Racism and Ethics in Healthcare the United

Racism and Ethics in Healthcare

The United States achieved significant advances in the second half of the 20th century to reduce the prevalence and impact of racism on minorities, after failing to address it adequately in the hundred years in between the formal emancipation of the African slaves in 1865 and the Civil Rights Act of 1964 (Edwards, Wattenberg, & Lineberry, 2009). During that time, systemic racism was evident throughout American society and business, and it even extended to medical research in ways that also fundamentally conflicted with the Hippocratic Oath, such as in the infamous Tuskegee Experiments (Beauchamp & Childress, 2009; Goldfield, Abbot, Argersinger, et al., 2005). Today, it is inconceivable that American medical researchers could use human beings for experiments in which they were deliberately left without treatment or actually infected with diseases for research purposes. Nevertheless, racism is still evident in American health care, albeit more subtly, such as in connection, in particular, with the relative availability of quality medical services in minority communities (Reid, 2009).

In the U.S., as many as 50,000 people die prematurely every year from medical conditions and diseases that could have been prevented, cured, or managed successfully by appropriate medical intervention (Kennedy, 2006; Reid, 2009). Those deaths are directly attributable to the fact that approximately two-fifths of the American population cannot afford the premiums of the cheapest health insurance policies that are available to them, or to the fact that they have (until very recently) been excluded from health care coverage and had no hope of being able to pay out-of-pocket for the cost of the medical services they would have required for effective treatment (Kennedy, 2006; Reid, 2009).

The fact that there is such a differential in the availability of health care is a serious ethical problem in and of itself as it relates to the economics of poverty (Beauchamp & Childress, 2009). However, when the additional factor of race is considered, it reveals that there is a sharp divide between the availability of health care to majority members of American society and minority members of society (Kennedy, 2006; Reid, 2009). In fact, African-Americans and Hispanics are represented extremely disproportionately in the poorest communities where health care is the least available (Kennedy, 2006; Reid, 2009). Unlike the manifestations of racism in medicine a half a century ago, that discrepancy is not a direct function of deliberate acts of racism. However, the maintenance of policies within the health care field that, in effect, guarantee the substantial exclusion of individuals by race as a function of income is another insidious form of contemporary racism (Beauchamp & Childress, 2009). The same holds equally true in other areas of essential services such as the relative quality of education in wealthy primarily white communities and poorer predominantly African-American communities (Kennedy, 2006).