African American Bioethics

African American Bioethics: Culture, Race, and Identity

Lawrence J. Prograis
Edmund D. Pellegrino
Copyright Date: 2007
Pages: 192
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  • Book Info
    African American Bioethics
    Book Description:

    Do people of differing ethnicities, cultures, and races view medicine and bioethics differently? And, if they do, should they? Are doctors and researchers taking environmental perspectives into account when dealing with patients? If so, is it done effectively and properly? In African American Bioethics, Lawrence J. Prograis Jr. and Edmund D. Pellegrino bring together medical practitioners, researchers, and theorists to assess one fundamental question: Is there a distinctive African American bioethics? The book's contributors resoundingly answer yes-yet their responses vary. They discuss the continuing African American experience with bioethics in the context of religion and tradition, work, health, and U.S. society at large-finding enough commonality to craft a deep and compelling case for locating a black bioethical framework within the broader practice, yet recognizing profound nuances within that framework. As a more recent addition to the study of bioethics, cultural considerations have been playing catch-up for nearly two decades. African American Bioethics does much to advance the field by exploring how medicine and ethics accommodate differing cultural and racial norms, suggesting profound implications for growing minority groups in the United States.

    eISBN: 978-1-58901-232-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-vii)
  3. Acknowledgments
    (pp. viii-viii)
  4. INTRODUCTION Culture and Bioethics: Where Ethics and Mores Meet
    (pp. ix-xxii)
    Edmund D. Pellegrino

    “Culture” is perhaps the slipperiest concept in the social sciences.¹ Some years ago, Kroeber and Kluckhohn collected 164 definitions.² Of the many definitions available, we believe Kuper best captures the connotations of the word in his crisp characterization of culture as a “collective cast of mind.”³

    In this book we have taken a “collective cast of mind” to be a summation of all those things that give identity to persons, nations, ethnic groups, and organizations. Under this rubric we include all those things humans value, those things that define them as who they are, what they perceive themselves to be...

  5. CHAPTER 1 Revisiting African American Perspectives on Biomedical Ethics: Distinctiveness and Other Questions
    (pp. 1-24)
    Jorge L. A. Garcia

    What could make for a perspective on medical ethics that might be meaningfully and helpfully described as African American? Such a point of view might be distinguished by (a) its topics, for example, a focus on the distribution of services and their delivery to the poor, or on certain illnesses disproportionately common or severe among African Americans (e.g., breast and prostate cancer, diabetes, sickle-cell anemia, hypertension); (b) its methodology, contrasting with a two-stage approach (first describing and then justifying “common morality,” as advocated by Bernard Gert, Charles Culver, and K.D. Clouser¹), for example, with a principlist method (in the manner...

  6. CHAPTER 2 The Moral Weight of Culture in Ethics
    (pp. 25-46)
    Segun Gbadegesin

    Social anthropology once had to nurse the self-inflicted wound of its characterization as a discipline that is insensitive to the values and identities of other cultures. Seeing non-Western cultures through the prism of a chauvinistic Western male, and judging the modes of life of others by Western standards, earned some pioneer social anthropologists and their political associates (who assumed the “burden of the White Man”) the unenviable title of cultural imperialists.¹ With a new orientation, however, anthropology has corrected the mistakes of its pioneers. This new orientation, roundly commended across non-Western cultures, especially in Africa by the apostles of Negritude,...

  7. CHAPTER 3 Whitewashing Black Health: Lies, Deceptions, Assumptions, and Assertions—and the Disparities Continue
    (pp. 47-66)
    Annette Dula

    Over the last several decades, the federal government and private foundations have focused on the appalling health disparities between racial/ethnic minorities and whites, with their goal being to narrow the health status gap between nonwhites and whites. For example, the 1965 Medicare-Medicaid legislation improved access to health care for African Americans and other poor populations. In 1985, the U.S. Department of Health and Human Services published the Report of the Secretary’s Task Force on Black and Minority Health, which acknowledged the tragic dilemma of persistent health disparities between whites and minority populations.¹ In 1998, then-president Bill Clinton launched an initiative...

