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Black Bioethics: Racism, Police Brutality, and Black Health — Transcript

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0:00a little bit more time
0:05well good afternoon everyone i'm kahan
0:07parsi and i'm an associate editor for
0:09the american journal of bioethics and a
0:11professor of bioethics
0:12at the knights wenger institute for
0:13bioethics at loyola university of
0:14chicago
0:15it's your school of medicine i wanted to
0:18welcome you
0:19all to the first ever a job webinar
0:22the title of today's webinar is black
0:23bioethics racism police brutality
0:26and what it means for black health we're
0:28fortunate to have an amazing panel
0:30to discuss today's topic a job and
0:33biothic.net is dedicated to exploring a
0:35variety of issues in the field of
0:36bioethics
0:37the idea behind today's webinar
0:39originated with our editor-in-chief
0:40david magnus who wrote a blog
0:42on police brutality his piece is listed
0:45among many other valuable
0:47resources in a toolkit on bioethics and
0:49race that craig klugman and keisha ray
0:51developed for bioethics.net
0:53i encourage you all to visit our site i
0:56also want to acknowledge the efforts of
0:58bella fishbein
0:59who is our executive editor of a job and
1:00megan sedanovic
1:02who is the interim executive editor as
1:04well as dr ray
1:05in planning and promoting today's
1:07webinar the recording will be posted on
1:10bioethics.net
1:12now i'd just like to introduce our
1:13panelists
1:16first of all we have dr kisha rari kisha
1:20ray phd received her phd in philosophy
1:22from the university of utah and is
1:24currently an assistant professor with
1:26the mcgovern center for humanities and
1:27ethics at the university of texas health
1:28science center at houston
1:30most of dr rey's work focuses on the
1:32social determinants of racial
1:33disparities in health and health care
1:35and incorporating race education into
1:37medical school curricula
1:39she's contributed to peer-reviewed
1:41journals edited volumes and textbooks
1:43and currently has two monographs in
1:45progress on racial disparities in health
1:47dr wray serves as associate editor of
1:49the american journal of bioethics blog
1:51site
1:51to which he's a regular contributor next
1:54we have patrick smith
1:55mdiv phd who is an associate research
1:58professor of theological ethics and
2:00bioethics
2:01as well as senior fellow keenan
2:02institute for ethics at duke university
2:05trained as a philosopher his area focus
2:07is in theological ethics
2:09and bioethics professor smith is also
2:11associate faculty with the
2:12trent center for bioethics humanities
2:15and history of medicine
2:16at duke university school of medicine he
2:19has specific academic interests in the
2:20relationship of bioethics
2:22and social ethics and the next we have
2:25rakai yearby jd mph
2:27she's a professor of law executive
2:29director and co-founder
2:31of the institute for healing justice and
2:33equity at st
2:34louis university preside is a specialist
2:37in racial disparities in health care the
2:39impact of employment on health
2:41and social justice and medical research
2:44due to her expertise in justice and
2:46medical research
2:47she presented her work at the 2016 at
2:50the oxford
2:50global health and bioethics
2:51international conference in oxford
2:53england
2:54she's dedicated her career to improving
2:56the lives of vulnerable populations by
2:58addressing the lack
2:59of equal access to quality health care
3:02and then finally we have dr ryan
3:04williams brian williams md
3:06is an associate professor of trauma and
3:08acute care surgery at the university of
3:09chicago
3:11dr williams led the trauma team that
3:12treated police officers ambushed by a
3:14sniper
3:15on july 7 2016. the largest loss of life
3:19for u.s law enforcement since 9 11.
