Slavery and Injustice in Medical Journals

Doctors get a majority of information from reliable medical journals. We scan the contents of each publication and take note of the articles that are pertinent to our practice. The leading article in the most recent publication of New England Journal of Medicine (NEJM, a respected publisher of medical knowledge for two centuries) snagged my attention like a dog spotting a squirrel. The title: Slavery and the Journal – Reckoning with History and Complicity (by historians Jones et al, vol 389;23. Dec 7, 2023) This captivating article recognizes that NEJM has played a role as a “prominent forum where physicians perpetuated race hierarchies before and after the Civil War” and published articles that referred to enslaved people in “dehumanizing ways.”

The article is rife with references from prior publications promoting the justification of slavery and demeaning attitude toward Blacks. A particularly egregious example was an account of a violent attack in 1856 by South Carolina Representative Preston Brooks on Massachusetts Senator Charles Sumner. Sumner, an abolitionist, had given an impassioned speech criticizing slaveholders. Two days later Preston beat him mercilessly with a cane, nearly killing him. This heinous act occurred in the United States Senate chamber. NEJM account “described Sumner’s injuries in exquisite detail but said nothing about what prompted the assault.” (This incident highlighted the intolerance of opposing sides regarding slavery and the inevitable violence that ensued leading to the Civil War.)

NEJM realizes that any current discussion of slavery is complicated by the prevailing attitudes of the time, but it takes responsibility for being complicit in spreading unsubstantiated racist claims, such as the concept that giving freedom to formerly enslaved people could cause mental illness. Ideas like these that support the underlying narrative of those in power are difficult to retract. Progress has been gradual, but purposeful. For instance, increased awareness of unethical treatment of minorities in the last century led to the establishment of safety nets such as Institutional Review Boards that oversee research with attention to Respect for Persons, Beneficence, and Justice.

Enslaved Africans were first brought to Virginia in 1619. The US abolished slavery in 1865, about 250 years later. The African race has known slavery on this soil for significantly longer than they have known freedom. True equality is still being sought. Progress is excruciatingly slow when embedded with deep, albeit erroneous, beliefs that are supported by trusted institutions such as published peer-reviewed medical knowledge. Over the past century, though, humans have developed tools based on logic that we can trust to help us improve as a species. Transparency tells us where we were. Vision lets us see where we want to be. Logic gets us there.

Kudos to NEJM for opening this discourse and allowing us to move forward by defining the errors of the past. The evolutionary process is sometimes sluggish, but it is persistent. Progress is facilitated when people who have enjoyed empowerment are willing to look at things through an enlightened and compassionate lens. We all benefit as we evolve together. Logic points us in the right direction.