  8. CHAPTER 4 Race, Equity, Health Policy, and the African American Community
    (pp. 67-92)
    Patricia A. King

    In 1903, W. E. B. Du Bois, the acclaimed African American scholar, writer, and activist, wrote that the color line would be the problem of the twentieth century. In retrospect, it appears that he was prophetic, but his timeline was too optimistic. One hundred years later, at the beginning of the twenty-first century, the color line remains a problem for American society.

    To be sure, important strides have been made toward achieving equality for African Americans, especially in the last half of the twentieth century. In the landmark 1954 decision of Brown v. Board of Education of Topeka,¹ the Supreme...

  9. CHAPTER 5 Religion and Ethical Decision Making in the African American Community: Bioterrorism and the Black Postal Workers
    (pp. 93-104)
    Cheryl J. Sanders

    In the weeks following the September 11, 2001, attack on the World Trade Center and the Pentagon, some letters containing deadly anthrax spores were mailed to two senators on Capitol Hill, leading to the first cases of bioterrorism-related anthrax in the United States. As they were processed and delivered through the mail system, the contaminated letters caused twenty-two cases of anthrax, and among them five fatalities. Nine postal employees associated with the postal facilities that processed the letters in Trenton, New Jersey, and in Washington, D.C., contracted anthrax. Two employees from the Brentwood facility in Washington, D.C., died.

    The mailing...

  10. CHAPTER 6 Personal Narrative and an African American Perspective on Medical Ethics
    (pp. 105-126)
    Ezra E. H. Griffith

    Biomedical ethics is a subject that is attracting much attention both from laypersons and from health care professionals. Indeed, I believe that developments in other peripherally related areas are catalyzing this renewed general interest in ethics. The Abu Ghraib prison debacle in Iraq certainly has contributed to focusing attention on the ethics of prosecuting war. But it is the possible direct or indirect involvement of physicians in the activity of torture that has furthered greater interest in the ethics of health care professionals.¹ Other revelations have now suggested that the medical records of detainees at Guantanamo Bay, Cuba, have been...

  11. CHAPTER 7 Does an African American Perspective Alter Clinical Ethical Decision Making at the Bedside?
    (pp. 127-136)
    Reginald L. Peniston

    The question in the title of this chapter is just the type of query for which Friedrich Nietzsche would have had scathing commentary. He might have asked, “Does a German, or Christian, or European perspective alter clinical ethical decision making at the bedside?” He would likely say, “Yes, and in a frightening and self-conscious fashion.” Any perspective tied to group thinking would be an artifice of meaningful ethics. I believe that Nietzsche did engage in a bit of sleight-of-hand when judging motives by outcomes and incentives; however his skepticism and condescension are not traits alien to physicians. My first chief...

  12. CHAPTER 8 Race, Genetics, and Ethics
    (pp. 137-152)
    Kevin FitzGerald and Charmaine Royal

    On August 24, 2004, Boston Globe correspondent Carolyn Johnson reported on a controversial development in the study of a new combination of drugs (BiDil) for heart failure. The controversy arose because the African American Heart Failure Trial (A-HeFT), the clinical trial for BiDil, sponsored by NitroMed, was halted prematurely after it was found to significantly extend the lives of African Americans who have had heart failure. The results of the study, subsequently published in the New England Journal of Medicine (NEJM) were in contrast to earlier results that showed no significant benefit for white patients.¹ The reporter summed up the...

  13. AFTERWORD An African American’s Internal Perspective on Biomedical Ethics
    (pp. 153-158)
    Lawrence J. Prograis Jr.

    Elie Wiesel’s articulation of what outlines, casts an illumination, or draws a rough image not only of objects but also of nonobjects defines a focus on the context of human life. We all cast shadows within and outside of our lives. These shadows can be said to be an expression of what defines all humans. We all arise from some place, some past; we have a context and a history. We do not rationally reason from within empty vessels. Like shadows, our perspectives (our perceptions, insights, and beliefs) arise from within and outside us, from our exposure to families, friends,...

    (pp. 159-160)
  15. INDEX
    (pp. 161-169)