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Saturday, March 18, 2023

Black Bioethics in the Age of Black Lives Matter

Ray, K., Fletcher, F.E., Martschenko, D.O. et al. 
J Med Humanit (2023).

Here are two excerpts:

Lessons Black Bioethics can take from BLM

BLM showed that telling Black people’s stories or giving them a space to tell their own stories is viewed as an inherently political act simply because Black people’s existence is viewed as political. At the same time, it taught us that we absolutely must take on this task because, if we do not tell our stories, other people will tell them for us and use our stories to deny us our rightful moral status and all the rights it entitles us.

BLM let Black people’s stories fuel its social justice initiatives. It used stories to put Black people at the forefront of protests and social inclusion efforts to show the extent to which Black people had been excluded from our collective social consciousness. Stories allowed us to see the total impact of anti-Black racism and the ways it infiltrates all parts of Black life. And for those who were far removed from the experience of being Black, BLM used stories to make us care about racial injustice and be so moved that we were unable to turn our backs on Black people’s suffering. In this way, stories are an act of rebellion, a way to force people to reckon with BLM’s demands that Black people ought to be treated like the full and complex human beings we are.

Black Bioethics is also a rebellion. It is a rebellion against the status quo in bioethics—a rebellion against Black people’s lives being an afterthought, particularly in issues of justice. Stories aid in this rebellion. Just as stories helped BLM show the full range of Black people’s humanity and the ways that individuals and institutions deny Black people that humanity, stories help Black Bioethics demonstrate just how our institutions contribute to Black people’s poor health and prevent them from living full lives. In Black Bioethics, stories can create the same emotional stirring that they did for BLM supporters since they share many of the same challenges and goals. And just as it would be imprudent to underestimate the role of stories in social justice, it would be imprudent of us to underestimate what stories can do for our sense of health justice for Black people.


Toward an intersectional bioethics

Bioethics is well-positioned to foster antiracism in scholarship, training, and advocacy (Danis et al. 2016). Although the field focuses on ethical issues in biomedical research and clinical care specifically, Danis et al. (2016) point out that many ethical dilemmas that impact health and well-being lie outside of healthcare settings. For instance, there are significant ethical dilemmas posed by the social determinants of health and complex disease. Social factors such as poverty, unequal access to healthcare, lack of education, stigma, and racism are underlying and contributing factors to health inequalities. These inequalities, in turn, generate the ethical dilemmas that bioethics grapples with (Danis et al. 2016). If the field genuinely values the just conduct of biomedical research and the just provision of clinical care, then it will need to draw upon intersectionality to understand and effectively analyze the many interlocking complexities in our world and in human experiences. Social activist movements like BLM and their use of intersectionality offer several lessons to those in the field working to secure justice in biomedicine, clinical care, and society.

First, as an analytic tool, intersectionality recognizes and understands that different social forces conjoin to produce and maintain privilege and marginalization. Therefore, intersectionality clarifies instances in which real lives and experiences are being erased. Bioethics cannot afford to “neglect entire ways of being in the world,” though it has and continues to do so (Wallace 2022, S79). Social activist movements like BLM are drawing attention to ways of being that are unjust yet largely ignored by mainstream hegemonic interests. For instance, BLM directly acknowledges within its movement “those who have been marginalized within [other] Black liberation movements” (Black Lives Matter n.d.). Using intersectionality, BLM heightens awareness of the ways in which Black queer and trans individuals, undocumented individuals, and people with disabilities have different experiences with White supremacy and advance colonialism. In doing so, it centers rather than erases real lives and experiences. Learning from this movement, bioethical scholarship grounded in the principle of justice will need to find ways to center the experiences of Black-identifying individuals without treating the Black community as a homogenous entity.