history and are an embarrassing mark on medical science. However, in a large number of the studies the author equates the high proportion of Blacks within these groups as part of medical racism, rather than a result of systemic inequities which has led to healthcare disparities and unequal access to healthcare.

For a book on medical research, it is poorly cited. She makes a number of arguments and says things like Black enrollment "might have" been high in the study because they didn't read the consent, or there were "probably" more Blacks in the study, or this "suggests" most were Black. This is a book about research, yet it is lacking in data or even certainty. There are a lot of inferences the reader is supposed to make (primarily because the experiments were conducted in prisons or urban centers they "must have been mostly Black" subjects) rather than citing actual data. There are also studies where the data feels exaggerated. For example, she states in the artificial heart study 2/6 of the participants are Black which is greater than the proportion of Blacks in the country at the time (12%), and therefore there must be racist motives at play. Two out of six is an extremely small sample size and can hardly be used to illustrate a point. In another example, she cites a study where the entire point of the study was to compare Blacks and whites, so there were an almost equal number of Blacks and whites enrolled in the comparitor groups. She goes on to say close to 50% of the study had Black subjects, which far exceeds the racial makeup of the country at the time. Yet this was the entire point of the study.

If she had only included well-documented, well-cited studies and experiments which actually demonstrated racism or bias, this book would be great. However, it is terribly diluted by assumptions and distortions. Making claims preceded by "maybe" or "probably" just led me to question what exactly I could trust. Using studies that were centered in urban areas and stating that the proportion of Blacks in the study exceeded that of the general population to prove a point that the studies were racists only made her other arguments less convincing. On top of that, when she addressed topics of medicine that I have some expertise in, she was often simply incorrect, or so terribly biased that I then wondered if I could believe anything she said at all. 

A few examples:
She makes the blanket statement that using genetics for medical treatment is dangerous. It is literally how we cure cancer now.
When discussing a vaccine trial for children, she did not state any of the benefits, but stated one of the risks as developing autism (!)
She is opposed to contact tracing for infectious disease (but also says if we don't know who is infected with STIs then we can't take measures to protect against them)
She is opposed to directly observed therapy for tuberculosis (I worked in tuberculosis for 5 years, this is not a racist practice by any means. It is standard. TB affects more POC than whites, so more TB patients are in therapy. Again, a result of systemic racism, not racist treatment. And this is not experimentation).
She grossly overstates the benefits of the TB vaccine and then ponders that it isn't used much because TB mostly affects Blacks (it isn't used because it really doesn't work).
She perseverates on the lack of follow through with the HIV vaccine despite the fact that the repeat experiments could not duplicate positive results (this is how science works).
She says placebo studies have fallen out of favor in the west. Have they? Someone tell the FDA.
She lists all of the risks of a therapeutic trial for the reader and none of the benefits, which is terribly biased.
There is an entire chapter on bioterrorism which includes very few medical experiments at all, and of the experiments she includes, half of them do not have a majority of Black subjects.
She refers to depo povera not as birth control but as "a carcinogen"
She views Planned Parenthood Clinics as eugenics/genocide clinics and tries to conflate voluntary birth control use with forced sterilization.

My concern about this book is that people will read it, take it for its word, and come out with the idea that Blacks are being singled out for medical research, and it will actual worsen the healthcare disparities it is trying to shed light upon. If you read this book, read it critically.



Note: I later read the NYT Review on this book and found that some of the studies she cites are actually factually incorrect. I suppose I was right in not feeling like I could trust her.

[Emmett · Rating 4 out of 5]

Now, I consider myself only SORT of dumb, and there have been some words which I did not know what they meant and there have been some words that I have never, ever seen, and look Lewis Carroll-y at first glance. But, Harriet Washington made me feel dumber than hell with her prodigious use of obscure words, both large and small.