3:22recognizing his many community
3:23contributions
3:24dallas mayor rawlings appointed him in
3:262017 as chair
3:28of the dallas citizens police review
3:30board in addition to being an academic
3:32surgeon dr williams is a renowned
3:34keynote speaker
3:35a guest opinion writer featured in the
3:37chicago tribune and dallas morning news
3:39and hosts the podcast race violence and
3:42medicine
3:43so welcome everyone and i'm delighted to
3:46have you all
3:46join us today for this first ever
3:48webinar and
3:50i just wanted to start off with this um
3:53question it it may be hard to believe
3:55but as of today july 14th
3:58it's been exactly 50 days since
4:01uh derek chauvin a white minneapolis
4:03police officer killed george floyd
4:05so i just wanted you all to kind of
4:07reflect on what's happened in these past
4:0850 days
4:10what surprised you what's disappointing
4:12what's encouraged you and i'll
4:13start off with dr ray um thanks kayden
4:17um i will say what i'm most
4:20uh surprised by and encouraged by is
4:24the the just how all-encompassing
4:27um the black lives matter movement has
4:28been the conversations that people are
4:31having about
4:32black lives beyond police brutality
4:35right i'm really really glad that we're
4:36starting to have these conversations
4:38about
4:39what police systems what police
4:41brutality
4:42um what it means for black people
4:44specifically what it means for black
4:46health specifically
4:47um but i'm glad that people are having
4:49these conversations about
4:51racism and white supremacy and their
4:54far-reaching effects
4:55outside of police systems right um
4:58if you're like me you've probably gotten
5:00an email saying we support black lives
5:02matter from
5:03any company that you've probably ever
5:05bought anything from
5:06from shoes to sofas or you know whatever
5:09um
5:10and so you're starting to see that it's
5:11sort of reaching these other places
5:14um and other than not just businesses
5:16but i'm really glad
5:17these conversations are happening in
5:19health because health and well-being
5:21uh as you know are just so essential to
5:23us and so i'm glad that these
5:25conversations about racism white
5:27supremacy is really
5:29extending into health care and we're
5:30asking these questions about
5:32what does it mean when we systematically
5:34withhold
5:35health and well-being from black people
5:37what does it mean for their life what
5:38does it mean for
5:39the future generations for their
5:41children and their families
5:42um and so i'm really excited and i feel
5:45really
5:46really rejuvenated by the fact that
5:48these conversations are not just about
5:49police brutality
5:51but are about uh racial disparities in
5:53health care racial disparities in
5:55business
5:55racial disparities in tv and media
5:58um so i've been i've been really
6:00encouraged by that um i will say though
6:03uh speaking back to all these emails
6:05that we've all received from various
6:06companies
6:07i'm i'm a little disappointed that we
6:09haven't seen these sort of plans for
6:11action right
6:11you see the emails and they say you know
6:13we care about black lives
6:15and what i want to know is okay now what
6:17is the plan show me
6:18that you care about black lives don't
6:20just say it what is your plan of action
6:22show us that you care about your
6:24customers and your employees
6:26um that are black show us what your plan
6:28of action is show us the racial makeup
6:30of your
6:31board of directors show us what you're
6:33doing to
6:34uplift black voices and to put them into
6:36positions of power and to dismantle
6:38white suprema's
6:39structures that keep black people out of
6:42various enterprises like healthcare
6:44business media banking housing um
6:47government
6:48so i i want to see more of the plan of
6:50action you know what what are we
6:51actually going to do
6:54thank you uh dr smith any additional
6:57thoughts about that
6:59yeah i just i stand in many respects
7:02with
7:03dr ray's comments and reflections on
7:06this score and
7:07i have been very pleased and surprised
7:09to see
7:10the widespread response from a number of
7:13different groups
7:14in this situation that did not seem to
7:16be present with some earlier incidents
7:19that gained national attention it's
7:22unfortunate that it takes
7:24situations like this to raise attention
7:27to these issues that many have been
7:29sounding off on
7:30for decades in many respects come from a
7:33particular tradition
7:34uh that says you know you continue to
7:37bear witness against the odds right that
7:39which you think is
7:40uh correct that what you see is true
7:42that what you see is where i
7:43continue to bear witness to that and so
7:46i am i think encouraged
7:48uh to see a kind of response after
7:51years of many people laying their bodies
7:54on the line their well-being on the line
7:56to bear witness to some very important
7:58issues that our country has to
8:00wrestle with and reckon
8:05professor your be any thoughts from your
8:06perspective as a law professor and a
8:08legal scholar yes so i would say
8:12that um i find it positive that
8:15uh in response to a lot of the protests
8:18that you see county cities
8:21school boards passing either
8:24proclamation
8:26or laws that say racism
8:30is a public health crisis um there was
8:33only about two of those prior to this
8:35incident and actually prior to covet 19
8:38and every day now you see people
8:40discussing this
8:41and really moving forward um i think the
8:44problem for me
8:45however goes back to something that dr
8:48ray said which is
8:49plans lots of companies have said that
8:52they are
8:53supporting racial equity uh but i
8:56haven't seen them come forward and say
8:59we're going to post our wage data to
9:01ensure
9:02that racial and ethnic minorities that
9:05women
9:06are paid the same as others when we look
9:08at england they have
9:10already made that data publicly
9:12available
9:13based on gender and race and we have not
9:15done that
9:16actually corporations continue to fight
