Harriet Washington responds to Ezekiel Emanuel’s (egregious) review

The New York Times

‘Medical Apartheid’

Published: March 18, 2007
To the Editor:

In 15 chapters and 501 well-annotated pages, my book “Medical Apartheid” offers a careful, nuanced discussion of trends, cases, problems, ethics and persistent patterns in the disparate treatment of black research subjects. However, Ezekiel Emanuel’s review (Feb. 18) ignores its rich content in order to claim that “Medical Apartheid” fails to place the experience of African-Americans in context. He dramatically misrepresents the work within an untrustworthy review that is rife with distortions, contradictions, errors, exaggerations and confusions.

Emanuel’s own troubling research agenda, elements of which I criticize in “Medical Apartheid,” may be pertinent. He champions such dubious policies as offering undue inducement to poor people and offering research subjects in developing countries inferior medications and standards of protection.

I have been allotted 650 words, insufficient for a point-by-point refutation, so I’ll address a smattering of his many mischaracterizations and errors.

Emanuel ignores how consistently “Medical Apartheid” quantifies my statements about the disproportionate use of blacks in abusive medical research. For example, researchers’ own statements reveal that the experimental development of gynecologic surgeries like Caesarian section, vesicovaginal fistula repair and ovariotomy were perfected almost exclusively using enslaved black women. The disproportionate theft of black cadavers was validated by records and events like the 1989 discovery of 9,800 bones, 75 percent from blacks, in the basement of the Medical College of Georgia’s former anatomical laboratory. Dr. Eugene Saenger’s fatal radiation experiments in 1950s Cincinnati were performed on a subject pool that was 75 percent black. The subjects of many other radiation experiments were all black, like the patients at Dooley and St. Phillip hospitals in Virginia who were intentionally given third-degree radiation burns by scientists “for investigational purposes.” By 1983, 43 percent of women sterilized by federally funded eugenic programs were black. Approximately 80 percent of the boys in the 1970s Baltimore XYY studies were black, as were nearly all of the children in that city’s KKI lead study. Every boy in a 1990s New York City fenfluramine experiment was black.

Medical treatment and public-health initiatives can also constitute medical research. Emanuel disingenuously writes as if an initiative must be either one or the other in order to accuse me of conflation. Despite Emanuel’s bewildering claim to the contrary, the “Black Stork” chapter does focus heavily upon medical research, including racialized studies that fueled involuntary sterilizations, Norplant and Depo-Provera investigations, research distortions that created the myth of the “crack baby,” and nonconsensual research with pregnant black South Carolina women.

Far from castigating directly observed therapy for tuberculosis, I lament that it is too often eschewed in favor of imprisonment. Thalidomide is indeed being given to black women subjects in Africa, and researchers fear that its presence in semen may make its use in men hazardous. Despite Emanuel’s assertion, the book is supported by a plethora of notes filling 50 pages.

Emanuel’s tenuous grasp of history is typified by his non-exculpatory focus on tangential, oft-told events and by the errors crammed into the single sentence with which he attempts to reconstruct the U.S.P.H.S. Study of Syphilis in the Untreated Negro Male. The men first were denied Salvarsan, not only penicillin; a significant minority obtained treatment; the study’s goals included not only observation but also a validation of a racially dimorphic progression of syphilis and diagnostic refinements. Researchers’ goals could not be accomplished without autopsy, and so were not achieved before death.

He falsely claims that “for Washington, the answer comes down to one thing: skin color.” Actually, I describe a terrible confluence of factors that changed over time, including a precise variant, scientific racism. My discussion of factors that tempered or trumped racism includes economics, politics, utilitarianism, communitarianism, black complicity, white beneficence, forbidden knowledge, deontological frameworks and social-justice issues. Emanuel’s failure to acknowledge these sophisticated arguments is a startling omission. Perhaps he is interested only in silencing them.

Harriet A. Washington

Chicago

Ga. Senate Panel OKs Confederate Month

The New York Times

Ga. Senate Panel OKs Confederate Month

By THE ASSOCIATED PRESS
Published: March 15, 2007
Filed at 9:16 p.m. ET

ATLANTA (AP) -- A panel of Georgia lawmakers signed off Thursday on a plan to create a Confederate heritage month, even as legislative leaders reacted coolly to a push to apologize for the state's role in slavery.

Sen. Jeff Mullis' bill would dub April as Confederate History and Heritage Month to honor the memory of the Confederacy and ''all those millions of its citizens of various races and ethnic groups and religions who contributed in sundry and myriad ways to the cause of Southern Independence.''

The unanimous vote by the Senate Rules committee -- which sent the plan on to the full Senate for consideration -- comes days after black lawmakers announced plans to ask the state to officially apologize for its role in slavery and segregation-era laws.

Virginia's legislature last month passed a resolution expressing ''profound regret'' for the state's role in slavery, and lawmakers in Missouri and Congress have proposed similar measures.

Democratic Rep. Tyrone Brooks, chairman of the Georgia Association of Black Elected Officials, said it's discouraging to see the Confederate month proposal moving ahead after leaders of the Republican-controlled House and Senate said they're not in favor of apologizing for slavery.

''Georgia needs to recognize and apologize and atone for its part in the slave trade, as Virginia has done,'' Brooks said. ''Until we do, I think there will continue to be resistance from African-Americans and others who are serving in the General Assembly'' to efforts like Confederate month.

Mullis, a Republican, said his bill was not a response to the slavery-apology movement.

''I'm from Chickamauga, so it seemed pretty appropriate for me to do something to commemorate the War Between the States,'' Mullis said. His family owned land at the site of the Battle of Chickamauga, the Civil War's second-bloodiest battle and the South's last major victory.

Mullis has supported efforts to create a Civil Rights History Month in Georgia but opposes a slavery apology. ''If I had done something personally, yes, I would apologize,'' he said.

The state's branch of the NAACP called the push for a Confederate month hypocritical.

''Although the supporters of the Confederate history bill feel responsible to honor the past deeds of their ancestors through official governmental action, they resist all notions that they have any responsibility to apologize to their ancestors' victims through official governmental action,'' said Edward Dubose, president of the group's Georgia chapter. ''That reeks of hypocrisy.''

Brooks, who said black lawmakers plan to officially introduce their slavery legislation next week, said he hopes Mullis' bill at least will encourage discussion. He said he's not necessarily against the idea of a Confederate month -- as long as similar recognition is given to the state's black history.

''All of Georgia's history should be promoted and respected and highlighted,'' he said. ''Hopefully this will lead us into some meaningful dialogue.''