Ironically, multiple times throughout the book she criticizes (rightly, of course) the use of high medical jargon that no non-medical expert could ever hope to decipher in the disclosure forms that some poor, unfortunate was goaded into signing. And then she peppers some dumb rube like me with all these big fancy words, to the detriment of my ability to understand the sentence or sometimes even the paragraph. So, I'm all like, "Whatever!", and I go on to the next sentence.

Anyways, the book: The book is good. The book is likely as good as a book about deplorable medical acts to Black Americans can be. Washington does a fine job of being clear and has a reporter-like detachment throughout the laundry list of experiments (the majority stomach-churning in their inhumanity). Thankfully, she doesn't really ever fall victim to the temptation of sensationalism or of editorializing too often.

On the downside, and this might not be something that bothers everyone, but there is little cohesion to the book. Each chapter has its distinct theme, so much to the point that it reads like a series of essays, rather than a book. Which would be fine, with a different author writing each one, but given Washington's wordy, editor-needed style, this lack of cohesion and having to start over with a brand new cast of mini-figures and themes, it began to get a bit tedious at the end and in the chapters that I didn't find as interesting.


The only part of the book I did not agree with her, was the chapter on prisoners as experimental subjects. Each previous chapter had been grounded in the fact that while blacks only made up roughly 10% of the population at any given time over the last 200 years, blacks made up the majority of, or even the vast majority of test subjects, and of course the number shouldn't be, yet is, very disproportionate. Considering the book is not just about unjust medical experimentation in general, but instead medical experimentation on Black Americans, this is a very important statistic that Washington uses liberally throughout the chapters, and rightly so.

However, when talking about the use of prisoners for medical experiments, this fact no longer comes into play, yet she tries to force it on the reader. She continues to cite the statistic of 10% of the population being 50+% of test subjects, however in the universe of the prison this is no longer so. Since, blacks make up (according to Washington) 46-48% of the prison population, this statistic should be tossed out the window. The fact that blacks make up such a disproportionate number of inmates in America is a subject for any numbers of books about the social issues that come with poverty, etc... But, the fact is, rightly or wrongly, blacks are not a minority in prison populations and a few of the experiments that Washington details in prisons say that the divide of black to white prisoners as subjects was about even relative to their total percentage population. Yet, Washington then continues to make the claim that the experiment was still racially biased, because the outside population. Which, I don't agree with when considering what the pool of people they had to pick from, they were constrained in their selection. Scientists on the outside were not, and still chose to choose subjects based on, or because of, race.

That might seem like a small issue, but in a book which Washington so smoothly laid out all of her points with great supporting evidence, that one chapter kind of swung and missed for me, since it seemed in my opinion, obvious that prison experimentation was worthy of an entire other book (of which I'm sure there are plenty), and Washington tried to quickly consolidate it into a chapter and messily stamp it with her book's agenda.

Could have used an editor, could have put away the thesaurus some. But, an incredible variety of sources and a good job of making a book both clinical and disturbing in its content and characters.

[Nancy · Rating 2 out of 5]

This book is a National Books' Critics' Circle award-winning examination of how African-Americans (and even some actual Africans') have been treated by the medical industry, and how so very many of them became guinea pigs in the name of medical research. I was pleasantly surprised to find out that this book is written by a medical social worker as I am also, though Ms. Washington has since apparently gone on to bigger and better roles as a Medical ethicist. She writes in excruciating detail how black people were "treated" for Syphilis in the infamous Tuskegee Syphilis Study. She also writes about unsuspecting black girls and women being surgically sterilized, grave robbing black cemeteries to supply bodies to medical schools, and a dying man unfortunate enough to be injected with Plutonium for no purpose other than to find out what happened, and so many other horrific treatments, all in the name of furthering medical research.

