Medical Apartheid

1. A Legacy of Exploitation: Medicine's Dark Alliance with Slavery

From the first, antagonism reigned between African Americans and their physicians.

Entrenched exploitation. Medical science was deeply intertwined with the institution of slavery, providing both economic security for physicians and a readily available supply of enslaved "clinical material" for research and training. This relationship fostered a profound antagonism, as the medical interests of enslaved individuals were often diametrically opposed to those of their owners and the physicians who served them. Early American medicine, particularly in the South, was primitive and harsh, with dangerous remedies and crude surgical practices.

Profit-driven care. Slave owners, the true clients of physicians, prioritized the "soundness" of their human property for work and breeding over genuine health. This meant medical neglect was common, with professional care often sought only as a last resort, and sick slaves frequently accused of malingering. Physicians, in turn, profited immensely from treating slaves, often deriving most of their income from this practice, and sometimes even owning slaves themselves for experimental purposes.

Resistance and distrust. Enslaved African Americans recognized this hazardous medical agenda, often avoiding Western doctors and concealing illnesses. They distrusted harsh Western remedies, which often worsened conditions, and preferred their own traditional healers who offered more efficacious, holistic, and less violent treatments. This deep-seated wariness, or iatrophobia, was a rational response to a system that viewed their bodies as commodities rather than as deserving of compassionate care.

2. Scientific Racism: Fabricating Justifications for Dehumanization

The scientific racist’s emphasis was not upon fact-based theories, logical methodologies, experimental data, control groups, and verification by replication.

Pseudoscience of inferiority. Scientific racism provided medical and scientific justifications for slavery, promulgating unflattering beliefs about the bodies and minds of people of African descent. These "research findings" were based on mythology, racial descriptions from antiquity, and biblical interpretations, rather than objective scientific rigor. Southern scientists, claiming unique expertise due to their proximity to blacks, asserted that black people were inherently debased and immutably inferior.

Fabricated biological differences. Physicians invented imaginary "black" diseases like drapetomania (insanity causing slaves to flee) and dysthesia Aethiopica (desire to destroy white property), recommending corporal punishment as treatment. They claimed blacks had smaller brains, different breathing apparatuses, and skeletal structures, and were immune to pain and certain diseases like malaria, while being susceptible to others like syphilis. These claims were often contradictory, serving whatever political or economic need arose.

Census manipulation. The 1840 U.S. census, ostensibly an objective federal document, was manipulated to provide "statistical proof" that free blacks suffered worse health and mental illness than enslaved blacks. This deeply flawed data, riddled with fictitious numbers and misclassifications, was used to argue that slavery was essential for black well-being, despite being debunked by statisticians like Dr. Edward Jarvis and Dr. James McCune Smith. This manipulation cemented the idea that scientific fraud often accompanied racially abusive research.

3. The Body as Spectacle: From Circus Freaks to Dissection Tables

The history of medicine has been written by medical professionals and so reflects their points of view.

Public display of difference. Beyond direct experimentation, black bodies were exploited for popular public display, often blurring the lines between entertainment and medical "science." Figures like Ota Benga, an Mbuti man exhibited in the Bronx Zoo with apes, and Joice Heth, a black woman marketed as George Washington's 161-year-old nurse, were presented as "missing links" or medical curiosities. These displays reinforced racist stereotypes of black people as primitive, animalistic, or inherently "other."

Medicalized voyeurism. Scientists, museum curators, and the public flocked to gawk, sketch, and measure these individuals, often with prurient interest in their anatomy, particularly the exaggerated features ascribed to black women. This voyeurism was medicalized, with "scientific" explanations emphasizing supposed parallels to animals and children, and often inventing fictitious histories to enhance their "exotic" or "freakish" nature. The goal was to provide visual "evidence" for theories of racial inferiority.

Postmortem desecration. The exploitation extended beyond life. Black bodies, particularly those of the poor and enslaved, were disproportionately targeted for anatomical dissection and autopsy in medical schools. This practice, often illegal and socially abhorrent for whites, was justified by the belief that black bodies were expendable and provided "clinical material." Grave robbing, often carried out by black "resurrectionists" hired by medical schools, was rampant in black cemeteries, further cementing the image of black bodies as objects of scientific utility even in death.

4. Tuskegee's Betrayal: A Prolonged Study of Untreated Syphilis

We now know, where we could only surmise before, that we have contributed to their ailments and shortened their lives.

