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08/17/2017

The Aftermath of Charlottesville: What’s a bioethicist to do?

by Craig Klugman, Ph.D.

Figuring out how to respond to one of the most egregious displays of racism in modern times (U.S.)  is not an easy task. Figuring out what this event means from a bioethics perspective is even more challenging. As anyone in the connected world knows, Mr. Trump explained his support (or at least lack of condemnation) of white nationalists and neo-Nazis in a rally in Charlottesville, Virginia. This progressive city in the south has a long history of bioethics. This city is the home of the University of Virginia, which has been “exploring and teaching…about the complexities of human illness, suffering, and practices of healing, as well as the processes of research and policymaking” since the 1960s. This was one of the first schools to have an endowed chair to teach baccalaureate bioethics.

In thinking about this event and the egregious statements from the highest office in our country, I first thought about how it affected me. My family immigrated to the United States between 1880 and 1910. They lived in urban New Jersey and rural New York State where they took such jobs as junk peddler, horse trainer, and wallpaper hanger. I grew up in a small, isolated town on the rural-suburban cusp, about an hour outside of New York City. Surprisingly, we were one of only a handful of Jewish families in this very Catholic town. In school, important exams were often scheduled for the Jewish High Holidays and make-ups were not permitted. From a young age, I was aware of fights with the school board over such issues including being forced to sing religious carols in school Christmas (not even winter holiday) events. I recall my father sitting me down when I was about 7-years-old and drawing a swastika in the corner of the newspaper page. There was a story about that symbol being spray painted on a building in town. He pointed to his drawing and said “This kills Jews.” Being a small child I took him literally and made him scratch it out until the paper tore, thinking that the symbol itself could kill, not realizing he meant the people whose beliefs it represented.

Despite my fairly pale skin, I never had the sense of growing up white. We were, in our small town, outsiders finding community with our close neighbors and with our small synagogue. Thus, I have been amused by the discussion this rally raised over “aren’t Jewish people ‘white?’” because that was never my experience. Just a few months ago this question was raised in the news media over Gal Gadot, the lead in Wonder Woman, this summer’s hit movie. Haaretz, an Israeli paper reported the debate under the headline, “Is Israeli Wonder Woman Gal Gadot White or a Person of Color?

Bioethics has a history of not engaging in advocacy or even positions in regards to social justice. In this space, I have written about this problem as have several other more notable scholars in their careers. Thus, I was pleased to see Audiey Kao’s commentary showing that medicine is dedicated to serving people no matter who they are or from where they came.

Let’s face it, bioethics has a diversity problem, a title that echoes that of John Hoberman’s 2016 essay in The Hastings Center Report. Hoberman was concerned with bioethics ignoring literature showing a lower quality of medical care provided to African-Americans. The same could be said for people of lower socioeconomic status, women, rural residents, older age, (dis)ability, and LGBQT persons to name a few populations. Cat Myser suggests that bioethics reproduces “the dominance and normativity of whiteness in the cultural construction of bioethics in the United States.” Part of the answer, she suggests, is not to think of “white” and “all others” but rather to “problematize and displace” in order to focus on issues of diversity.

Kayhan Parsi points out that racism is structural and the reluctance of bioethics to engage in changing the structure is related to how clinical bioethicists are employed—by hospitals and medical centers that do not offer tenure and academic freedom. To speak against the system is to endanger one’s position. Only a courageous person would put her/himself on the line to achieve justice. As I wrote in 2013, “Medical education does not provide courses in moral courage, defying authority, or turning against the tide of one’s peers.” Today, I will add that bioethics education does no better.

I do not know how bioethics should respond to our current climate of hate and social divide. Perhaps there is no coming together for civil discourse and dialogue with people who want to run others out of their homes. Or maybe discourse is what is needed. Only six months ago I broached this very topic and the response in bioethics has been silence. When my husband came home today he looked at the mezuzah—a small traditional case containing an excerpt of religious text that is affixed to the doorpost of most Jewish homes—and said that we should take it down because he did not want to attract any trouble given the events of the last week. I said it was more important than ever that we maintain our identity as part of the fabric of the nation. We must not run and hide. We must engage. We must remember. And we must act. I’m just not sure how.

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