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The Banality of Evil.
Yesterday, I took a break from researching to go to a talk that sounded interesting, “Slave Medicine and the Banality of Evil.”
I have to say, I don't usually find historical talks given by physicians that interesting, but this was not only fascinating, but it also gave me some really great ideas about teaching race and medicine in the future.
A brief summary of the talk: Starting with a physician's bill, Halperin discussed the role of doctors in slavery - from ship physicians who got paid more if slaves arrived here alive and healthy, to plantation physicians who were kept on retainer by slave owners to treat their slaves. He then transitioned to the issue of the "banality of evil," a term you are probably familiar with from Hannah Arendt and the Nuremberg Trial. Arendt's point is that while we often ascribe evil to sociopaths (like Hitler), the greatest evil is when ordinary people participate in evil because they think it is normal. In regards to physicians who treated slaves, they partipated in the perpetuation of a system that they saw, perhaps more than any other class of persons, how evil it was and still considered themselves objective, above politics, and "doing no harm."
When I teach this subject the go-to topic is the Tuskeegee Syphillis Study - we try to break student's (especially pre-med students') belief that it was an isolated incident (in fact, it is *very* represenative of medicine at the time) and that physicians and medicine reflect the society they live in. The analogy to Halperin's talk seemed obvious at first, but the more I thought about it, the more I realized his example was so much more powerful - his physicians wanted their patients to live and be healthy - the Tuskeegee physicians wanted to bring their patients to autopsy.
It's easy for students to black box the Nazis or Tuskeegee as an exception carried out by evil people, but physicians who treated slaves? They actually gave their patients the best care they could (it was in their financial best interest to do so) - in order to send those slaves back to work...
I have to say, I don't usually find historical talks given by physicians that interesting, but this was not only fascinating, but it also gave me some really great ideas about teaching race and medicine in the future.
A brief summary of the talk: Starting with a physician's bill, Halperin discussed the role of doctors in slavery - from ship physicians who got paid more if slaves arrived here alive and healthy, to plantation physicians who were kept on retainer by slave owners to treat their slaves. He then transitioned to the issue of the "banality of evil," a term you are probably familiar with from Hannah Arendt and the Nuremberg Trial. Arendt's point is that while we often ascribe evil to sociopaths (like Hitler), the greatest evil is when ordinary people participate in evil because they think it is normal. In regards to physicians who treated slaves, they partipated in the perpetuation of a system that they saw, perhaps more than any other class of persons, how evil it was and still considered themselves objective, above politics, and "doing no harm."
When I teach this subject the go-to topic is the Tuskeegee Syphillis Study - we try to break student's (especially pre-med students') belief that it was an isolated incident (in fact, it is *very* represenative of medicine at the time) and that physicians and medicine reflect the society they live in. The analogy to Halperin's talk seemed obvious at first, but the more I thought about it, the more I realized his example was so much more powerful - his physicians wanted their patients to live and be healthy - the Tuskeegee physicians wanted to bring their patients to autopsy.
It's easy for students to black box the Nazis or Tuskeegee as an exception carried out by evil people, but physicians who treated slaves? They actually gave their patients the best care they could (it was in their financial best interest to do so) - in order to send those slaves back to work...
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One thing I hate about mandatory human subjects/ethics trainings that are required in research (& I'm assuming are similar in the clinical side of things) is that the examples used are always so heinous. Like, an example will be, "You find Jimmy Stewart's medical record! Should you go home and call up a tabloid newspaper?!" OBVIOUSLY NO.
But a way more plausible situation would be, "You come across the medical record of a neighbor. Should you tell your spouse what you read?"
I get in so many arguments with doctors because their mindset is, "The regulations shouldn't hamper me because I'm nice!"
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This talk sounds awesome. I never thought of the doctors as complicit, but then I didn't know there were docs hired for the sole purpose of treating slaves. The more you know.
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All that aside, I have an uncle who is a doctor and works in ER services and he wishes he could refuse treatment to those who can not pay for it. Mostly because he's pretty much a jerk about a free market economy - but there's that side of it as well. How does a free market economy conflict with ethical treatment of patients?
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http://whatever.scalzi.com/2012/03/20/guest-post-a-doctor-on-transvaginal-ultrasounds/
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