'The problem of the twentieth-century is the problem of the color-line.' Originally published in 1903, The Souls of Black Folk is a classic study of race, culture, and education at the turn of the twentieth century. With its singular combination of essays, memoir, and fiction, this book vaulted W. E. B. Du Bois to the forefront of American political commentary and civil rights activism. The Souls of Black Folk is an impassioned, at times searing account of the situation of African (...) Americans in the United States. Du Bois makes a forceful case for the access of African Americans to higher education, memorably extols the achievements of black culture (above all the spirituals or 'sorrow songs'), and advances the provocative and influential argument that due to the inequalities and pressures of the 'race problem', African American identity is characterized by 'double consciousness'. This edition includes a valuable appendix of other writing by Du Bois, which sheds light on his attitudes and intentions. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more. (shrink)

The paper summarizes recently published data and recommendations about healthcare disparities experienced by African Americans who have Medicare or other healthcare coverage. Against this background the paper addresses the ethics of such disparities and how disadvantages of vulnerable populations like African Americans are typically maintained indecision making about how to respond to such disparities. Considering how to respond to disparities reveals much that vulnerable populations would bring to the policy-making table, if they can also be heard when they get there. (...) The paper argues that vulnerable populations like African Americans need fair representation in bodies deciding what to do about such disparities and that fairness requires proportional representation at all levels of decisions that affect healthcare – a radical change. In this decision setting, howto provide adequate protection of minorities needs much further attention. The most attractive decision-making model is deliberative democracy. The paper shows that in deliberation, fair representation requires not only having a voice in decisions, but a fair hearing of those voices. Achieving a fair hearing requires changes in norms of communication and training of all to give importance to greetings and other measures of civility and trust building, and to be open to diverse forms of expression. Decisions about how to respond to healthcare disparities would include what programs to initiate for whom, howto evaluate the programs, and what to do in response to such evaluations. Conclusions are that achieving such goals will take a sea change in how healthcare institutions and providers do their business, and that social activism at every level will be needed to effect these changes. The discussion highlights many ethical issues that need much greater attention. (shrink)

This paper argues that stoicism as a central element of whiteness shapes, controls, and ultimately limits the experience and expression of emotion in public space. I explore how this may play out in particular medical settings like hospitals in Aotearoa New Zealand. I argue that working in conjunction with other values of whiteness identified by Myser —hyper-individualism, a contractual view of relationships, and an emphasis on personal control and autonomy—this makes hospitals emotionally unsafe spaces for Māori and other groups who (...) place high importance in the collective sharing of emotion. Using death and bereavement as an example, I suggest that challenging and addressing stoicism in the structure and performance of whiteness in hospital settings may provide an important point of entry for anti-racism measures and health equity. (shrink)

There is good evidence that many people harbour attitudes that conflict with those they endorse. In the language of social psychology, they seem to have implicit attitudes that conflict with their explicit beliefs. There has been a great deal of attention paid to the question whether agents like this are responsible for actions caused by their implicit attitudes, but much less to the question whether they can rightly be described as racist in virtue of harbouring them. In this paper, I (...) attempt to answer this question using three different standards, providing by the three dominant kinds of accounts of racism. I argue that on none of these accounts should agents like this be described as racists. However, it would be misleading to say, without qualification, that they are not racists. On none of these accounts are agents like this entirely off the hook. (shrink)

A complimentary assessment of Blum's award-winning book about racism and its affects. Well written as it is, it needs to be supplemented with a definition of racial injustice, and also to analyze racism not only on the level of individual morality but from a human rights perspective that discredits political and economic motives for racism (e.g., by drawing on Hannah Arendt's Origins of Totalitarianism).

This article argues that criminal justice and health institutions under settler colonialism collude to create and sustain “truths” about First Nations lives that often render them as “bare life,” to use the term of Giorgio Agamben. First Nations peoples’ existence is stripped to its sheer biological fact of life and their humanity denied rights and dignity. First Nations people remain in a “state of exception” to the legal order and its standards of care. Zones of exception place First Nations people (...) in a separate and diminished legal order. Medical and health agencies have been instrumental in shaping colonial “biopower,” both in and beyond carceral settings to ensure that First Nations lives are managed in accordance with the colonial settler state project. This project is able both to threaten First Nations rights to live and to maintain settler self-perceptions of decency and care. We illustrate this discussion with reference to the tragic and unnecessary deaths in custody of twenty-two-year-old Yamatji woman Ms Dhu in 2014 in South Hedland Police Station, Western Australia, and twenty-six-year-old Dunghutti man David Dungay Jnr in Long Bay jail in Sydney, NSW, in 2015. Health professionals and police demonstrated callous disregard to Ms Dhu and Mr Dungay—treating them as “bare life.”. (shrink)

In this essay, I argue that exploring institutional racism also needs to examine interactions and communications between patients and providers. Exchange between bioethicists, social scientists, and life scientists should emphasize the biological effects—made evident through health disparities—of racism. I discuss this through examples of patient–provider communication in fertility clinics in South Africa and the ongoing COVID-19 pandemic to emphasize the issue of mistrust between patients and medical institutions. Health disparities and medical mistrust are interrelated problems of racism in healthcare provision.

