Uninformed Consent: The History of Healthcare for Black Americans

In Green-Wood Cemetery in Brooklyn, NY, a statue of Dr. J. Marion Sims stands. Sims was known as a pioneer in surgery and is often referred to as “the father of modern-day gynecology.” Less known is that he developed his expertise by experimenting on enslaved people named Lucy, Anarcha, and Betsey. The statue had resided in Central Park in New York for decades, across from the New York Academy of Medicine, until it was removed after complaints in 2018. A portrait of Sims and his colleagues named, Medical Giants of Alabama” hung over a fireplace in the University of Alabama-Birmingham Center for Advanced Medical Studies until its removal in 2006.

Memorials to Sims still exist in Montgomery, Alabama, and South Carolina. Sims performed multiple surgeries on the same patients, mostly without anesthesia, while seeking a surgical cure for vesicovaginal fistula and related disorders. He had the permission of the enslaved person’s owners and said, “they were willing and had no better option.” Their “willingness” is contradicted by his writing in which he described Lucy as in so much pain that she “wanted to die!” Sims performed thirty surgeries on Anarcha before declaring her “cured.”

There is general knowledge of the medical experimentation that took place in Nazi Germany prisoners. Less so of the centuries-long practice of experimenting on Black patients, during and after slavery, without informed consent. Slaves were an investment; the most valued weren’t the strong bucks who could perform the most work but the “breeders” who could produce a good quantity and quality of enslaved people without dying in the process. President Thomas Jefferson, a Virginia slaveholder who owned over 600 enslaved people during his lifetime, wrote, “ a child raised every two years is of more profit than the crop of the best laboring man. The labor of a breeding woman is of no object; it is not their labor, but increase which is our first consideration.” Like any investments, concern about slave health existed to ensure their continued contribution.

Rarely noted in American history is the existence of slave hospitals, though the term hospital is an exaggeration. Slave hospitals were most likely tiny cabins, dirty and ill-supplied. Their objective equal parts declaring enslaved people fit to return to work without serious injury and for those unable to return them to labor as soon as possible. Historians had noted the occasional rogue physician that had experimented on enslaved people without consent. It took scouring the medical journals to realize that the most-respected doctors were using slaves to practice on. The Baltimore Medical and Surgical Journal and Western and Southern Medical Recorder were filled with reports of surgical experiments to treat congenital disabilities, tumors, and injuries, without anesthesia and in non-sterile environments. Needless to say, without consent.

On September 22, 1862, President Lincoln issued the preliminary Emancipation Proclamation. This would theoretically free the slaves in the Southern states that had seceded from the Union. But only if they escaped to the North or joined Union forces. Also freed were the enslaved people in the District of Columbia. When enslaved people started arriving, they were often malnourished or otherwise diseased. In Washington, D.C., a “contraband hospital” was set up to treat recently freed slaves and injured colored soldiers. After the war, that became the Freedmen’s Hospital and, eventually, part of the largest teaching hospital serving primarily African-American doctors, Howard University Hospital.

In the Tuskegee Experiment, Black patients were diagnosed with syphilis, observed while they suffered, often went blind, and died of the disease, all without treatment or consent. Less known is a similar treatment of Terra Haute, IN prisoners, although it is claimed they consented. Once those activities were discovered and the public rejected them, some of the same doctors conducted similar research in Guatemala on a slightly less dark population.

Even today, there are studies that black patients are administered smaller doses of painkillers and other medications based not on their injuries or disease but on prejudiced beliefs about black people’s ability to withstand pain or theories Black people have thicker skin or smaller lung capacity.

These inherent beliefs cause physicians to make different medical decisions based on race without consulting other physicians or, heaven forbid, the patient. It’s impossible in today’s America to participate in high school sports without physical and parental consent. Not too long ago, if you were Black, you could have healthy brain tissue removed or unneeded operations without being asked first. It’s documented that black men and women are less likely to seek treatment from a doctor or hospital in America. Given this nation’s history, it’s not hard to imagine why.

—

This post was previously published on MEDIUM.COM.

***

You may also like these posts on The Good Men Project:

Escape the Act Like a Man Box

What We Talk About When We Talk About Men

Why I Don’t Want to Talk About Race

The First Myth of the Patriarchy: The Acorn on the Pillow

—

Photo credit: iStock.com