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15 St. Louis U. Pub. L. Rev. 191 (1995-1996)
Slavery, Segregation and Racism: Trusting the Health Care System Ain't Always Easy--An African American Perspective on Bioethics

handle is hein.journals/stlpl15 and id is 203 raw text is: SLAVERY, SEGREGATION AND RACISM: TRUSTING THE
HEALTH CARE SYSTEM AIN'T ALWAYS EASY!
AN AFRICAN AMERICAN PERSPECTIVE ON BIOETHICS
VERNELLIA R. RANDALL*
I am a registered nurse and a family nurse practitioner. I have a master's
degree in nursing. I practiced nursing for 15 years in Alaska and Washington.
I write and work in the area of health care law. I understand the health care
system and the legal system ... I am African American and trust the health
care system to work in ways that ultimately will harm my people.'
I. INTRODUCTION
Many people are surprised at the level of distrust of the health care system
held by African Americans. However, fear and distrust of the health care
system is a natural and logical response to the history of experimentation and
abuse.    The fear and     distrust shape our lives and, consequently, our
perspectives.2 That perspective keeps African Americans from getting health
* Professor of Law, The University of Dayton School of Law. J.D., 1987, Lewis and Clark
College-Northwestern School of Law; M.S.N., 1978, University of Washington; B.S.N., 1972,
University of Texas.
1. My distrust of the health care system is typical of a belief held in the African American
community: I believe that the AIDS virus was developed in government labs for the purpose of
controlling black folks. Annette Dula, African American Suspicion of the Healthcare System Is
Justified: What Do We Do About It?, 3 CAMBRIDGE Q. HEALTHcARE ETHics 347, 347 (1994)
(citations omitted). [Many black Americans believe that AIDS and the health measures used
against it are part of a conspiracy to wipe out the black race. The AIDS 'Plot' Against Blacks,
N.Y. TIMEs, May 12, 1992, at A22. There's still so much fear and trepidation about what
happened in Tuskegee, and it fuels the distrust blacks have of public health. Cheryl Clark, The
Ghost of Tuskegee, S.D. UNION & TRm., Jan. 28, 1996, at D14. Behind the facade of big
hospitals, many African Americans can only see one big medical experiment. Carol Stevens,
Research: Distrust Runs Deep, Medical Community Seeks Solutions, DET. NEWS, Dec. 10, 1995,
at A12 (quoting Vernice Anthony, Senior Vice-President of the St. John Health System, who has
seen the paranoia).
2. See generally Barbara A. Koenig & Jan Gates-Williams, Understanding Cultural
Difference in Caring for Dying Patients, 163 W.J. MED. 244 (1995) (asserting that experiences
of illness and death, as well as beliefs about the appropriate role of healers, are profoundly
influenced by cultural background); Clark, supra note I, at D14; Cynthia Hubert, African Ameri-
cans Breaking Silence on Reality of AIDS, SACRAMENTO BEE, Jan. 2, 1996, at Al (reporting that

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