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

An analysis of 'racism' in terms of disrespect. This article argues against the views that racism should be understood in reductive ways as, variously, an attitude of ill-will (Jorge Garcia), a cognitive object such as ideology (Tommie Shelby), a behavior (Michael Philips), or some disjunctive hybrid (Lawrence Blum). In fact, it argues that racism should be conceptually released from having any one location. The disrespect analysis favored here can accommodate a variety of important desiderata for a theory of racism.

I argue that there has been inadequate attention to and questioning of the dominance and normativity of whiteness in the cultural construction of bioethics in the United States. Therefore we risk reproducing white privilege and white supremacy in its theory, method, and practices. To make my argument, I define whiteness and trace its broader social and legal history in the United States. I then begin to mark whiteness in U.S. bioethics, recasting Renee Fox's sociological marking of its American-ness as an (...) important initial marking of its whiteness/WASP ethos. Furthermore, I consider the attempts of social scientists to highlight sociocultural diversity as a corrective in U.S. bioethics. I argue that because they fail to problematize white dominance and normativity and the white-other dualism when they describe the standpoints of African-American, Asian-American, and Native-American others, their work merely inoculates difference and creates or maintains minoritized spaces. Accordingly, the dominant white center of mainstream U.S. bioethics must be problematized and displaced for diversity research to make a difference. In conclusion, I give several examples of how we might advance the recommended endeavor of exploring our own ethnicity, class, and other social positioning and norms operating in U.S. bioethics, briefly highlighting "white talk" as one challenge. (shrink)

We seek to bring Black bodies and lives into full view within the enterprise of Indigenous health research to interrogate the unquestioned good that is taken to characterize contemporary Indigenous health research. We articulate a Black bioethics that is not premised upon a false logic of beneficence, rather we think through a Black bioethics premised upon an unconditional love for the Black body. We achieve this by examining the accounts of two Black mothers, fictional and factual rendering visible the racial (...) violence Black bodies have been subjected to. We call for a Black bioethics that reimagines the Black body as beautiful and belonging—to both someone and somewhere. (shrink)

In this essay, I argue that bioethicists have a thus-far unfulfilled role to play in helping life scientists, including medical doctors and researchers, think about race. I begin with descriptions of how life scientists tend to think about race and descriptions of typical approaches to bioethics. I then describe three different approaches to race: biological race, race as social construction, and race as cultural driver of history. Taking into account the historical and contemporary interplay of these three approaches, I suggest (...) an alternative framework for thinking about race focused on how the idea of race functions socially. Finally, using assisted reproductive technologies as an example, I discuss how bioethicists and scientists might work together using this framework to improve not only their own but broader perspectives on race. (shrink)

This paper discusses the ethical implications of racism and some of the various costs associated with racism occurring at the institutional level. We argue that, in many ways, the laws, social structures, and institutions in Western society have operated to perpetuate the continuation of historical legacies of racial inequities with or without the intention of individuals and groups in society. By merely maintaining existing structures, laws, and social norms, society can impose social, economic, and health costs on racial minorities that (...) impinge on their well-being and human dignity. Based on a review of multidisciplinary research on racism, particularly focusing on healthcare, we demonstrate how institutional racism leads to social and economic inequalities in society. By positing institutional racism as the inherent cause of avoidable disparities in healthcare, this paper draws attention to the ethical significance of racism, which remains a relatively neglected issue in bioethics research. (shrink)

The U.S. healthcare system has a long history of displaying racist contempt toward Black people. From medical schools’ use of enslaved bodies as cadavers to the widespread hospital practice of reporting suspected drug users who seek medical help to the police, the institutional practices and policies that have shaped U.S. healthcare systems as we know them cannot be minimized as coincidence. Rather, the very foundations of medical discovery, diagnosis, and treatment are built on racist contempt for Black people and have (...) become self-perpetuating. Yet, I argue that bioethics and bioethicists have a role in combatting racism. However, in order to do so, bioethicists have to understand the workings of contemptuous racism and how that particular form of racism manifests in U.S. healthcare institutions. Insofar as justice is part of the core mission of bioethics, then antiracism must also be part of the mission of bioethics. (shrink)

The following pages sketch the outlines of “a Canaanite reading” of the health system. Beginning with the Black person—African, Afro-diasporic, Aboriginal, and Torres Strait Islander—who is seen by a health professional, the functions and effects of the racializing gaze are examined. I wrestle with Al Saji’s understanding of “colonial disregard,” Whittaker’s insights into the extractive disposition of settler institutions vis-à-vis Indigenous peoples, and Saidiya Hartman and Fred Moten’s struggle with the spectacular. This leads me to conclude that the situation of (...) the Black within the health system is a tragic one. The prescription for the path out of this tragedy that I settle on, responding to Okiji’s opening call, is found in Vernon Ah Kee’s “Unwritten” series. (shrink)

