Posted: July 17th, 2022

Plenary Addresses
Journal of Healthcare, Science and the Humanities Volume IV, No. 1, 2014 23
“Why We Are Here:
We Are Here Because Communal Bad Blood Perpetuates
A Legacy of Mistrust”
Joan R. Harrell, MS, MDiv, DMin (cand)
Director of External Communications
Trinity United Church of Christ
Chicago, IL 60628
Tel: (773) 962-5650
Email; jrharrell@trinitychicago.org
Author Note
The Reverend Joan R. Harrell is a public theologian, strategic communications practitioner
and cultural critic. She is the founder of www.racismcontradictschristanity.com and producer
and host of the syndicated podcast series, Empowering Voices: Uplifting the Voice of the
Voiceless. This article is a revision and expansion of the Public Health and Ethics Intensive
lecture that was presented on April 2, 2013 at the 2013 Commemorative Anniversary of the
1997 Presidential Apology for the United States Public Health Service Syphilis Study. The
opinions found in this article are those of the author and do not necessarily represent those
of the agencies or institutions she serves.
Abstract
Within the context of racism, classism and sexism, the intersection of alterity, discriminating
language, religion, media, economics, business and unethical practices in public health
have presented evidence for people of color and impoverished communities to mistrust the
medical care system in the United States. Understanding these issues is critically important
for women and men of all cultures and races across the globe. A deeper understanding and
appreciation of the in-depth factors surrounding racism in medicine and healthcare, as well
as in all cultural activities, is critically important so as to counter the problem of power and
its effects on the lives of all persons.
Keywords: medical mistrust, racism, medical apartheid, syphilis study, alterity, Tuskegee,
Guatemala
Introduction
“Why Are We Here: Because Communal Bad Blood Perpetuates A Legacy of
Mistrust,” posits a hermeneutical lens of suspicion about why persons in the United States,
today in the 21st century, are suffering from the repercussions of medical abuse because an
unethical bioethics episode occurred for nearly four and half decades in the 20th century
in an impoverished predominantly African American community in the rural South. The
U.S. Public Health Service Syphilis Study allowed hundreds of men of African descent to
participate in a medical research project that caused some of them to lose their eyesight and
Plenary Addresses
24 Volume IV, No. 1, 2014 Journal of Healthcare, Science and the Humanities
live with sores on their bodies. And, as medical members of the U.S. Public Health Service
Syphilis Study knew, innocent women were infected with syphilis and passed the bacterial
disease that causes blindness and death to their unborn babies inside their wombs. All of
the African American (black) men living with syphilis in the Syphilis Study in Tuskegee and
Macon County, Alabama eventually died because they were not given penicillin to treat
syphilis while penicillin was prescribed for and prevented other American citizens, particularly
Euro Americans, from passing syphilis to their wives and children and dying of syphilis.
No Personhood in Medical Apartheid
“I was a nobody and all the men included in the experiment were nobodys, so there wasn’t a lot to
say about it for years.”
Ernest Hendon, last survivor of the USPHS Syphilis Study
died January 16, 2004
The aforementioned heartrending sentence expresses the human poignancy of the
linguistic context of Ernest Hendon’s description of his Sitz im Leben – his reality setting for
life; a man of African descent living in an economically poor rural environment. Although he
was not living with syphilis, he was unethically manipulated by medical persons who wanted
to research and discover the natural progression of syphilis – a sexually transmitted disease.
What is more startling and sorrowful is that the majority of men, in the Syphilis Study, were
living with syphilis but they were never told they had syphilis and they were never medically
treated. Mr. Hendon and more than 600 other men in the study were emotionally and
physically abused and oppressed because they were black and poor. In what is titled, “The
Blog of Death,” Mr. Hendon, an adult male in his late nineties, referred to himself and his
victimized adult brothers of the United States Public Health Syphilis Study as “Nobodys.”
Semiotics is the study of signs, significance, signifiers, and meaning. The meaning
of human skin color and its socially constructed interpretation is one of the subjects of
semiotics. The sociological and psychological construct of color symbolism in U.S. society, in
this particular case, White-versus-Black – manifests in the intersectoral synergy of the United
States medical, public health, media, advocacy, faith and political institutions. Therefore
this multidisciplinary intersection influences the moral culture of our communities – local,
national and international.
