Saturday, August 20, 2022

Review: Medical Apartheid by Harriet Washington

 I think this one is a must-read for anyone conducting biomedical research.

Some parts —
particularly the first third, dealing with the slavery and reconstruction era of US history — I'd read before in books like Angela Davis' Race, Women and Class. A few parts felt like rather long deviations that I didn't feel added all that much to the central thesis — for example, the chapter on display of Black people at zoos and freak shows, the part on apartheid South Africa's bioterrorism against its own citizens (the US, as Washington clearly demonstrated, has done plenty such terrorism and testing against its own citizens).

Some parts I thought I knew well — the Tuskegee syphilis trials, for example — but I was surprised there were still shady details to learn (for example, the time pressure on the ad hoc Tuskegee investigative committee, the shameful political maneuvering by its chair to soften the language of the report).

The book was written in 2006, and in the intervening 15 years, I think the big new issue we need to grapple with is the role Big Data plays in healthcare. Non-interventional anonymized healthcare data is sold and re-sold so companies can better target their marketing efforts or assess the potential ROI of a pharmaceutical intervention. These companies have data on some 300 million Americans (of 330 million people). This type of use of medical records has minimal benefit to the people whose records are being sold and analyzed, and I think few people know their information is used this way. I don't think it should be tolerated.

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