Ethics and Racism

Statement by the Faculty and Staff
of the University of Miami Institute for Bioethics and Health Policy.

America's current and collective torrent of grief and anger over the murder of George Floyd and others is an expression of dismay that something so clearly wrong could be so clearly displayed, no less by peace officers. The wrong of racism is not ethically interesting. There are no moral puzzles, no dilemmas, no pro-con debates – racism is wrong and ugly and beneath us. Racism undermines civil society itself. 

This is what we have learned:

• Racism is baked into our country and our culture. Health professionals have long recognized that social determinants of disease are systemic. Translation: poverty and geography make Black people, Brown people, poor people and Hispanics sick and make them die younger.
  

• As we tried to support our intensive care clinicians by providing guidelines for rationing in a pandemic, we ran into social determinants as yet another impediment to fair allocation. How do you share a scarce resource based on predictions of mortality when mortality itself is shaped by society? Expressions of anger, disgust and even optimism are, well, expressions. They are inadequate to the task. Something more is needed.

• Many institutions and organizations are moved to articulate and sometimes to shout this cri du coeur or cry of the heart. We declare the obvious: racism is wrong, and we’re against it. We document our anti-racist bona fides and affirm that Black lives matter. Now what?

This is a university, and we are teachers. Let’s start there. Even the ethics community – which cut its teeth on the Tuskegee study and the smug evil of allowing Black sharecroppers’ disease go untreated for 40 years – has its work cut out for it. Here are some tools:

• Association of Bioethics Program Directors statement
• Medical Rhetoric Standing Group
• American Journal of Bioethics
• PubMed search on “racism and science” and “racism and medicine”
• Black Lives Matter Syllabus
• American Philosophical Association Diversity and Inclusiveness Syllabus Collection
• The Miami Foundation Racial Equity Fund
  

The University of Miami, like others, has a checkered past when it comes to confronting racism. At our best, however, we were recognized with the American Association of Medical Colleges’ first award for Outstanding Community Service; we spent years with NIH support trying to reduce the underrepresentation of minorities in science; and we have long struggled to improve minority communities’ access to higher education, including post-graduate professional education, and to support the retention of minority students. See also President Julio Frenk's message after the death of George Floyd, and Dean Henri Ford's town hall.

UM has an opportunity to do more and, indeed, lead others. Our Ethics Programs and Institute for Bioethics and Health Policy condemn racism and police brutality. That’s the easy part. Now we need to put our shoulders to the wheel of American society and, through education and wise advocacy, ensure it honors the values and the promise of equal opportunity and treatment. This – not mere declarations, no matter how heart-felt – is what morality and ethics require.

FACULTY

Jeffrey P. Brosco, MD, PhD
Professor of Clinical Pediatrics, University of Miami
Associate Director, Mailman Center for Child Development
Faculty Education Development Director, Dept. of Pediatrics
Director, Population Health Ethics, Institute for Bioethics and Health Policy
Chair, Pediatric Bioethics Committee, Holtz Children’s Hospital, Jackson Health System

Thomas H. Champney, PhD
Professor, Department of Cell Biology
RCR Consultant, Institute for Bioethics and Health Policy

Kenneth W. Goodman, PhD, FACMI, FACE
Professor and Director, Institute for Bioethics and Health Policy
Co-Director, UM Ethics Programs
Chair, Ethics Committee, University of Miami Hospitals and Clinics
Chair, Adult Ethics Committee, Jackson Health System

Sergio G. Litewka, MD, MPH
Associate Professor of Surgery
Director, International Initiatives, Institute for Bioethics and Health Policy

Stephen E. Olvey, MD
Associate Professor of Neurology
Clinical Ethics Consultant, Institute for Bioethics and Health Policy

Raul E. de Velasco, MD
Associate Professor of Medicine, Institute for Bioethics and Health Policy

ADMINISTRATION 

Ana Bezanilla
Director, Research Support, Institute for Bioethics and Health Policy

Esther Galguera
Senior Administrative Assistant, Institute for Bioethics and Health Policy

June 2020