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Medicine, Race and Ethnicity - Coggle Diagram

- - - - Division of humans into 4 varieties based on geographic origin and skin colour
        
        In the 10th edition, Linneaus divided people based on physical characteristics, psychological traits, forms of governance etc.
        
        Employing MEDICAL HUMORALISM to understand each race! (Americans = choleric, Asians = melancholic...)
        
        No correlation between temperament and climate (for Linnaeus)
        
        NOTE: In claiming that Africans were a race that needed to be governed, Linnaeus was trying to draw a link between race and social status/intelligence
    - - L1 Beltran notes:
        
        Castas system was a hierarchy designed by the Europeans to 'protect' the purity of their blood --> They wanted to isolate their race socially, so they could preserve power in the colonies
        
        L1 Beltran
        
        Argues that Hippocratic theory was useful for Creoles to contend with the casts systems in Latin America (especially since they were a mixed race group)
        
        Mainly, they tried to show that the incorporation of European blood was beneficial to the American bodies (using Hippocratic landscpae/arguments)
        
        So, the Hippocratic language was useful for the Creoles to navigate the casts system, and to help them define/better understand their social positions
    - - Solidism
        
        Recognition that human/racial differences were hereditarily HARD-WIRED --> So, one's susceptibility to disease was a result of their internal body's organsiation
      - Stadialism
        
        Races perceived as STAGES in human development, and so some races were the advanced phases, others were primitive
        
        To a certain extent, this view is still valid even among scientists today in terms of the way they view natives/indigenous populations!
      - Monogenists vs Polygenists
        
        Whether or not humans had a single origin, or if races were distinct species with distinct origins
    - - Race as a Hardened Category
        
        This meant that race was more seen as a result of hereditary differences
        
        Any notion of 'naturalisation' and 'acclimatisation' receded as a result!
        
        What did this mean for colonies/medicine?
        
        Tropical Medicine!
        
        There emerged a view that the tropics were places ridden with dangerous diseases for the non-White bodies (and that the other races were acclimitised)
        
        Viewing indigenous/local bodies as 'strong and dangerous' compared to the vulnerable white body --> Rationalised efforts for 'sanitation' and 'control'
        
        Institutionalisation: London School of Tropical Medicine, Hamburg Institute for Tropical Diseases
        
        For a C20 case study:
        
        American colonisation of the Philippines
        
        L2 Anderson
        
        Anderson explains that initially, the American colonisers had this view that the locals possessed inherent immunity to diseases. Combined with physicians' obsession with accounting for human difference, it created the framework to connect race and disease!
        
        As such, there were policies to protect the white body (the colonisers), and to reinforce/legitimise the neglect of the locals' health (EXCLUSION)
        
        However, this paradigm was challenged by microbe theory/changing perceptions of 'acclimitisation': With more observations, they started to realise that actually the locals weren't immune (as previously thought)
        
        This actually generated a stronger framework for racist policies: They blamed the cultural practices of the natives (and their lack of hygiene) for their own poor health
        
        Hence, this rationalised American attempts to force the Filipinos to copy/adopt American ideas of modernity and sanitation!
  - - - Medical Experimentation
        
        Using non-white bodies to conduct experiments (unethically, though this wasn't really a concept then)
        
        This was also a gateway to understanding/conceptualising the differences between Europeans and others
        
        L1 Schiebinger
        
        Argues that there was a paradox in C18 medical experiments: While European practitioners emphasised racial differences in researching racial bodies, they still wanted to show that their results/methods were universal
        
        Race was studied most extensively in the colonies, and must be viewed as closely associated with the slave trade!
        
        In terms of race, the main inquiry was to understand WHY there were differences in skin colour and how this related to different climates
        
        They also conducted very exploitative experiments on slave bodies, taking more liberties than they would un the metropole!
    - - Race-Specific Diseases
        
        This perception that the 'blacks' or non-European races were immune to certain diseases
        
        The idea that different races had different levels of immunity to diseases --> So it was the norm for them to continue working
        
        What dominated in the C18 however was more this idea that it was just because they were ADAPTED/ACCLIMITISED to the conditions
        
        L1 Charters
        
        By exploring the military needs of the British empire in the C18, Charters arguers that war experiences did not necessarily create racist observations, but produced a FRAMEWORK/LAUNCHPAD for the rise of racist ideologies in the C19
        
        C18 racial medicine was understood in terms of malleability (not like the C19 hard-concept)
        
        War experiences in the C18 gave physicians the opportunity to conduct/observe/monitor soldiers, and collect new information about diseases
        
        The focus was about the danger of new environments to the European body, and to that end, motivated efforts to recruit natives to do hard labour tasks (since they were 'better adapted') --> This was how one could slowly generate/produce racist thought/ideology
      - The Hospital as a Site of Experimentation, Observation and Control
        
        Foucault's BC describes how in the 1800s, hospitals became a privileged site for medical observation --> More patients in a controlled environment
        
        Observing and exploiting black bodies!
        
