Race in Contemporary Medicine

Posted in Anthologies, Books, Health/Medicine/Genetics, Media Archive, Politics/Public Policy, Social Science on 2013-03-23 20:03Z by Steven

Race in Contemporary Medicine

208 pages
Hardback ISBN: 978-0-415-41365-7

Edited by:

Sander L. Gilman

With the first patent being granted to “BiDil,” a combined medication that is deemed to be most effective for a specific “race,” African-Americans for a specific form of heart failure, the on-going debate about the effect of the older category of race has been renewed. What role should “race” play in the discussion of genetic alleles and populations today? The new genetics has seemed to make “race” both a category that is seen useful if not necessary, as The New York Times noted recently: “Race-based prescribing makes sense only as a temporary measure.” (Editorial, “Toward the First Racial Medicine,” November 13, 2004) Should one think about “race” as a transitional category that is of some use while we continue to explore the actual genetic makeup and relationships in populations? Or is such a transitional solution poisoning the actual research and practice.

Does “race” present both epidemiological and a historical problem for the society in which it is raised as well as for medical research and practice? Who defines “race”? The self-defined group, the government, the research funder, the researcher? What does one do with what are deemed “race” specific diseases such as “Jewish genetic diseases” that are so defined because they are often concentrated in a group but are also found beyond the group? Are we comfortable designating “Jews” or “African-Americans” as “races” given their genetic diversity? The book answers these questions from a bio-medical and social perspective.

This book was previously published as a special issue of Patterns of Prejudice.


  • Introduction: On Race and Medicine in Historical Perspective. Sander L. Gilman (Emory)
  • Reflections on Race and the Biologization of Difference. Katya Gibel Azoulay (Grinnell)
  • Against Racial Medicine. Joseph L. Graves, Jr. (North Carolina A&T State University) & Michael R. Rose (University of California, Irvine)
  • Blood and Stories: How Genomics is Rewriting Race, Medicine and Human History. Patricia Wald (Duke)
  • “Why are Genetic and Medical Researchers Accepting a Category Created by Slaveholders?” A Social History of the Reification of “Race” James Downs (Princeton)
  • Eugenics and the Racial Genome: Politics at the Molecular Level. Sharon Snyder and David Mitchell (University of Illinois – Chicago)
  • The Risky Gene: Epidemiology and the Evolution of Race. Philip Alcabes (Hunter College School of Health Sciences)
  • Folk Taxonomy, Prejudice and the Human Genome: Using Heritable Disease as a Jewish Ethnic Marker. Judith S. Neulander (Case Western Reserve University)
  • The price of science without moral constraints: German and American medicine before DNA and Today. Robert E. Pollack (Columbia)
  • Deadly Medicine Today: The Impossible Denials of Racial Medicine. C. Richard King (Washington State University)
  • Biobanks of a “Racial Kind”: Mining for Difference in the New Genetics. Sandra Soo-Jin Lee (Stanford)
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Against racial medicine

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2012-05-13 00:14Z by Steven

Against racial medicine

Patterns of Prejudice
Volume 40, Numbers 4/5 (2006), Special Issue: Race and Contemporary Medicine
pages 481-493
DOI: 10.1080/00313220601020189

Joseph L. Graves Jr., Dean of University Studies; Professor of Biological Sciences
North Carolina Agricultural and Technical State University, Greensboro

Michael R. Rose, Director of the University of California Network for Experimental Research on Evolution; Professor of Biological Sciences
University of California, Irvine

Some scholars claim that recent studies of human genetic variation validate the existence of human biological races and falsify the idea that human races are socially constructed misconceptions. They assert that analyses of DNA polymorphisms unambiguously partition individuals into groups that are very similar to lay conceptions of race. Furthermore, they propose that this partitioning allows us to identify specific loci that can explain contemporary health disparities between the supposed human races. From this, it appears that racial medicine has risen again. In this essay Graves and Rose construct a case against racial medicine. Biological races in other species are strongly differentiated genetically. Because human populations do not have such strong genetic differentiation, they are not biological races. Nonetheless, the lack of population genetic knowledge among biomedical researchers has led to spuriously racialized human studies. But human populations are not genetically disjoint. Social dominance may lead to medical differences between socially constructed races. In order to resolve these issues, medicine should take both social environment and population genetics into account, instead of dubious ‘races’ that inappropriately conflate the two.