Within the context of semiotics, Ernest Hendon labeled himself and the other men
as “Nobodys.” As we critically analyze the meaning of this historically unethical bioethics
episode, we must take a close read at the specific language of oppression, which Ernest
Hendon used to describe himself as a victim of the unjust syphilis study conducted by the
United States Public Health Service.
A “nobody” is a person of no importance, no authority, and a non entity.
Ernest Hendon described himself and the other victims of the syphilis study
as a non entity because of the intersection of the misuse of biblical scripture to describe
dark skinned people as cursed people, and media gate keepers, including religious
communications mediums, consistently using negative stereotyped media images of dark
Plenary Addresses
Journal of Healthcare, Science and the Humanities Volume IV, No. 1, 2014 25
skinned people, to officially symbolize societal pathologies and issues such as poverty, hunger,
suffering, violence, criminality, pain and evil.
The Intersection of Religion, Discrimination in Public Health and
Negative Media Stereotypes
Religion impacts morality and immorality. Whether an individual practices a
religion or not, each person is human and within the context of compassion and respect
for humanity, each discipline in the public square should implement an ethos of ethics.
However, religious history presents a culture antithetical to a philosophy of moral codes for
every member of the human condition.
As one scholar, Ashley Montagu, points out to us from history: “In the year 1455
by papal decree approval was given for the subjugation of infidels by Christians. The net
effect of this decree was the official sanction for the enslavement of Blacks, indigenous
Americans and other “infidels,” for their benefit of course: the salvation of their souls and
their admission into “God’s kingdom.”
One way of capturing what Montagu says is found in the work of Darnell Hunt:
“White = European = civilized = rational = superior = free = good
Versus
Black = African = savage = emotional = inferior = slave = bad”
To continue, sociologist Darnell Hunt offers the aforementioned alterity
(otherness of difference) formula to provide an analytical dialogue about how racist societal
injustices projected onto and about people of color, poor people, marginalized persons
such as prisoners, prostitutes, and the mentally ill impact how unethical public health care
practitioners treat the other members of the human condition.
While addressing this communal crisis in the year 2013, it is essential to critically
think about how a particular community’s language was used to psychologically make the
men, women and youth internalize poor self esteem about their personhood and medically
manipulate them to possibly think they were physically inferior because they were of a darker
hue; they were black, they were descendents from Africa and their bodies were abnormal.
They were black and had bad blood. Bad blood in the black community of Macon County
colloquially denoted a person was physically tired or was living with some kind of disease.
During my own investigation about the United States Public Health Service Syphilis
Study, I discovered evidence about how privileged members of society took advantage of the
colloquial language to manipulate poor black people because they had bad blood. In his work,
Bad Blood: The Tuskegee Syphilis Experiment, James H. Jones reported that a white foreman
who was working in Macon County, Alabama, literally ordered his black employees to
participate in the United States Public Health Service Syphilis Study. The foreman said, “Tell
these niggers the health doctor will be at the Possum Hollow School tonight. He’s got some
Plenary Addresses
26 Volume IV, No. 1, 2014 Journal of Healthcare, Science and the Humanities
government medicine to cure the blood disease. A lot of these niggers have got blood trouble,
sickly, no count, lazy, but maybe it’s not their fault. This doctor will find out.”
The black men, many of whom were husbands, fathers, grandfathers and
outstanding citizens of their communities in Tuskegee and Macon County, Alabama did not
know that the United States Public Health Service’s researchers officially labeled the medical
study, “Tuskegee Study of Untreated Syphilis in the Negro Male.”
Why were men and women who took the Hippocratic Oath allowed to conduct a
medical study not to treat human beings who were living with a life threatening disease which
could also be passed on to their wives and children? Evidence also revealed that in 1947,
approximately 15 years after the United States Public Health Service’s “Tuskegee Study of
Untreated Syphilis in the Negro” was initiated, penicillin became a medicine to treat syphilis
but the Negro (black, African American) men in the control and non control group for the
medical study were never given penicillin.