        Case Study: The Kingston Hospital and Asylum for Deserted Negroes
        
        Noting that hospitals were also a means to CONTROL and CONTAIN the slaves
        
        L2 Hogarth
        
        Argues that, while the hospital seemed to have been created out of white altriusm, it was fundamentally a symbol of the control of slaves in a time of unrest over the slave trade
        
        Essentially, the hospital helped the whites extend their power over the slaves under the guise of altriusm
        
        C18: A time of growing uncertainty and unrest, as there was sharp anti-slavery sentiments that grew both within the metropole and in Jamaica
        
        Most of the reforms that were implemented were ineffective, because all they did was try to 'humanise' the trade so it could continue operating
        
        The hospital was constructed so as to contain the unsupervised blacks (the freed slaves), who were those who seemed to threaten societal stability the most
        
        Hence, the hospital was a way of policing transient blacks and preventing insurrections!
        
        By being placed in the hospitals, these slaves were in a state of perpetual and constant surveillance --> So the hospitals blended medical care and discipline/supervision
        
        Foucauldian ideas of how hospitals, by adopting a strategy of social assistance, served as a site for social control
      - In turn, recognising how medicine contributed to racism in the C18/C19
        
        A peculiar history of INCLUSION and EXCLUSION
        
        When included in medical practices, non-White bodies were racialised, disciplined and colonised
        
        But they were simultaneously excluded/denied access to healthcare services
        
        L2 Deacon
        
        Argues that medical racism in South Africa was influenced/reinforced by the socio-economic conditions of the period
        
        Even if Western doctors avoided putting racist ideas into scientific terms, legislation in the colony effectively shut off/cut off indeingeous practices in medicine
        
        Also, socio-economic and institutional arrangements provided the space for doctors to view their patients differently/discirminate against them! It was these racist ideologies that professiaonlised medicine in the colony
    - - So, as one can imagine, many of their concerns about the health of the slaves came from a place of concern for their own plantations (LABOUR)!
- - - - Statistics in C19
        
        C19 psychiatrists working at asylums started to study the hereditary causes of mental illnesses
        
        These institutions produced large amounts of data, and so useful for studying alienism --> And to understand what the 'normal man' was!
      - Francis Galton (1883)
        
        Introduced the term in 1883, to refer to 'the science of improving the human stock'
        
        Fundamental to this was the concept of ancestral inheritance (that traits weren't obtained from parents, but in the germline)
      - The Industrial Age
        
        Because industrialisation also come with massive/rapid population growths, the study of CONTROLLING/MANAGING the population came into prominence
        
        For nations and empires, health became an area for political action
        
        The emergence of the 'working class', the 'poor' etc. --> the social classes of people were linked to inheritance (Lamarckian principles of hardened inheritance!)
  - - - Case study:
        
        Trying to construct TB as a hereditary disease in the US
        
        L3 Wilson
        
        How eugenicists in the US (in the ERO) tried to prove that TB was a hereditary, rather than germ-baed disease (how genetics and statistics lent credibility to the eugenics movement)
        
        For Davenport, Mendelian theory was a key step, because it made the whole study of inheritance a STATISTICAL one)
        
        What the ERO did was to employ statistics and conduct large-scale studies of family pedigree charts --> And often, what was emphasised was the relation between RACE and susceptibility to TB
        
        It led to the implementation of sterilisation laws and eugenic marriage laws in some US states!
        
        In this case study, we are able to understand the objectives/agendas of eugenicists: Why they are different is their insistent/focus on POLICYMAKING! --> They produced knowledge with the aim of producing laws/policies that affected society.
      - L3 Teicher
        
        Argues that germ theory of disease shared many parallels/similarities with gene theory of disease
        
        Both theories were connected by this concept of purity, and the importance of CARRIERS
        
        They also sought to make their agents/vectors (germs and genes) VISIBLE --> So there was a reliance on similar visual charts/diagrams
        
        The common use of military metaphors to erdadicate/remove them
        
        And the concept of a healthy, asympotmactic carrier
        
        Finally, the perception/emphasis given on the women as 'heatlthy carriers' (esp. for genetic diseases)
        
        The idea of a carrier was what lent credibility/strength to the racial connotations of the eugenics movement --> Non-White bodies became a source of medical anxieties!
    - - L3 Weiss
        
        Argues that in the Nazi regime, human genetics and racial politics shared a symbiotic relationship. This explains why scientists were willing to justify/rationalise the regime's exterminationist racial policies (why scientists participated in *morally-compromised science)
        
