CARTE BLANCHE

An alarming indictment of exploitative medical research.

Medical ethicist and journalist Washington offers considerable evidence of deceptive and devious practices in medical research, which especially impact Black Americans. After World War II, she notes, in response to “forcible human experimentation” inflicted upon prisoners and concentration camp victims, “the Nuremberg Code was imposed to ban research without voluntary consent. Informed consent was enshrined into U.S. law in 1947 to ensure that research would never be imposed on Americans without their knowledge or consent.” However, researchers have found ways to undermine that law, leading to the continuation of nonconsensual experimental abuse. Reprising evidence that she presented in Medical Apartheid (2007), Washington underscores her argument that African Americans historically have been victimized by researchers. “Whether subjected to laissez-faire experimentation on the plantation, early clinics, or other institutions, black Americans were sold to doctors expressly for nineteenth-century research and physician-training purposes,” she writes. This included the testing of reproductive surgical procedures on Black women “because unlike white women, they could not say no.” The infamous Tuskegee syphilis study, which ran from 1932 to 1972, withheld treatment for 600 Black men diagnosed with syphilis, instead maintaining them in an infected state so they could be “tracked, studied, and ultimately autopsied.” In 2010, researchers “intentionally induced hypothermia in unwitting black men who suffered gunshot wounds.” Prisoners and soldiers have repeatedly become research subjects without their consent, but Washington asserts that nonconsensual research—for profit—is becoming more normalized, risking the well-being of all Americans. She advocates clear disclosures to allow the average patient to agree to become an informed participant, including “possible lifestyle effects” of a given study. A patient who refuses or is deemed incapable of consent “should be considered ineligible for research and simply treated with the best known care, as if there were no research study to worry about.”

An enlightening and well-supported examination of shocking malfeasance.