9:18and the government has decided not to
9:20collect this information
9:22and so i think that is very important if
9:25we're going to say that we're going to
9:27address uh racial disparities around
9:31income inequality um i would finally
9:34say for me in terms of the legal system
9:38um that i would hope that we would make
9:40changes to the legal system i think
9:42oftentimes we look at
9:44policing as something separate from the
9:47problems the inherent
9:50hierarchy and structural racism and
9:52discrimination that is a part of the
9:54legal system
9:55and we really haven't begun to talk
9:57about those issues about
9:59why are we policing people in this way
10:02why are there crimes that we're
10:05enforcing
10:06in a way that leads to somebody's death
10:09um so i'll stop there but i think
10:11we have more to do and what i hope is
10:14that
10:15if we are going to move forward to
10:17change that it actually
10:19actually results in some structural
10:21change particularly around
10:23employment wages and how our legal
10:26system
10:27treats people who are poor black
10:30latino native american and women
10:34and all the other vulnerable groups
10:38dr williams what are your reflections
10:40over the last 50 days as a
10:42trauma surgeon i'm very encouraged
10:46uh by the breadth of the voices that are
10:49speaking out now particularly as a
10:51healthcare professional and seeing how
10:54this has
10:55pushed the discussion about what uh it
10:57means as far as medical education and
10:59talking about the legacy of racism in
11:01this country
11:02and in our education and seeing how
11:04healthcare intersects with so
11:06many other segments of our society and
11:09what that means for us as professionals
11:10and how we
11:11can become advocates and activists to
11:14improve the society for all outside of
11:17our trained
11:18specialties so to see that energy to see
11:21that discussion happening
11:23it's encouraging and i actually feel the
11:25energy
11:27but also you know i'm holding back
11:29because it's really easy
11:31for us to you know raise our fists
11:34in march we're in a crowd but to be the
11:37one that's out front
11:38and leading that change that takes a
11:40another level of courage
11:42and that's what i want to see happen is
11:44that we continue to push this
11:45and not let this energy wane uh as the
11:48weeks and months
11:49pass so
11:52the next couple questions i want to
11:54combine because i think they're they're
11:56linked so one is why is police violence
11:59even a bioethics issue because
12:02people that come from traditional
12:03bioethics may not even see this as a
12:04biotic issue and then
12:06how does modern day policing affect the
12:07health of black individuals in this
12:09country specifically so
12:11press dr ray you want to take a stab at
12:14that one
12:15yeah yeah so um first i'll talk about um
12:18i guess
12:19why is it a bioethics issue um as
12:21someone
12:23who from the very beginning of my
12:25bioethics career work has been
12:27questioned
12:28as a whether it's a legitimate topic of
12:31bioethics i've been really thinking
12:34about this question a lot as i
12:36have conversations with fellow bioethics
12:38friends and you know
12:39we're thinking through these topics and
12:41what can we do as a profession
12:43um we you know we all know that
12:45bioethics is a very principleist
12:47um discipline right we have these
12:49principles that we follow and one of
12:50those
12:51is justice another one is respect for
12:54persons and i think
12:56it also um in some direct and indirect
12:59ways is also about um upholding or
13:03uplifting the value of humanity and you
13:05know we all have different approaches to
13:07these topics but
13:08i think we can all agree that that's at
13:10least something that we focus on
13:12and any threat to dignity and humanity
13:15of people any threat to justice
13:17any threat to respect for persons ought
13:20to be something
13:21that we um condemn something that we
13:23study something that we research and
13:25something that we
13:26um work against or something that we
13:28work to dismantle and so
13:30police brutality um is an antithesis to
13:33all those things respect for life
13:35respect for persons
13:36um and justice and so i think that when
13:39we're
13:40when we're confronted with these threats
13:42to humanity
13:43particularly when it's due uh uh for
13:45certain groups
13:46that should encourage us even more to be
13:49outspoken to take these stances against
13:51these topics
13:52i mean against these happenings um and
13:54to to become advocates and i think
13:57advocacy is a big part of bioethics so i
13:59think talks like this
14:01um in committing actual plans of action
14:03is something that by what this is
14:05should be a part of um and also if
14:08bioethics is about the health of humans
14:11um police brutality is a direct threat
14:13to the health of individuals who
14:15experience it
14:16the people who watch it the the videos
14:18on social media
14:20it's also a threat to future generations
14:22of black people right
14:24we have this thing research is called
14:26racial hyper vigilance right
14:28where black people other people of color
14:30are always aware of their race and
14:32always aware
14:33of how other people interact with them
14:36because of their rapes whether that's
14:37being followed around in a store because
14:40of their race or
14:41whether that's being denied a loan a
14:43home loan application because of their
14:45raise
14:45and so this ratio hyper vigilance is not
14:48good for our
14:49social health our psychological health
14:51or our biological health right to
14:53be under constant racial stress
14:56and so i think racial hyper vigilance is
14:59something that we really have to think
15:00about
15:01as this connection between police
15:03brutality
15:04um unjust systems and black health it's
15:07it's
15:08again it's not that race is makes a
15:10person
15:11um have poor health it's the effects of
15:13race it's racism
15:14and so i think police brutality is a