Deception as research. The U.S. Public Health Service's (PHS) Tuskegee Syphilis Study (1932-1972) promised free medical care to desperately poor black sharecroppers in Macon County, Alabama, but instead deliberately withheld treatment for syphilis to observe the disease's natural progression. The men were told they were being treated for "bad blood," a vague term encompassing various ailments, while PHS doctors actively prevented them from receiving effective therapy, even after penicillin became available in 1943.

Racialized rationale. The study was predicated on the racist belief that syphilis manifested differently in blacks, primarily affecting their cardiovascular system while sparing their "primitive" brains. This allowed researchers to justify their inaction, claiming the men's brains were too underdeveloped to suffer neurological damage. The PHS also used the men's blood to develop new, more reliable, and profitable syphilis tests, effectively turning them into human incubators for scientific gain.

Enduring trauma. The study resulted in the early deaths and severe complications for hundreds of subjects, infected their wives, and led to congenital syphilis in their children. Its exposure in 1972 ignited national outrage, leading to an apology from President Clinton in 1997 and the establishment of the National Center for Bioethics at Tuskegee University. However, the study's legacy continues to fuel deep-seated iatrophobia among African Americans, often overshadowing other historical abuses and hindering participation in beneficial medical research.

5. Eugenics and Control: Suppressing Black Reproduction

We don’t allow dogs to breed. We spay them. We neuter them. We try to keep them from having unwanted puppies, and yet these women are literally having litters of children….

"Well-born" ideology. The early 20th century saw the rise of eugenics, a movement advocating selective procreation to "improve" the human race. This philosophy, embraced by scientists and popular figures like Margaret Sanger, often conflated biological fitness with class and race, labeling the poor, uneducated, and particularly black individuals as "dysgenic" or "unfit." Black women were demonized as hypersexual and biologically constrained to bear "defective" children.

Forced sterilization. This ideology led to widespread compulsory sterilization, with African Americans staggeringly overrepresented among the victims. Procedures like the "Mississippi appendectomy," where black women were unknowingly sterilized during other surgeries, became common. Welfare programs often coerced women into sterilization, linking aid to reproductive control. These practices, often performed without informed consent or under deceptive pretenses, were seen by many as a form of "black genocide," echoing UN definitions of the crime.

Contraceptive experimentation. Black women were also disproportionately targeted for testing new reproductive technologies like Norplant and Depo-Provera. These methods, often developed and tested on poor women of color abroad, were then widely distributed in urban clinics serving predominantly black and Hispanic populations. The selective marketing and coercive implementation, sometimes involving cash incentives or judicial orders, raised serious ethical concerns about exploiting vulnerable women for population control rather than genuine reproductive health.

6. Nuclear Shadows: Radiation Experiments on Unwitting Subjects

If anybody knows how to do a good job of body snatching, they will really be serving their country.

Secret atomic tests. Between 1944 and 1994, the U.S. Atomic Energy Commission (AEC) and Department of Energy (DOE) supported over two thousand radiation experiments on human subjects, many of whom were African American. These clandestine projects, often conducted without consent, involved injecting individuals with plutonium, exposing them to X-rays, or feeding them radioactive elements. Subjects like Ebb Cade and Elmer Allen, often misdiagnosed or deemed "moribund," were used to calibrate the physiological devastation of radioactive substances.

Disproportionate targeting. While not exclusively black, African Americans were consistently overrepresented in these dangerous, nontherapeutic experiments, sometimes constituting 25% or more of subjects despite being only 10% of the population. The rationale often involved claims of military necessity or the belief that blacks responded differently to radiation, echoing earlier scientific racism. When subjects died, their bodies were often autopsied and their remains collected for further study, sometimes without family knowledge.

Enduring harm and denial. These experiments caused severe health problems, including cancers, bone damage, and psychological trauma, yet researchers often denied wrongdoing or justified their actions by citing military expediency or the supposed "consent" of vulnerable patients. Despite the Nuremberg Code's clear prohibitions against such research, U.S. scientists largely ignored it. The legacy of these experiments, including the Cincinnati TBI tests and the Savannah River Site exposures, continues to fuel distrust and calls for justice from victims and their families.

7. Caged Guinea Pigs: Prisoners as Disposable Research Material

Criminals in our penitentiaries are fine experimental material—and much cheaper than chimpanzees.

