Medical ethicist, author Harriet Washington to address racial disparities at R!L

Research!Louisville, a weeklong research symposium with a focus on health-sciences research at the Louisville Medical Center, kicked off its 28th year on Sept. 28. Sponsored by the University of Louisville’s Office of the Executive Vice President for Research & Innovation, UofL Health Sciences Center Office of Diversity & Inclusion and Norton Healthcare, the event promotes excellence and health equity in health-sciences research.

“Research!Louisville is a great opportunity to explore the important role UofL research plays in our day-to-day lives,” said Kevin Gardner, executive vice president for research and innovation. “That work positively impacts our world, from creating meaningful educational experiences and career pathways for students to developing innovative new technologies and companies.”

The event includes a presentation by author and medical ethicist Harriet Washington on Thursday, Oct. 5 from 12 noon to 1 p.m. at Kornhauser Auditorium on the Health Sciences Center campus presented by UofL's Office of Institutional Equity and the HSC Office of Diversity and Inclusion. Washington’s latest work is the award-winning "Medical Apartheid: The Dark History of Experimentation from Colonial Times to the Present." 

UofL News caught up with V. Faye Jones, a pediatrician and associate vice president for health affairs/diversity initiatives at the UofL Health Sciences Center, and Kiana Fields, coordinator, UofL Office of Diversity and Inclusion, to talk about the importance of Washington’s research.

UofL News: What kind of perspective does Harriet Washington bring to the discussion about racial health disparities?
 

Jones: She brings great insight into medical ethics and racism, how they intersect with each other. Our work focuses on the harms inflicted on historically minoritized populations by bringing attention to that history now. For many people, it’s the first time they are hearing that history. She tells us about things we may have not delved as deep in as we should have and holds all of us accountable for it.

Fields: Washington’s been doing this work for decades. She saw a need and a gap within the literature to address the longitudinal atrocities that have taken place. In addition to medical apartheid, she has talked about the erosion of informed consent and how it’s systemic racism. 
She incorporates different identities and different systems of oppression and explores the health impacts and the ethical dilemmas that exist as well.

UofL News: What are some of the specific ways Washington has shined a light on little-known history of medical inequity?
 

Fields: She started going deeper into her research for medical apartheid when she was working in a hospital and saw medical files of kidney failure patients that were different for Blacks and whites. While the files were comparatively similar, in the Black patient’s file, it said imminent demise was expected. That’s when she knew some of her suspicions were true and there was more that needed to be uncovered. One other medical story is about J. Marion Sims, who was known as the father of gynecology. This physician and researcher conducted painful experiments without anesthesia using enslaved women, which ultimately led to important gynecological advances. There is a lack of acknowledgement of the harms that were done in that way.

Jones: First, we need to acknowledge this, showing that these disparities exist and then understanding why they exist, and then developing and implementing strategies to change it. Just like Kiana said about the kidney patients, there are so many things where if you’re black then you get this type of treatment, and if you're not black you get this. So how is that right? It's not. You focus on these things so that we can correct and hopefully improve patient care and address health disparities to get us more to that standard of health equity.

UofL News: According to CDC data, Black women are two to three times more likely to die from pregnancy-related complications than white women, with most of the maternal deaths being preventable. Multiple factors contribute to these disparities, such as variation in quality health care, underlying chronic conditions, structural racism and implicit bias. How does Washington’s examination of the history of medical inequities help inform the present?

Fields: With Black maternal and infant mortality disparities, we often think that if you were in a higher socioeconomic status that you would be exempt. But a great example of that is Serena Williams. She had preeclampsia for her first pregnancy and the physicians didn't take her concerns seriously, and so she found herself in a very precarious situation where both her life and her child's life were in danger.

Jones: When you look at what happened with Serena Williams and the pulmonary embolism, I think it's important to note that if that can happen to a person of that stature, that wealth and who is that well known, then what is happening to people who don’t have voices? Are they invisible? With Black maternal mortality, it’s amazing how it is present in every community, including in Jefferson County. There is such a disparity there and we must be able to say yes, it exists, and to look into the root causes of it and do something about it, not just talk about it.

UofL News: For those who come to hear Harriet Washington’s presentation on October 5, what questions and reflections do you hope it prompts for people?
 

Jones: One thing I would hope it would prompt is to ask what does it look like in the health care system and where we are right now where we live and what kind of things can we do? Each one of us can make a difference here. We are not waiting for somebody else to take that banner and run with it, but what can we do as individuals to make that difference? Because each of us have the power to make a change.

Fields: I believe Harriet Washington, in her work, is elevating that we all have a shared responsibility to start to disrupt these systems of oppression and acknowledge and reimagine our health care system to benefit the most vulnerable populations in our society. How do we continue to strive to uncover the hidden voices? How do we continue to not only take action, but also start reconciling the atrocities and healing some of the harm that has been done so that we can create interventions that are long lasting?

RSVP for the event.

Attend via Zoom