15:16part of that system
15:17of racism that makes it bad for black to
15:20be bad for health
15:23you know i've written that bioethics has
15:25been kind of a johnny come lately to the
15:26issue of bioethics
15:28and i've pointed to other fields such as
15:29public health and perhaps professor
15:31you can talk to this do you think other
15:32fields of public health have done
15:35a more effective job of addressing
15:37issues such as race especially systemic
15:38racism and that
15:40bioethics is kind of catching up or what
15:41what can biologists learn from other
15:43disciplines with regards to this issue
15:47i would say that uh speaking quite
15:49frankly
15:50from a law perspective and public health
15:53that
15:53none has done a great job of really
15:56centering racism and structural racism
16:00and linking it to differential outcomes
16:03for
16:03people when i say structural racism i
16:07mean the ways that our systems
16:09have been structured to produce
16:11differential conditions between whites
16:13and racial and ethnic minorities and it
16:15could be structural discrimination
16:16right that includes women disabled
16:20all the poor and public health
16:23we mention the social determinants of
16:25health but we do not
16:27ground it back into the root causes we
16:29talk about that there are differential
16:31conditions we might talk about
16:33residential civic
16:34segregation or other areas but we don't
16:38bring it back
16:38to the structures um to discussing how
16:42the structures are set up to
16:44disadvantage people
16:45and so that causes a lot of stress as dr
16:48ray mentioned right because you're hyper
16:51vigilant
16:52you're always worried about racism
16:54impacting you
16:56but then you also blame yourselves i
16:59think that when we look at copic 19
17:01you can see this playing out quite
17:03clearly
17:04in the sense that you know we began to
17:07talk about that there are racial and
17:09ethnic disparities in covet 19
17:11infections and deaths and here you have
17:14public health officials beginning to
17:16blame
17:17african americans and latinos for
17:19actually suffering
17:21and i think you can see this in the
17:22legal system as well that we often blame
17:25the victims
17:26and not hold the perpetrators
17:28accountable and so yes
17:30racism has been discussed in the law it
17:32has been discussed in public health
17:35but it's never grounded in a sense of we
17:38need to change the structures that
17:40actually
17:41produce these outcomes and so what can
17:44bioethics learn
17:45is that when we begin to talk about ways
17:48that we need uh to inform justice
17:52discussion
17:53respect for persons that we need to
17:55ground it and these are structures that
17:58we need to change
17:59and not blame people who are victims
18:02of it and really begin to talk about how
18:05do we change these structures
18:07to accomplish just justice equity and
18:10fairness
18:12so dr smith what are your thoughts do
18:14you what what can biologics bring to the
18:16table
18:17with this kind of issue with regards to
18:19police violence structural racism
18:22these kind of systemic issues yeah i
18:25think
18:26that uh some of my work has really been
18:28interested in bringing together some of
18:30the values the virtues the insights
18:32from social ethics in general religious
18:34social ethics in particular
18:36to these questions of bioethics uh
18:39colleague dr galerno from harvard
18:42medical school she's written a lot about
18:44communities right important communities
18:45and the bifurcation
18:47uh that we have sometimes between
18:48clinical ethics and public health ethics
18:50well
18:50many of us recognize that in some ways
18:53that could be a
18:54bit of a false dichotomy yes there are
18:56insights with regard to each of those
18:58that need to be
18:59uplifted in some ways but we have to
19:01recognize that people are interconnected
19:03and interdependent
19:05in such deeply intricate ways that
19:08we have to be careful that our ethical
19:10frameworks don't create a kind of
19:12artificiality that does not reflect the
19:14embodied
19:15material experiences of human beings and
19:17so this is where
19:19many uh traditions and ethical
19:22other ethical approaches have tried to
19:24start from below so to speak to look at
19:26the live material conditions of where
19:28people are
19:29have a particular kind of vision of
19:30where we need to be and where we want to
19:32go
19:32and then try to recognize the means that
19:35can help us
19:36best accomplish uh those given ends and
19:40so
19:40these notions of solidarity as dr reyes
19:42said earlier
19:43uh how do we think about you know
19:45questions of human dignity
19:46uh the role of justice i think
19:48recapturing the virtue of the
19:51love as a political virgin right not in
19:53some type of squishy sentimental
19:55this understanding of that but as a is a
19:58human political virtue that's connected
20:00deeply
20:01uh to this notion of justice so we think
20:04about police violence and the stress
20:07that it causes on certain communities
20:09when they have encounters with other
20:11individuals
20:12becomes really important uh we think
20:14about at times some of our hospitals
20:17they have uh police officers who are in
20:20those spaces
20:21who have their uniform have their guns
20:24and there may be good reasons for
20:25is you know for that presence but what
20:28does that
20:29suggest when you have people from
20:30different communities coming
20:32into these spaces that already have uh
20:34sorted history sometimes with healthcare
20:37and maybe even with law enforcement in
20:39some ways and all of these things come
20:41together
20:41and so the last point i would just make
20:43is i do think there is this
20:45reason why uh these issues come together
20:47because
20:48it's the same i would say underlying uh
20:51social pathology
20:52uh that permeates all of this right and
20:54it's this whole idea of the racialized
20:55imagination
20:56right reality is that if we live in the
