September 27, 2022

Bioethics must repudiate its white past to confront racism

The Black Lives Matter movement has exposed a crisis in bioethics, argues Camisha Russell, of the University of Oregon, in the American Journal of Bioethics. In a long and wide-ranging article, she says that the field of bioethics must repudiate its white past and work to expose and eliminate racism and the noxious concept of race.

The dominant model of bioethics, the principlist movement, is itself racist. “At the time of its mid-twentieth-century founding, the modern form of medical ethics could also be described as a Herrenvolk ethics. Its newly elaborated concerns about autonomy, consent, transparency and acceptable levels of risk in medicine and medical experimentation seemed not to apply to nonwhite patients and research subjects, who continued to suffer ethical violations.”

So what should be done? All hands are needed on deck, Russell says, to cope with the emergency.

“it will require from each of those hands an individual commitment against structural racism. Functionally, I break that commitment down into three necessary parts: (1) the ability to see oneself inside unjust systems and/or institutions, (2) a centering of one’s own transformation rather than one’s guilt or innocence, and (3) a commitment to praxis.”

Thus, practitioners need to move away from “bioethics as usual” – which is inherently racist – to “expanding analysis beyond individual patient care and toward structural barriers to health”. It is vital for bioethicists to recognise that race and racism are not niche topics within the field, but central to all ethical analysis.

On a practical level, “bioethicists should be helping physicians, scientists, and health care workers to study theories of racial inequality, engage in critical self-reflection, and generate practical steps for improving their practices”.