Paradoxically, a new version of the Hippocratic Oath was revised in 1943, during
the 11th year of the U.S. Public Health Service Syphilis Study. A portion of the Hippocratic
Oath read — “I will remember that I do not treat a fever chart, a cancerous growth, but a
sick human being, whose illness may affect the person’s family and economic stability. My
responsibility includes these related problems, if I am to care adequately for the sick. I will
prevent disease whenever I can, for prevention is preferable to cure.”
According to philosopher Paul Ricoeur, “Symbols give rise to thought.” The United
States Public Health Service’s “Tuskegee Study of Untreated Syphilis in the Negro Male”
created a legacy of mistrust. This has become a warning symbol for people of color today in
the United States, particularly African Americans but not all, not to trust health professions
and public health policy makers. The Journal of the National Medical Association revealed the
following important point that underscores this.
Over 76 percent of black and 47 percent of white survey participants said they
believed that a study similar to the Tuskegee Study could occur again today. Blacks
who had heard of the Tuskegee Study were 120 percent more likely than their white
counterparts to believe a similar study could occur today.
Based on the results of the above, we can understand deeply the experience of
Mr. Ernest Hendon who is cited at the beginning of this article. Mr. Hendon’s 20th century
lived experience of medical abuse because he was a black person treated in a scientific study
as the other type of human, continues to perpetuate a legacy of mistrust for medical care in
the 21st century.
No human being should refer to her or himself as a nobody and be able to use the
description nobody to justify why she, he and or an entire community can be inhumanely
treated because of the color of their skin and or their socio-economic position.
As Elaine Hegwood Bowen, a reporter for the National Newspaper Publishers
Association, confirmed, the bioethics episode of the United States Public Health Syphilis
Plenary Addresses
Journal of Healthcare, Science and the Humanities Volume IV, No. 1, 2014 27
Study involved the lack of respect of persons and the absence of consent guidelines during
research. The black men who were approached to become participants in the study were
never told they had legal rights to sign an informed human consent form.
The medical and administrative persons who were working on behalf of this
unethical study gave the sick, uninformed men free medical exams, free meals and burial
insurance in exchange for their human bodies to be used as human medical research guinea
pigs. United States Public Health Service Syphilis Study physicians, researchers and other
medical personnel let the disease ravage the black men’s bodies and later after the men died,
medical personnel performed autopsies to find out how untreated syphilis affected the
human body.
What scientific public health method gives a legal right to medical researchers and
physicians to determine when a person of color’s body can be determined inhuman while a
disease is killing his/her body and yet, perform an autopsy on the dead body of color to help
scientists, researchers and health practitioners treat white people who are living with the same
life threatening disease?
The Legacy of Mistrust is Global
Ernest Hendon died on January 16, 2004. Six years later, on October 1, 2010,
CNN Correspondent Elizabeth Landau reported that Wellesley College medical historian
Professor Susan Reverby had discovered that approximately eight years after the U.S. Public
Health Service started the “Study of Untreated Syphilis in Negro Males,” in Macon County,
Alabama, the American government began another unethical bioethics study in Guatemala.
The Guatemala Syphilis experiment focused on how penicillin affected the syphilis ridden
bodies of Latino men, women and children who lived in urban settings, while the syphilis
experiment in rural Alabama, focused on the natural progression of syphilis in the bodies
of black men. Neither physicians, nurses, nor researchers gave the black men penicillin, the
medicine that was known to cure syphilis. However, according to Reverby, members of the
U.S. medical study team in Guatemala deliberately infected more than 700 Guatemalans
with syphilis, oftentimes without their knowledge so that researchers could find out if
penicillin really was a cure for syphilis.
The Guatemala Syphilis Study involved nearly 1,000 people who were prisoners in
the Guatemala national Penitentiary, soldiers in army barracks, and mentally ill patients and
the National Mental Health Hospital. The victims did not give permission to participate in
the study.
Womanist Ethicist, Emilie Townes, theorized a construct that described the
calculated case of the unethical bioethics episode in Macon County, Alabama. “Ethics took
a back seat,” when syphilis was allowed to purposely destroy the bodies of disenfranchised
black skinned people and in Guatemala where medical practitioners intentionally infected
marginalized brown skinned people with syphilis.