20:59united states
21:00we have all been racialized whether we
21:02like it or not right
21:03uh we have all been identified in
21:05particular ways
21:07uh with particular uh perceived social
21:09hierarchies
21:10it uh informs how we view each other how
21:13we
21:14include each other how we exclude each
21:15other how we shape our
21:17social arrangements right so there's no
21:20way that we can avoid the fact
21:21that we have all been racialized which
21:24gives rise to this notion of a
21:25racialized imagination
21:27uh that puts certain groups at the
21:30top of the kind of social hierarchy in
21:33particular ways
21:34and so i do think the racialized
21:36imagination continues to rear its head
21:38even when we deal with the symptoms of
21:41it
21:41in certain respects it continues to
21:43re-emerge and evolve in different ways
21:46because we haven't i think
21:47uh rooted out this notion of racialized
21:49imagination
21:50such that bioethics i think uh thinking
21:53about police violence and the negative
21:55health outcomes that that has
21:57on people and communities of color if we
22:00wrestle with these issues perhaps we can
22:02make even more progress
22:03in some of these discussions um dr
22:06williams i wanted to address the next
22:08couple questions you because of your
22:09experience in dallas with the police
22:11board um
22:13so these two questions again i'm going
22:14to group together so we often hear
22:17in the popular press that officers like
22:19um derek children are bad apples
22:22and we hear repeatedly that kind of
22:24trope of the the bad apple theory
22:26um even though that we know that
22:27systemic racism permeates
22:29a number of our institutions including
22:31the police and
22:32seth stotten who's a former police
22:34officer and
22:35a law professor at the university of
22:36south carolina he said something
22:38recently
22:39he said we don't have a race issue in
22:40policing we have a race issue in society
22:42that gets reflected enough and magnified
22:44on police encounters and i was wondering
22:45what your thoughts are in response to
22:47uh professor starting's view on policing
22:50and perhaps bringing in some of your
22:51experience on the dallas police board
22:54yeah so i'll impact the professor's
22:57statement and
22:58you're correct i'm coming at this
23:00through the lens of
23:01a trauma surgeon a doctor and all the
23:05ethical obligations i have to my
23:07patients
23:07but also as the chairman of the board
23:09our former chairman
23:11the what i learned interacting with
23:13police officers particularly command
23:15level police officers who also have an
23:17official obligation
23:18to their communities and
23:22what binds us both is that as a doctor
23:25and as
23:26launch person we have a certain degree
23:27of power over
23:29individuals who are either less educated
23:31than us you know they come to us and
23:33they're sick
23:33they expect me to help them as a law
23:36enforcement officer
23:37you have the backing of the law and the
23:40state to execute
23:41certain certain duties so there are
23:44vulnerable communities
23:45because of those two because of that
23:47reality and
23:49ethically we have an obligation to you
23:52know to serve humanity
23:54somehow and i criticize health care for
23:57its systemic racism
23:58and the legacy of racism within
24:00healthcare particularly exploitation of
24:04racial and ethnic minorities throughout
24:06the history of medicine
24:07uh but we also talk about policing as
24:09well and recognize that
24:12police departments have existed for a
24:14lot purchase this country for large
24:16second in this country in order to
24:17contain and restrict racial and ethnic
24:20minority groups
24:21not necessarily uplift those groups
24:24right and that is the history
24:26and once we address that we can talk
24:28about progress moving forward
24:29the same way we're having a discussion
24:31in healthcare now about how healthcare
24:33has its own issues with systemic racism
24:36and implicit blindness
24:38you can acknowledge the history you can
24:40still be supportive of
24:41the police you can back the blue and
24:43still criticize to talk about what can
24:46be
24:46improved and when it comes down to
24:48ethics
24:49you know this is about our shared
24:50humanity and that is something we need
24:52to address to move forward
24:56i'm glad you brought up history because
24:58i feel like
25:00we treat these issues ahistorically
25:02whether
25:03it's policy level or
25:06whether it's within our own fields and
25:11my next question deals with this issue
25:13and i'm glad you brought it up that
25:14you know scholars such as uh khalid
25:16muhammad he was
25:18stated in a recent npr interview about
25:20the history of policing in this country
25:21and how is rooted in slave patrols
25:23um and he said that that was the
25:25dominant form of law enforcement for
25:27for many many years and a good part of
25:30of this country's history
25:32um so i'm just i just want to get your
25:35thoughts about this
25:36this history and how does the history
25:39inform
25:40where we are now with regards to not
25:43just policing but the systemic issues
25:45um i want to kind of go back to
25:48something that professor yerby mentioned
25:49about
25:50um segregation because it seems that
25:52that is a social determinant
25:54that over determined so much of our
25:56health in this country
25:57you know we've read that one zip code
26:00says a lot about your
26:01health status and so i was wondering if
26:03you all can kind of talk a little bit
26:05about
26:06the history of systemic racism but also
26:10how things like segregation contribute
26:13to
26:14what we see now with regards to issues
26:16of access to health care
26:19having law enforcement seen as an
26:21oppressive force as opposed to
26:24a group of professionals that serve the
26:26interests of humanity so
26:27um i'll throw it out there dr ray you
26:29want to take that
26:30um sure so i think um the one the part
26:34of your question