In colonial states and settings, constitutional arrangements are often forged within contexts that serve to maintain structural racism against Indigenous people. In 2013 the New Zealand government initiated national conversations about the constitutional arrangements in Aotearoa. Māori leadership preceded this, initiating a comprehensive engagement process among Māori in 2010, which resulted in a report by Matike Mai Aotearoa which articulated a collective Māori vision of a written constitution congruent with te Tiriti o Waitangi by 2040.This conceptual article explores the Matike (...) Mai Aotearoa report on constitutional transformation as a novel means to address structural racism within the health system as a key domain within the constitutional sphere. Matike Mai suggests alternative conceptual structural formations through its focus on the kāwanatanga, the relational and the tino rangatiratanga sphere. This framework is informed by a range of Indigenous ethical values such as tikanga, belonging, and balance that can usefully inform the redesign of the health sector.We assert that constitutional transformation and decolonization are potentially powerful ethical sources of disruption to whiteness and structural racism. We argue that, to eliminate entrenched health disparities, change processes need to be informed by the Indigenous inspirations expressed in the Matike Mai report. (shrink)

Racism is a key driver of the social, political, and economic injustices that cause and maintain health inequities. Over centuries and across continents, racism has become deeply ingrained within societies. Therefore, we believe that it is our professional and ethical obligation as scientists, and public health scholars specifically, to address racism head on in order to ameliorate racialized health disparities. We argue that greater focus is needed on addressing racism rather than race and how race is described or defined. We (...) offer input from public health scholarship to help bioethicists and other scientists contribute to addressing racism. To do so effectively and comprehensively, public health scholars, bioethicists, and other scientists should work together to identify and implement equity-driven collaborations to eliminate the deleterious effects of racism on individuals, families, and communities. (shrink)

This review essay critically examines Catherine Mills’s Biopolitics and Camisha Russell’s The Assisted Reproduction of Race. Although distinct works, the centrality of race and reproduction provides a point of connection and an opening into reframing contemporary debates within bioethics and biopolitics. In reviewing these books together I hope to show how biopolitical theory and critical philosophy of race can be useful in looking at bioethical problems from a new perspective that open up different kinds of analyses, especially around historically embedded (...) problems like institutional racism and the legacies of colonialism in healthcare. (shrink)

A discussion of whiteness as an “ethos” or “relational category” in bioethics, drawing on examples from medical and historical research.

Philosophers working in bioethics often hope to identify abstract principles and universal values to guide professional practice, relying on ideals of objectivity and impartiality, and on the power of rational (individual, autonomous) deliberation. Such a focus has made it difficult to address issues arising from group‐based, sociohistorical differences like race and ethnicity. This essay offers a survey of some of the major issues concerning race in the field of bioethics. These issues include a long history of racialized abuse in medical (...) and scientific research, reproductive injustice and abuse against women of color, and persistent racial and ethnic disparities in U.S. health and health care. The essay also argues that the field of bioethics as a whole would be improved by taking the experience of racial minorities into account in all its theorizing. Philosophers can aid in this task by expanding their theoretical focus beyond questions of individual rights to questions of social justice, beyond informed consent to community collaboration, and beyond cultural competency to both structural competency and cultural humility. (shrink)

ABSTRACT This paper is a case study in public health ethics. It considers whether there is a basis in ethics for political action by health professionals and their associations in response to inhumane treatment. The issue arises from Australia's treatment of asylum seekers and the charge that this treatment has been both immoral and inhumane. This judgement raises several questions of broader significance in bioethics and of significance to the emerging field of public health ethics. These questions relate to the (...) role of health professionals in response to inhumane treatment of people in their charge; to the discipline of public health in light of a growing recognition of its ethical basis; and the role of public health and bioethical associations in response to ethical issues arising in a political context. It is argued that, in serious cases of humanitarian and human rights abuses affecting health and well‐being, there is a case for political action by health professionals, academic and professional institutions, and associations of public health and ethics. (shrink)

In the September-October 2001 issue of the Hastings Center Report, editor Gregory Kaebnick encouraged bioethicists to turn their attention toward “easily overlooked, relatively little-talked-about societal topics” such as race. In 2000 the president of the American Society for Bioethics had called for a more socially conscious bioethics. Race was risky territory, Kaebnick pointed out, but this challenge did not justify avoidance. Over the next fifteen years, the response to this editor's invitation to examine the racial dimensions of medicine in the (...) Report was limited both in quantity and in terms of the range of topics covered. All told, the bioethics community has not responded to the editor's call for bioethicists to engage with the racial dimension of medicine, and the Report has not really come through on the tacit commitment made in 2001. The lack of interest in race matters evidenced in the Report as well as the American Journal of Bioethics has also prevailed in medical humanities journals, whose few pieces on race have tended to remove race relations from our current realities in two ways: some articles locate medical racism in the American past or in colonial Africa, while others analyze the medical disorders of fictional characters. Bioethicists have not embraced the opportunity to create a sociologically and historically informed bioethics that might be applied to the lives of black Americans and their unending health crisis. (shrink)