Unfortunately there were more than a few errors that I noticed here and there, and even some questionable claims that made me want to put this book down and walk away from it. First, the little stuff. There were a couple of words that were just misprinted with letters juxtaposed, and which were nothing more than technical errors in the print shop. Secondly, seeing as how the author admits to working in the medical industry, I don't know how the following errors made it past the editor. In one case, she uses the word "ovariotomy" to describe the surgical removal of an Ovary. In the medical world, the -otomy" suffix is meant to cut a hole into something, as in this case it suggests cutting a surgical hole in the woman's ovary. Except that's not what the author intended to say; she clearly meant to say that the ovary was removed, in which case the relevant word would be "ovariectomy" or "oophorectomy." In another instance, she writes about some medication or another changing the color of the patient's pupils. Um. I used to work for ophthalmologists, so this error was especially jarring. You see, pupils are nothing more than the holes in a person's eye that lets light into it. Short of some pretty incredible medical gymnastics, there is no way to change the color of a patient's eye holes to blue, green, or brown. In this case, I am sure that she was referring to the Iris of the patient's eye which is the colored part.

I was able to overlook those relatively trivial errors, but the bigger ones really tested my willpower. Firstly, this book was written in 2006, so technology hasn't advanced too much since then. In one section, she states that DNA testing is less reliable than fingerprinting. Now I don't work in the legal industry, but I do know that DNA testing is sufficiently thorough enough that it can eliminate several millions of suspects. Fingerprints can be easily explained away, or polished off of a surface. I thought that I had misread the passage, but after several re-reads, there is no misunderstanding; she really does say that fingerprint testing is superior to DNA testing. The final issue that I had with this book is that she tends to overuse the word "genocide." In many instances, it is justified, such as when she is writing about white people in colonial America trying to rid the New World of black people. But when she suggests that a genetics counselor may be guilty of genocide by meeting with a black couple to rule out the possibility of Sickle-cell Anemia in their offspring. No, that is taking things way too far. Again, I read and re-read that paragraph in case I was mis-interpreting it, but no, there it was; the suggestion that a genetic counselor is committing genocide by providing his or her services to a black couple who may be carriers of Sickle Cell Anemia.

This book was informative and includes a lot of episodes of mistreatment of black people by white doctors and scientists. Most of them were pretty horrible. The editing of this book is also pretty bad and deserves another good long look. It is important to remember the horrors of the past, but it's also important to remember basic grammar skills.

[Traci Thomas · Rating 4 out of 5]

A hard read. Full of so much information. Not really enjoyable but beyond necessary. The detailed examination of racism in medicine and science is terrifying. It also exists in the shadows and this book gives the victims of these crimes a voice. I didn’t like reading this book but I’m glad I did and I’m incredibly grateful it exists.

[Cara · Rating 5 out of 5]

There was a whole lot of "holy shit" while reading this book.

[Jorie]

I don't give non-fiction works star ratings

That this is such a hard book to read speaks to the necessity of reading it, especially now when CRT is under attack in the American educational system. But if white people are capable of committing such atrocities as described so thoroughly in this book, we should be just as capable of being taken to task for them. We have a responsibility to confront our past, learn, apply, and atone. Our discomfort is nothing compared to the suffering we've caused.

This is about how science was manipulated to defend the illogical (racism), and how black bodies have been exploited to further white health. Harriet A. Washington covers an incredible scope of medical abuse against black people, beginning with early experimentation during slavery. She conveys the information in a clear narrative that follows the new forms these abuses took with the changing circumstances of black Americans throughout history. She illustrates the multiple hypocrisies in the pseudoscience used to justify the constant maltreatment, and holds several notable figures accountable for egregious acts (many of whom are/were revered in the white medical community).

So no star rating - because I don't know how to give stars to our history. But I have filed it on my "Best Non-Fiction" shelf here.

[Shanae · Rating 3 out of 5]

This took forever for me to read (I started in March - oh wow!!). It took forever to finish this book and not because it was incredibly hard for me to read, but because I found it a little redundant. The book is well written and Harriet A. Washington is very clear throughout it. I really appreciated that and I feel that I have learned a lot from Medical Apartheid. I recommend Medical Apartheid to those who are interested in learning more about the history of medical experimentation.