26:35sort of threefold um the one part that i
26:38want to make uh very clear
26:39is that um uh something that dr yerby
26:43said
26:43um about segregation and um
26:47what's really really important to think
26:48about the social determinants of health
26:50and the social influences
26:52on our health when we talk about
26:53segregation we also have to talk about
26:55um the nature of housing right other
26:58than race
26:58where we live like you said zip codes
27:00has so much influence
27:02on our health the safety of our
27:04neighborhoods
27:06if there's recreation areas in our
27:08neighborhoods
27:09if our neighborhoods provide adequate
27:12heating and cooling in our homes
27:14if we feel safe or we hyper vigilant
27:16because we're worried about crime
27:18and protecting our children in our home
27:20if there's access to
27:22pharmacies nearby into grocery stores
27:24that have
27:26good healthy food is there access to
27:29clean water and clean air is there
27:31a landfill nearby and a lot of what we
27:34find is that
27:35the kind of housing that we can expect
27:37to find in predominantly black
27:39neighborhoods
27:40is not conducive to good health so a lot
27:44in particular environmental injustices
27:46right we think about where landfills are
27:48built
27:49we think about um what areas have the
27:52most air pollutants and the most
27:53carcinogens
27:55it is neighborhoods predominantly
27:57populated by black people
27:59or near schools predominantly populated
28:01by black children
28:03so there's already this disparity that's
28:05happening in housing
28:06that then affects their health if you
28:08live in an area such as cancer alley in
28:11louisiana
28:12or in mississippi where they have five
28:14times the rates of cancer in their
28:15predominantly black neighborhoods
28:18you are going to see differences in
28:21cancer rates for black people right
28:23if you have um schools mostly populated
28:26by black children and they're near
28:29highways that have pollutions or they're
28:30near landfills
28:32and then we start talking about
28:33differences in uh
28:35asthma among black children particularly
28:37black boys
28:38you see this you see the connection you
28:40can't talk about
28:42black health and the disparities in
28:44black held if you don't start to talk
28:45about
28:46the history that put black people in
28:48certain neighborhoods or put black
28:50people
28:51living near pollutants so i'm glad that
28:53this conversation about police brutality
28:55has sort of opened up and expanded this
28:58conversation about social determinants
29:00of health
29:00um one because that's area i work in so
29:02i'm glad people are paying attention
29:04but also it's starting to open up this
29:05conversation about the historical
29:07connection like you said
29:08police force we can't talk about police
29:10brutality if we don't talk about the
29:12history of police and how history
29:14um tells us that police were never there
29:16to safeguard
29:18the the health or the um the freedom for
29:21black people that was not their
29:22intention
29:23the same thing with housing housing was
29:24never meant to make sure that black
29:26people lived in safe neighborhoods
29:28it was to keep black people out of white
29:30neighborhoods or out of the safe and
29:32wealthy neighborhoods
29:33so i'm really glad that you brought this
29:35historical dimension because
29:37we can't talk about where we are now
29:38with black health we don't all talk
29:40about
29:41um the origins mccain can i
29:44add to that yeah go ahead what she's
29:47saying like
29:48those were intentional policies there
29:50was no accident where all of these
29:51neighborhoods were placed
29:52and that persists to this day and the
29:54connection with policing
29:56i i think about five percent of all
29:59police calls or actually responses to
30:01violent crimes
30:02uh the majority of the work that they're
30:04doing is a response to these all these
30:06other social
30:06issues that they're being asked to
30:09address
30:10now imagine if we took the energy and
30:13money
30:14that was put into isolating uh black
30:17people
30:17brown people from the rest of society
30:20and made efforts to radically include
30:22them into mainstream society how they'll
30:23reduce all these issues that we're
30:25talking about in regards to inequity in
30:26health care
30:27and economic and opportunity and
30:29education and
30:30probably that will lead to a dramatic
30:32decrease in crime
30:33and less need for policing less police
30:36brutality
30:37it's not a utopian vision it seems to
30:40make absolute
30:41sense right so let's talk about doing
30:43that radical inclusion
30:44for groups that we've always excluded
30:46from society
30:48yeah uh that was uh interesting what you
30:50said that uh
30:51the structures that we've inherited are
30:53not by accident right they
30:55they were done intentionally created for
30:58specific purpose and and um
30:59i have my students read pathologies of
31:01power by paul farmer and he he has a
31:03quote in there that's something like
31:04something like you know uh what's the
31:06deficit of a liberal someone who thinks
31:07that all bad things happen because of
31:08accidents
31:09well he said you know that's that's not
31:12you know
31:12bad things happen because that was the
31:14intent you know the structures have
31:16created these bad effects so
31:18um so we can recreate the structures
31:20right
31:21these we will have that in our power um
31:24hey
31:24can i please jump in yeah i think this
31:27is so
31:28uh important with this historical
31:30connection just to underscore this point
31:31of
31:32housing right there's a long history
31:35about um how our social arrangements
31:37have come to be
31:38uh and a lot of people are sometimes
31:41surprised when they learn that ghettos
31:43just don't happen
31:44right as dr williams was saying uh you
31:46think about you know whether it be like
31:48the mexican
31:49um uh um repatriation
31:53uh you know responses or what was going
31:55on with native americans uh
