African American Bioethics: Culture, Race, and Identity (review)

At first glance at the cover of Lawrence Prograis, Jr., MD, and Edmund D. Pellegrino, MD’s African American Bioethics: Culture, Race and Identity, I was struck by the rather overt picture of a black hand, palm faced forward. The words, in black—“African American Bioethics”—were stamped into the palm of that hand, and at a closer look, even the savvy observer would notice that the hand was a left hand, with opposable thumb to the left. The sub-text, written in white and quite off-centered toward the bottom-right, cascaded from the top-down the words in smaller print: “Culture, Race, and Identity.” This image of a weathered black hand grabbing as it were the reader’s attention is commensurate with the book’s overt topic at hand: the position of the African-American experience in relation to the field of medical ethics, specifically its practice toward the African-American community.

Prograis and Pellegrino introduce and deliver an answer to their seminal inquest: Is there a distinctive African American Bioethics? As combined editors and contributors themselves, both Prograis and Pellegrino tackle this question admirably in their work African American Bioethics: Culture, Race, and Identity. Moreover, they are not alone. Armed with the distinct voices of medical practitioners, philosophers, researchers, and ethicists, this volume analyses the collective subjects of the work’s subtext: Culture, Race, and Identity.

The work features ten sections, of which an “Introduction” by Pellegrino and an “Afterword” by Prograis frame eight rather meaty selections within 169 pages of text. These chapters range from the philosophical offerings of Jorge L. A. Garcia’s “Revisiting African American Perspectives on Biomedical Ethics: Distinctiveness and Other Questions,” to the personal narrative of medical practitioner and forensic psychiatrist Ezra E. H. Griffith’s “Personal Narrative and an African American Perspective on Medical Ethics,” as well as the hard-hitting semantic examination of race by oncologist Kevin FitzGerald and geneticist Charmaine Royal’s “Race, Genetics, and Ethics.” Threaded throughout the text is a constant reminder of what’s at stake: health decisions based on race and the implications of those decisions for both African Americans and other non-dominant groups. In other words, the essays focus on the science and philosophy of genetics and race, including the intersections of the two as well as historical case studies, which help narrate the difficult decisions that often arise from such bioengineering. One such example concerns the BiDil trials as discussed in detail by Kevin FitzGerald and Charmaine Royal in the final chapter: “Race, Genetics, and Ethics.” Moreover, a moral response is also privileged once such decisions to treat are met. Still, the collective point in this particular chapter is to administer a better healthcare practice, not necessarily a better drug.

For the non-specialist reading African American Bioethics, there is still much to digest, specifically the exciting, historical considerations of the bioethical movement itself. For instance, Pellegrino, in a section entitled “Evolution of Bioethics,” offers a brief overview of the modern concept of bioethics. His assertion that, “Modern bioethics is barely thirty-five years old,” and that, “It grew out of a 2,500—year tradition of medical ethics,” makes the subject an intriguing one (x). Moreover, Pellegrino echoes the work of Tony Hope’s Medical Ethics: A Very Short Introduction (Oxford University Press, 2004), wherein the very work of medical ethics “will appeal to many temperaments: to the thinker and to the doer; to the philosopher and to the woman or man of action” (1). What has emerged from the medical ethics field and subsequent bioethics field, then, are two major camps: the moral philosopher and the social scientist. Pellegrino defines and defends each throughout the book, and gives no real indication as to which one group or which particular camp is tipping the scale of best health practice. In short, both are needed. Moreover, it is within this sphere, however, of ethical consideration toward an African-American bio-context, that this book has emerged...