The inhuman treatment of bodies of color in general and, in particular, human
beings whose skin is not white and who live in poverty stricken urban and rural communities
Plenary Addresses
28 Volume IV, No. 1, 2014 Journal of Healthcare, Science and the Humanities
created a negative communal bad blood between cultures and classes in and outside the
United States.
Health professionals cannot afford to allow ethics to take a backseat in public
health care. Trans-discipline scholars, researchers, faith leaders, community advocates,
students, medical and public health practitioners need a universal-global-community
ethos that will stop creating communal bad blood between races/ethnicities, genders and
socio-economic classes and end the perpetual legacy of mistrust that is founded in the evil
hegemonic constructs of the intersectionality of racism, classism, poverty, ethnic privilege,
homophobia, educational injustice, internalized oppression, environmental injustice, and
health care injustice.
In 1972, after the inhumane bioethics episode of the victims of syphilis study was
reported by the Associated Press — the Helpant Secretary for Health and Scientific Affairs
appointed an Ad Hoc Advisory Panel to review the United States Public Health Service’s
“Tuskegee Study of Untreated Syphilis in the Negro Male.” The panel had 9 members from the
fields of medicine, religion, law, labor, education, health, administration and public affairs.
The members of the Ad Hoc Advisory Panel met thirty years ago to investigate
how the syphilis study was allowed to be conducted and how it impacted the uncommented
victims — and yes, I intentionally use the word victim because the men whose bodies were
used for public health research were not told the truth about the experiment, they were not
given the opportunity to sign a consent form. Therefore, ethically they were victims– not
willing participants.
The work of the AD HOC Advisory Panel was started in 1972, but in 2013 there is
still more work to complete because the tragedy of the Communal Bad Blood experience that
was allowed to occur in Macon County, Alabama is still impacting the American and Global
Public Health Community. Poor people and people of color, as well as other persons who
are socially and politically labeled as the other — mistrust the public health care community
because their ancestors, like the victims of the syphilis study in Tuskegee, Macon County,
Alabama and Guatemala were scientifically treated like human guinea pigs.
This then is the reason many interreligious and/or particular communities located
in environmentally polluted environments and/or food desserts will not allow members of
the science and public health community to approach their congregants or neighbors to ask
them to participate in clinical trials or even surveys because there is a legacy of mistrust.
Why is it that oftentimes, members of the medical and public health care
community approach me, a faith leader in a predominate faith community of color, to ask
congregants or other faith centers of color to participate in clinical trials? Yet, when I ask
medical doctors, public health practitioners and/or researchers to provide free health care
clinics to serve these same communities they replied, no, or the process for them to offer days of
free healthcare to members of faith centers or the community is slow or it never manifests.
Plenary Addresses
Journal of Healthcare, Science and the Humanities Volume IV, No. 1, 2014 29
Conclusion:
A Critical Need for a Universal Public Health Covenant
As a womanist public theologian, I suggest it is time for a new paradigm. There
must be a respect for all members of humanity approach, with a true heart in full assurance
of ethics, with a sincere intent, a true heart to heal and improve the health condition of all
people, without any waving that might be caused by race, gender, class or environmental
discrimination or the temptation to create another unethical bioethics episode because
of competition for research money or some form of notoriety in the trans-disciplines and
throughout the local, national and international community.
Religion impacts morality and immorality. Whether one practices a religion or
not, each person is human and ethical decisions affect each discipline. The ethical and
unethical treatment of human beings symbolizes the semiotics of an individual’s heart and an
institution’s intentionality for justice or injustice for each member of the human condition.
“The Tuskegee Study of Untreated Syphilis in the Negro Male,” epitomizes
the inhumanity and evil practiced by the privileged on poor peoples of color, prisoners,
prostitutes, poor countries, the mentally ill and youth in poor communities.
This article is based on my invitation as a womanist public theologian, from the
National Center for Bioethics in Research and Healthcare at the historic Tuskegee University
to lecture at the 2013 Commemorative Anniversary of the 1997 Presidential Apology for the
U.S. Public Health Service Syphilis Study at Tuskegee and Public Health Ethics Intensive
about the topic, “Why are We Here?”
My response is “We are here because Communal Bad Blood between races, cultures
and classes perpetuates a Legacy of Mistrust.”