31:57giving of being brought off of their
31:58lands trying to be assimilated into some
32:00of these urban environments you think
32:01about the great migration
32:03where uh black folks were fleeing racial
32:06terror uh to the north only to be uh
32:10confronted with laws right that said
32:12they can only
32:13live in certain areas and these were
32:15areas that were
32:16already impoverished with poor housing
32:19already established so black people in
32:22these situations were already
32:24poorer than their counterparts then they
32:27were relegated
32:28to these really dense dilapidated areas
32:30that needed
32:31um housing updated but they did not have
32:35the money to be able to afford those
32:37kinds of things then you see this kind
32:38of
32:39reinforcing effect that was taking place
32:41with respect to housing
32:42people can look and say see our
32:45neighborhoods our communities
32:46are better without these particular
32:49individuals being in it becomes another
32:51way of
32:52uh blaming those individuals for these
32:56conditions
32:56and these situations when these were
32:59kind of foisted upon them
33:00uh in the respects it's just a really
33:02insidious
33:04uh circle and cycle sometimes that uh
33:07often is represented by these kinds of
33:09issues and goes back again to this idea
33:11i think of the racialized imagination
33:12that is
33:13shot through this uh and when i was
33:15working uh in new england working with a
33:17community development
33:18um corporation uh dealing with bringing
33:21affordable housing to certain areas
33:22i continued to see this firsthand where
33:25people were so
33:26resistant to particular groups coming
33:28into their communities
33:29because even if they wouldn't utter it
33:32the idea was that we
33:34would be better without them being here
33:36is 2018
33:382016 2017. yes
33:42yeah please go ahead professor when we
33:44look at this how do we accomplish
33:46it we often accomplish it through law
33:48and i think the problem
33:50is is that we accomplish it often
33:52through neutral
33:54laws and policies that allow us to
33:56continue this process
33:58right and so when we think of
33:59residential segregation
34:01it was pretty clear um sometimes though
34:04neutral in a sense to say
34:06yes everybody can have housing but
34:09we're not going to ensure
34:12any loans that go to blacks we fast
34:15forward to the mortgage crisis
34:17with all the practices that were done uh
34:20to go after black latino and poor people
34:23again losing their housing but never
34:26getting
34:27restored back to the place that they are
34:29and when you look at covet 19
34:31so many people are being infected and
34:34we're just
34:34at the top or beginning of another
34:37mortgage crisis
34:38where people are not going to be able to
34:40stay in their homes
34:42but i want to highlight something i
34:44think that hasn't been discussed and
34:45probably because it's my
34:47area too is that it's the same thing
34:49when we look at employment
34:51right when we look back to the new deal
34:54and the jim crow area
34:56era at the same time you see lots of
34:58people who are now essential workers
35:00not covered under paid sick leave not
35:03protected
35:04and provided with the federal minimum
35:06wage or overtime pay or workers comp
35:09and those are poor people black and
35:12brown people
35:13women who are working as home health
35:16care workers
35:16agricultural workers me processing
35:20cleaning up in the hospitals right they
35:23don't have the protections because even
35:25though the laws are neutral
35:27and neutrally applied to everybody right
35:30there's always an exception
35:32to carve out the people who are poor
35:35black and brown who are doing this work
35:37and you can even see that in some of the
35:39covert relief acts
35:41that have been passed that do not cover
35:43some of these workers
35:45and so i think what we need to highlight
35:47is that law
35:48is so important the political process
35:51and law
35:52because it is often neutral but
35:55it reinforces these systems and
35:57structures that keep people separate and
36:00down
36:01and then what happens we blame those
36:03people when
36:04the system gets exactly what it wants
36:07which is to separate the last thing i
36:09would say i think
36:11um two things is that one
36:14i want to be clear that when we talk
36:16about racism
36:17it doesn't just harm black and brown
36:19people it hurts
36:20everybody and you can see that in the
36:23health research that shows
36:25as people come here how their health
36:27deteriorates
36:28whether that's latino whether that's
36:30caribbean
36:32whether that's white why because you
36:35cannot have
36:36equality you cannot have racism and
36:39expect
36:40everybody to do well because there's a
36:42burden placed on all of us
36:44and so what i would hope that as we move
36:47to shift
36:48um at this moment of covet 19 to say
36:50we're going to change that we do so
36:53together to understand that we are
36:55harmed
36:56all by racism and discrimination and
36:59that
36:59if we work to change it then we all will
37:02benefit from it
37:05um i wanted to go back to something dr
37:08smith said about this notion of a
37:10racialized imagination
37:12and um this idea and i can't remember
37:15which one of you mentioned this but
37:17this notion of love and it reminded me
37:20of what dr sandra golia who's a dean of
37:22the
37:22school of public health at bu has said
37:24that he's given talks and he's written
37:27a variety of articles where he says
37:29quote a world rooted in love embraces
37:31health as a public good
37:33and that's always struck me because i
37:35think people find that
37:36you know love is kind of amorphous or
37:39how do we root
37:41our public policy and love and i'm just
37:43curious what that means
37:45as opposed to something rooted in
37:48justice
37:58um i guess in one respect
38:01um i don't think our society has been
38:03rooted in justice
38:05um so it's very hard to compare
38:08uh or shift to say it should be rooted