Inmates as subjects. From the 17th century, prisoners were considered ideal subjects for medical experimentation due to their vulnerability, stigmatization, and expendability. This practice intensified in the 20th century, particularly for Phase I drug trials, which test drug safety on healthy volunteers and carry the highest risks. African Americans, consistently overrepresented in U.S. jails and prisons, bore the brunt of these dangerous experiments.

Holmesburg's horrors. At Philadelphia's Holmesburg Prison, Dr. Albert M. Kligman conducted decades of abusive experiments for pharmaceutical and cosmetic companies, often on thousands of predominantly black inmates. These included testing toxic chemicals, inoculating men with infectious diseases like syphilis and herpes, and even CIA-funded mind-control experiments with psychotropic drugs. Inmates suffered extensive scarring, baldness, organ damage, and severe psychological changes, often for meager pay.

Coercion and invisibility. Despite claims of "voluntary" participation, inmates were coerced by the harsh realities of prison life, seeking money for bail or commissary, or respite from violence. Informed consent was often absent, misleading, or incomprehensible to illiterate subjects. While white inmates like Nathan Leopold gained positive publicity and parole for their participation, black prisoners remained largely invisible in media accounts, their suffering unacknowledged, reinforcing the perception of their disposability.

8. Children's Crusade: Targeting Vulnerable Black Youth for Research

What’s done to children, they will do to society.

Exploiting vulnerability. American medicine has subjected black children to some of its worst research abuses, often under the guise of studying violence or mental health. Studies like the Columbia University fenfluramine experiments (1990s) and the Johns Hopkins XYY studies (1970s) specifically targeted healthy black and Hispanic boys, often identified through juvenile justice systems, to find genetic links to aggression. These nontherapeutic experiments involved risky drug challenges, invasive procedures, and stigmatizing psychological assessments.

Ethical breaches. These studies were rife with ethical violations: undue inducement (toy certificates, cash), breaches of confidentiality, and medically risky procedures on healthy children that clearly exceeded "minimal risk" guidelines. The fact that Institutional Review Boards (IRBs) approved these protocols highlights their failure to protect vulnerable populations. The focus on black boys for "violence" research, despite white boys being the perpetrators of prominent school shootings, revealed a deep-seated racial bias.

Mind-altering interventions. Beyond genetic screening, black children were subjected to crude, experimental brain surgeries like lobotomies in the mid-20th century. Neurosurgeons like Dr. Orlando J. Andy performed multiple brain ablations on "aggressive" or "hyperactive" black children as young as six, often without parental consent or clear therapeutic justification. These procedures, which destroyed brain tissue and personality, were seen as a "murder of the mind," reflecting a medicalized response to perceived "unacceptable" black behavior.

9. Genetic Paradox: DNA's Promise and Peril for Black Americans

The same technology that will exculpate people today is also being used to put people who have merely been stopped by the police into genetic databases.

DNA's dual nature. Genetic technology, while instrumental in freeing wrongfully convicted black men through projects like the Innocence Project, also presents new perils. DNA databases, initially for felons, are expanding to include individuals merely suspected of crimes, disproportionately affecting black and Hispanic men. These "DNA sweeps" create a collective presumption of guilt, storing genetic data of innocent individuals for future use, raising serious privacy and civil rights concerns.

Sickle-cell stigmatization. African Americans have a troubled history with genetic screening, particularly for sickle-cell disease. In the late 1960s and 70s, widespread, often compulsory, screening programs confused healthy sickle-cell carriers with those suffering from the disease. This led to discrimination in employment and military service, and inaccurate counseling that equated carrier status with illness, fueling accusations of genocide and reinforcing the perception of black genetic inferiority.

Molecular bias. The commercialization of genetic medicine, exemplified by drugs like BiDil for heart failure in African Americans, raises concerns about "molecular bias." While potentially beneficial, BiDil's marketing as a "blacks-only" drug, based on questionable and outdated data, risks racializing disease and diverting attention from crucial environmental and socioeconomic factors. This approach could lead to stereotyped, less appropriate care and reinforce the notion of dramatic, often negative, physiological differences in blacks.

10. Infectious Inequities: Racialized Disease and Punitive Responses

Unhealthy places and decadent times infect us by their contagion.