Death by gunfire is another public health bioethics episode in the 21st Century. On
April 2, 2013, two days before the 45th anniversary of the death of Dr. Martin Luther King
Jr, a black man, was violently murdered with a Remington 760 Game Master Chambered
Rifle because of the color of his skin. Days after she performed at the second inauguration of
President Barack Obama, 15-year-old Hydiya Pendleton, an honors student at King College
Prep, was tragically shot and murdered by gunfire blocks away from President Obama’s
family’s Chicago home. President Obama avowed that more youth have been killed by guns
on the streets of Chicago than men and women, at that date, had been killed in war torn
Afghanistan. According to law enforcement officials, the majority of the gun violence occurs
in urban African American and Latino neighborhoods.
Many youth in Chicago vowed to wear the color orange because they said hunters
wear orange so that they will not be shot when they are hunting for wild animals in the
woods. Within the context of the semiotic meaning of gun violence against urban African
American and Latino youth, youth of color in Chicago are tired of being targets of gun
violence because of their social location. Like Ernest Hendon, the last survivor of the U.S.
Public Health Service’s “Tuskegee Study of Untreated Syphilis in the Negro Male,” youth
in Chicago and across the U.S. are treated like “nobodys.” Guns are not seen as a public
health threat in the United States. Oftentimes more national public policymakers become
Plenary Addresses
30 Volume IV, No. 1, 2014 Journal of Healthcare, Science and the Humanities
concerned about gun violence only when shootings occur in predominantly white suburban
schools and or colleges and universities and communities.
When we reflect on the public health repercussions of the syphilis studies in
Tuskegee, Macon County, Alabama and Guatemala; the scientific evidence that cancer rates
and disparities for Native Americans are higher than for other Americans; and that Native
Americans are 500% more likely to die from tuberculosis; we must not forget the tragic death
toll of black and brown youth caused by guns. The time has come to begin an intersecting
dialogue in the public sphere that transcends negative cultural, academic, business, health
and media stereotypes; to intentionally write and implement a proactive public health justice
covenant that holds every discipline, including religion, accountable; and to practice an ethical
public healthcare justice which benefits every member of humanity. No child, youth, woman,
man, impoverished person or community was created to live as victims of “Medical Apartheid.”
“Why are We Here? The Communal Bad Blood of Mistrust is still on Our Hands.”
Plenary Addresses
Journal of Healthcare, Science and the Humanities Volume IV, No. 1, 2014 31
For Further Reading
Brandon, D T., Isaac, L A., and LaVeist, T. A. (2005). “The Legacy of Tuskegee and Trust in
Medical Care: Is Tuskegee Responsible for Race Differences in Mistrust of Medical
Care?.” Journal of the National Medical Association. Retrieved 1, March, 2013 from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569322/
Herman, E. S. & Chomsky, N. (1988). Manufacturing Consent: The Political Economy of the
Mass Media. New York: Pantheon Books.
Hunt, D. M. (2005). Channeling Blackness: Studies on Television and Race in America. Oxford
Univ Press.
Isai-Diaz, Ada Maria. (1996) Mujerista Theology: A Theology for the Twenty-First Century.
Maryknoll, NY: Orbis Books.
Jones, J. H. (1992). Bad Blood: The Tuskegee Syphilis Experiment. New York: The Free Press.
Jones, S. & Lakeland Paul eds. (2005). Constructive Theology: A Contemporary Approach to
Classical Themes. Minneapolis: Fortress Press.
Katz, R.V. & Warren, R.C. (Ed.) (2011). The Search for the Legacy of the USPHS Syphilis
Study at Tuskegee. Lanham, Maryland: Lexington Books.
Montagu, A. (1997). Man’s Most Dangerous Myth: The Fallacy of Race (1st ed.) Oxford
AltraMira Press.
Reverby, S. M. (2009). Examining Tuskegee: The Infamous Syphilis Study and Its Legacy.
The University of North Carolina Press.
Townes, E. M. (1997). “The Doctor Ain’t Taking No Sticks: Race and Medicine in the
African American Community,” Embracing the Spirit Womanist Perspectives on Hope
Salivation and Transformation, (179-196). New York: Orbis Books.
Washington, H. A. (2008). Medical Apartheid: The Dark History of Medical Experimentation
on Black Americans from Colonial Times to the Present. New York: Doubleday.

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