Racial medicine has risen again

Charles B. Davenport, one of the most respected scientists of the first decades of the twentieth century, argued that laziness was a hereditary trait. Davenport claimed in particular that laziness was a heredity character of Southern Whites. Later epidemiological studies determined that ‘white trash’ laziness was actually the result of heavy infections caused by the nematode necator americanus.  But, for Davenport and many other biologists of his time, the phenotypic differences displayed by particular populations were proof positive of the existence of human races. They believed that these races differed in readily observable features, such as skin colour and body proportions, and also in those they could not directly observe, such as intellect, morality, character, disease predisposition and resistance. In 1921, for example, Ernest Zimmerman published a report on differences in the manifestation of syphilis in Blacks and Whites. Such thinking helped to sanction the now infamous Tuskegee syphilis experiment.  Modern biologists recoil with horror when asked to revisit this sad episode in the history of science.

The rationale for the Tuskegee experiment was the underlying assumption that the Negro was genetically inferior to Whites. Thus, the perceived differences in incidence rates and progression of disease were thought to reside in characteristics intrinsic to the race, as opposed to the social conditions under which visibly darker-skinned persons of African descent lived in the United States. (It is significant that many ‘white Americans’ have African ancestors but ‘pass as white’, an anomaly to which we will return below.) Therefore, the Tuskegee experiment suffered not only from its moral shortcomings, but also from poor experimental design. The results of the experiment could not have distinguished between any genetically based difference in disease progression, since many environmental and social differences between African Americans and the Swedish cohorts with which they were to be compared were not properly controlled. With hindsight, the scientific problems of this experiment are obvious. What is not recognized is that modern discussions of race and medicine have not moved very far beyond the misconceptions that gave birth to the Tuskegee research programme...

…The identification of human races is not based on cogent biology

While humans have always recognized the existence of physical differences between groups, they haven’t always described those differences in racial terms. Racial theories of human differentiation were not a consistent theme of the ancient world, and really did not begin to flourish until after the European voyages of discovery in the fifteenth century. European naturalists of the eighteenth century were divided about the characterization of human differences. Almost all agreed that there was only one human species, yet they disagreed about whether there was a legitimate way to rank the various groups of humans hierarchically. For example, Carl Linneaus’s Systema Naturae (1735) classified human races partly on the basis of subjectively determined behavioural traits. It is not clear, however, what Linnaeus meant by the use of the term ‘race’. It seems that his classification scheme was describing subspecies of humans based on morphological features. According to it, European traits were clearly superior to others, and Africans were assigned the lowest rung in the hierarchy.

Such racist ideas were transplanted to America during colonial times, along with other biological absurdities. During American chattel slavery, the socially defined race of the offspring of slavemasters and slave women was ‘Negro’. Virginia law classified Eston Hemmings, who was 87.5 per cent European according to genetic ancestry, as ‘Negro’. Geneticists now suspect that Thomas Jefferson was his father, based on family genealogies and a genetic marker specific to the Jefferson family found in Eston’s descendants.

The one-drop rule (also called ‘hypo-descent’) in the United States differs from definitions of ‘blackness’ in Canada, Mexico, Britain and Brazil. Individuals, therefore, could move from one country to another and be classified differently according to the social custom. Indeed, in the United States, individuals have been born as a member of one race and died as a member of another. European ethnic groups, such as the Irish and Italians, did not become ‘white’ until the twentieth century. Such ‘races’ are clearly based on social conventions, as opposed to biological measures of genetic ancestry. Socially produced racial ideology from the very beginning influenced the collection and interpretation of data relating to human biological variation…

Read the entire article here.

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