C. The Space: “The mere imparting of information is not education.” - Carter G. Woodson
The Tuskegee Syphilis Study reigns as the most infamous reminder of government-initiated unethical conduct meted upon human subjects. However, the prevailing issues of race, gender, and healthcare that have been historically under-discussed in a medical education setting are currently being mandated under the auspice of cultural competence. Medical education provides a venue for an optimal understanding that “[c]ultural competence can be viewed in relation to general competence in professional medical practice as an integrated aspect of overall competence.” Pursuant to the Office of Minority Health:
In addition to defining cultural competence as essential to professional competence in general, cultural competence can be defined in terms of the power dynamics in medicine as well as society at large. The need for cultural competence arises from inherent power differential in the physician-patient relationship [ ]. Ethnicity and social status are inextricably linked [ ], and social issues such as stereotyping, institutionalized racism, and dominant-group privilege are as real in the examining room as they are in society at large. Therefore, the goal of cultural competence training in health care should be to guide physicians in bringing these power imbalances into check. This process, consisting of ongoing self-reflection and self-critique, requires *166 humility.
“Today, as before, the Tuskegee Study has much to teach us about racism in the United States and the social warrant of medicine in people's lives.” The need to contextualize the purported “training” object of the Rosenwald/PHS alliance is wholly under-analyzed and would benefit from applying a notion of Critical Race Feminist Bioethics (“CRF Bioethics”). The biomedical significance of the Tuskegee Syphilis Study becomes more apparent in light of the fact that “[t]he program's medical services were designed to meet the Fund's long-range goals. The demonstrations would provide training for “private physicians, white and colored, in the elements of venereal diseases treatments” and the “more extensive distribution of anti-syphilitic drugs and the promotion of wider use of State diagnostic laboratory facilities.” Todd L. Savitt correctly points outs that “[t]hroughout history medicine has required bodies for teaching purposes.” The more introspective issue, however, is “whose body has the U.S. healthcare system historically exploited or marginalized due to the intersection of race, gender and research?” Medical schools should address this question as they train future doctors about the human toll in pursuit of medical research and training.
