The American Medical Association’s governing body, the House of Delegates, resolved recently that racism, as it operates within the realms of medical research and healthcare delivery, is a public health issue. The House of Delegates found, for example, that the fact that race is treated as a factor in tabulating the results of research is an “algorithmic bias” biasing the research, because race is a social construct, not a biological fact.
Between 1932 and 1972 the US Public Health Service conducted the Tuskegee Syphilis Experiment in collaboration with a historically black college in Alabama. Black men were recruited for the study. Half of them had latent syphilis, the other half were regarded as a control group.
During the course of this study penicillin became widely available (by 1947) and became the standard treatment for syphilis. The men in this study never received that or any other genuine treatment. They received placebos. They were deceived – falsely told that they were receiving health care when in face they were experimental subjects only, and the point of the experiment was to track to course of untreated syphilis. Twenty-eight men died of the untreated syphilis, many more of related complications.
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The algorithmic bias cited by the AMA in 2020 is much more benign-seeming a problem than the blatant racism and manipulation of the Tuskegee study. But it helps give the physicians and scientists of the AMA of all backgrounds a sense of an obligation not just to free their field of racism but to imbue it with anti-racism.