Disease as crime. Historically, and continuing today, infectious diseases among African Americans have been racialized and met with punitive, rather than supportive, public health responses. Tuberculosis, for instance, disproportionately affects blacks due to socioeconomic factors, yet patients like Milton Ellison have been involuntarily confined and shackled for "noncompliance" with treatment. This contrasts sharply with the less restrictive measures applied to white populations, even during epidemics.

AIDS: A shifting narrative. Initially identified with gay white men, the AIDS pandemic's narrative shifted as infection rates rose among black populations. This led to stigmatization, moral judgment, and a perception of indifference from the medical establishment. While early public health efforts for gay men prioritized human rights and confidentiality, similar protections were often abandoned for black communities, with mandatory testing and contact tracing laws disproportionately applied to African Americans.

Research failures and blame. Misguided research has also hampered effective HIV treatment for blacks. An early, flawed VA study suggested AZT was less effective for black patients, leading to its initial withholding and contributing to higher black AIDS mortality. This was often blamed on black "distrust" rather than the medical establishment's errors. The abandonment of the AIDSVAX vaccine, despite its efficacy in black and Asian populations, further highlights how racial biases can influence research decisions and deny potentially life-saving therapies to minority groups.

11. Technological Exploitation: Black Bodies Perfecting Medical Devices

It has become appallingly obvious that our technology has exceeded our humanity.

Disparate access and risk. New surgical technologies, from artificial hearts to blood substitutes, have often been developed through research on black subjects, yet access to these perfected technologies remains disproportionately low for African Americans. The cases of James Quinn and Robert Tools, both black, who received experimental AbioCor artificial hearts, highlight this pattern. While their participation advanced medical science, the high costs and limited access to such advanced care mean that the very population that helps perfect these technologies often cannot afford them.

Erosion of consent in emergencies. The AbioCor company's request to implant artificial hearts in unconscious emergency room patients without consent, and the ongoing use of artificial blood substitutes like PolyHeme in similar scenarios, represent a dangerous erosion of informed consent. Given that African Americans are more likely to use emergency rooms and less likely to have health proxies, these practices disproportionately affect them, turning desperate situations into opportunities for nonconsensual experimentation.

Historical parallels. This pattern of using black bodies for technological advancement without equitable benefit is deeply rooted. From medieval engravings depicting the transplantation of a black leg onto a white body to Dr. William Osler Abbott's 1930s experiments on poor black men for intestinal intubation, the belief in black bodies as suitable for risky, low-paid, or nonconsensual testing has persisted. Even the foundational cell line (HeLa) for modern cell culture came from Henrietta Lacks, a black woman, without her or her family's consent, yet African Americans remain the only group to largely oppose stem-cell research, partly due to this history.

12. Bioterrorism's Racial Target: Weaponizing Disease Against Blacks

The development of molecular medicine based on our new understanding of genomics will allow a vast range of new weaponry to be developed. Among that range could be biological weapons specifically targeted at particular ethnic groups.

Domestic biological attacks. The U.S. government, through programs like the CIA's MK-NAOMI, conducted secret bioterrorism experiments on its own citizens, often targeting black communities. In the 1950s and 60s, disease-carrying mosquitoes were released in predominantly black areas like Carver Village in Florida and Georgia, leading to spikes in mysterious illnesses and deaths. These experiments, ostensibly to test biological weapons against foreign enemies, were conducted without residents' knowledge or consent, and their records were later destroyed.

Racialized counterterrorism. The 2001 anthrax attacks exposed a racial disparity in government response: while Congress was swiftly evacuated and decontaminated, predominantly black postal workers at the Brentwood facility faced delays in treatment and were offered an experimental vaccine with conflicting advice. This fueled suspicions of a two-tiered system, where the safety of white officials was prioritized over that of black workers, reinforcing historical patterns of neglect and exploitation.

Global ethnic weapons. The concept of "pigmentation weapons" or genetically targeted bioweapons, once dismissed as science fiction, has been actively pursued by regimes like apartheid South Africa's Chemical and Biological Warfare Programme (CBWP). With critical assistance from American scientists like Larry Ford, the CBWP developed agents to sabotage black fertility and create viruses that would kill only black people. This chilling history underscores the potential for genetic and biological research to be perverted into tools of racial genocide, exploiting existing genetic variations or lifestyle patterns to target specific ethnic groups.

Last updated: February 11, 2026