Medical Apartheid: Research Ethics and Reviewing Ethics

For those who missed it, the recent widely praised (and I think important) book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, was trashed in a review in the New York Times Book Review. The critic, Ezekiel Emanuel, chairman of bioethics at NIH, dismissed many of Washington's claims, arguing that blacks have not been disproportionately subjected to unethical medical experimentation, accusing her of factual inaccuracies, and more.

I often write about race and medicine, so I know that not long ago, Emanuel published a seriously criticized study concluding that there is no gap between the willingness of blacks and whites to participate in research studies, despite many studies saying otherwise. Because of that, I was surprised to see his byline on this review (seems like a no-brainer that a man who doesn't believe blacks distrust medical research might not be the best critic for a book about why blacks' distrust of medical research). And in fact, at points the review reads like it's arguing less against the book, and more against everyone who believes blacks have been unduly subjected to science. (Disclosure: I once interviewed Harriet Washintgon as a source)

Now a very lively debate in this Sunday's NYTBR letters to the editor section -- which includes a detailed response from the author, and a counter-response from Emanuel -- has opened this up to the public. Two letters suggest that Emanuel's research on race and medicine may not be the only reason to question whether he was the right critic for this book, or whether he came to it with an agenda, though he argues otherwise. Should be interesting to see how this one plays out.