        Eugen Fischer was the 1st director of the KWIA, but under the Weimar government, Fischer lamented about a lack of funds (Great Depression, hyperinflation)
        
        So, when a 'eugenics-friendly' regime came into power, Fischer marshalled resources for his institute by emphasising its utility as a national resource
        
        Scientists in the KWIA thus often conferred legitimacy to the Nazi racial project, and even defended German interests/ideologies in overseas conferences
        
        After Verschuer took over as director in 1942, things got worse as KWIA became further involved in war crimes and unethical research (using biological samples from victims at Auschwitz)
        
        This episode demonstrates the complicity of scientists with engaging in the Nazi regime's policies/the Holocaust
        
        It may be a matter of individual survival, but you cannot deny the symbiotic rs between the KWIA's genetics research and racial politics
      - L3 Proctor
        
        Argues that the scientists in the regime were complicit with its genocidal policies, and not mere 'pawns' forced to cooperate! This chapter examines the history/origins of German eugenic thought
        
        While Ploetz and co. tried to emphasise that racial hygiene wasn't meant to be racist (but for nation building), Ploetz himself had subtly demonstrated the racist connotations of racial hygiene! - Noting also that the idea of racial hygiene found supporters from ACROSS the political spectrum (not just exclusive to the right-wing movement)
        
        Ultimately, scientists were the ones who came up with the concept of racial hygiene, and they willingly accepted state funds to conduct research to justify/implement racist ideologies
        
        An interesting contrast is with Lamarckian ideas of Acquired inheritance vs Mendelian genetics
        
        While Marxists tended to side with Lamarck, eugenicists in Germany promoted Mendelian ideas (because this denied the plasticity of humans) --> And so, Lamarckian theory became an 'enemy' of the state
    - - Advancements in science that strengthened the movement
        
        Mendelian genetics (opposing Darwinian blending inheritance, and also Lamarckian principles)
        
        Microbiology and serology to study/confirm Mendelian inheritance!
        
        Statistical methods/studies
- - - - L4 Bivins
        
        Here, Bivins uses the case study of managing rickets among the Asian-migrant community in the UK during the post-war period to argue that even in the postcolonial, bodies of immigrants/ethnic minorities continued to be exploited, as an extension of the imperial medicine framework
        
        Rickets was constructed as an archetypal Asian disease in Britain in the post-war period, and we again see ethnic minorities' bodies being used as test subjects, as a source of medical knowledge, rather than to be treated
        
        The state often turned to notions of cultural practices and acclimitisation to justify their policies to help treat/minimise the ticket incidences among the migrant populations
        
        It became a way for the state to FORCE assimilation, and to homogenise the populations
  - - - L4 Wailoo and Pemberton
        
        Examine the various failed promises of medical treatment that have left the AA community disillusioned. Indeed, the treatment of SCD, especially when contrasted to that of CF, shows how political, rather than scientific calculations affected its treatment
        
        1st proposal was to use urea to treat SCD, but this was nothing but false optimism as it was unproven
        
        Even when things like penicillin were proposed, the economics of it was a huge concern (could the families afford having long-term access to the antibiotics?)
        
        Analgesics: Came with the concern/stereotype of African Americans as narcotics, and so wasn't something that authorities wanted to consider
        
        Bone Marrow Therapy: Came with high risks of death, and so was met with muted optimism
        
        Basically, the history of SCD treatment contains a repeated theme: Rasied expectations, failed dreams --> Coupled with the mistrust of the government (on the back of the Tuskegee trials), the path to SCD treatment was a long and perilous ones for many African Americans, especially in contrast to the case of cystic fibrosis.
  - - - In short, even though modern C20 biology sought to dismantle racial categories, it ended up reinforcing them!
        
        L4 Reardon and TallBear
        
        Argue that scientific anti-racial projects ended up impeding anti-racist movements, because scientists participating in these projects often assumed ownership of the genetic material of the minority roups
        
        Often, in these projects, the white scientist see the indigenous groups as representing an 'earlier' stage of 'untouched civilisation'
        
        And in the case study of the Havasupai tribe and ASU, these assumptions led to misuse of the DNA samples of the tribe members!
    - - Foucault's "Technologies of the Self"
        
        Tools for the empowerment of the indiviudal
        
        With these technologies, there is NO presence of the medical establishment (so, individuals bypass medical establishments to get medical/biological information about themselves)
      - In a weird way, humans have become the model organism in modern-day biology, and the new modern genetics comes with new configurations of biosocial relations
      - To also recognise that these personal genomics projects, innocent as they seem, could likely be connected with larger biomedical projects/endeavours
        --> Biobanking!