38:11in love
38:11i don't think at any point we have said
38:15that we're going to be fair to poor
38:17people black people native americans
38:19latinos
38:20i mean this nation was built on the
38:23backs
38:24of people who did not benefit from it
38:26and so to me
38:28if we are going to move to love then
38:30that means that we value
38:32everybody who's a part and who
38:35is giving and providing um in this
38:38nation
38:39um and i think the best example for me
38:42at this time is just looking at
38:44uh the millions of people out there
38:46working as essential workers
38:48uh who we do not value who we do not
38:51love
38:52and who it's an injustice that we ask
38:54them
38:55to go to work without protective
38:59gear without financial support um
39:02and so i would say if we're going to
39:04shift to that then our actions need to
39:06speak to that
39:08yeah um i would say um you know to be
39:12frankie hun i don't
39:14care about love i don't want people's
39:15love i want people's justice i want the
39:17policy
39:18because i think you know we have to
39:20start with a top-up i think a lot of
39:22times when we talk about
39:23love and again like uh dr smith said i
39:26don't we're not talking about this in
39:28in no romantic love right there's
39:29different kinds of love there's a care
39:30there's an empathy
39:32there's um a fairness like dr yerby said
39:35and so
39:36when i think about that to me that seems
39:38very secondary first i want your justice
39:40i want you to care about me in the legal
39:42sense we haven't even done that yet
39:44too much of our legal system um is
39:47racist in white and it has white
39:49supremacist tendencies
39:50so first i want that fixed i want those
39:53input i want those policies and those
39:55regulations
39:56to legally um
39:59to legally care about my life to be
40:01forced into it
40:02i want policies and institutions like um
40:05in the clinical setting in the housing
40:07setting in the banking setting
40:08in the environmental setting right those
40:11sort those sectors
40:12give me justice and then after you give
40:14me justice then sure we can talk about
40:16love but right now
40:17i frankly i don't care about it i want
40:20justice give me policy
40:23let me just chime in i think this is
40:25really important and i actually
40:27uh would uh not necessarily disagree
40:29with the way dr explained this what i
40:31would actually say is that sometimes
40:34in particular uh more reflection people
40:36pitted justice and love
40:38against one another whereas i think they
40:40need to come together
40:41in a particular way and this could be my
40:42larger kind of religious social ethic
40:44coming through that's been informed by
40:46uh people like martin luther king jr by
40:48james baldwin some of his
40:49autobiographical essays
40:51and so somebody like cornell west would
40:52say uh that justice is just what love
40:55looks like in public
40:56right but these two things are so uh
40:59tightly wound
41:00woven together that only dealing with
41:03policy in a particular kind of way
41:06we've seen that when we've had policy
41:07that's supposed to go to certain ends
41:09that um human beings are the kinds of
41:12entities right
41:13that are able to manipulate those
41:15policies in certain ways and do a work
41:17around
41:17those particular ends and so there was
41:19this interesting essay that martin
41:20luther king jr wrote years ago
41:22not as many people have read as opposed
41:24to some of his other
41:26kinds of works but he talks about the
41:27ethical demands of integration
41:29and bringing together both this notion
41:31of yes we have to change the laws i will
41:34continue to advocate for that
41:35policy we have to do uh we also have to
41:39begin to
41:41help other people see one another
41:44as people who have dignity
41:47and who have value so it goes back to
41:50some of these points that
41:51uh dr yerby was raising about all of us
41:53coming up together
41:54that's one of the things i really loved
41:56about james baldwin's writings because
41:58one of the things he would often remind
41:59us
42:00is is that when we as people have to
42:03define
42:03ourselves as being over and against
42:06another group that our worth and our
42:07value
42:08comes from um uh being in opposition to
42:12someone else
42:12that that is unhealthy for us as people
42:16because when those individuals continue
42:18to
42:18break those moles and those stereotypes
42:20it creates a
42:21kind of an existential crisis in some
42:23ways that work itself out
42:25in policies that aren't beneficial uh
42:27for all so in that sense i i
42:30uh do not want to hear much talk about
42:32uh
42:33love apart from justice and it's one of
42:35the reasons why i talk about it as a
42:37political virtue
42:38that has to be integrally tied
42:41with this note with particular notions
42:43of justice uh
42:44or else like dr ray i don't think i want
42:47any part of
42:48dr williams any thoughts on this oh yeah
42:51my definite
42:52i can't believe i'm talking about love
42:55you know on a webinar
42:56but my definition of uh love actually
43:00changed a couple years ago i read a
43:01uh quote and i can't remember that quote
43:03but essentially
43:05um buddhist monk said you don't throw on
43:07that term
43:08love um without really thinking about
43:11what that means
43:12so the love you have for your child or
43:14your partner is different than saying
43:15you know
43:16i love lasagna oh which i do like
43:19lasagna
43:20but you you can't um conflate like what
43:23love means by by diminishing it
43:25uh by removing the the human connection
43:29that human humanistic aspect of that and
43:31i i agree
43:32that for justice it is incumbent upon us
43:36to recognize everyone shared humanity
43:38and within that
43:40that being showing love or
43:43are admitting to loving your your fellow
43:46man
43:47and the way the policies and laws
43:50uh are done nowadays that are that are
43:52impacting marginalized communities
43:55it is it is separate from that we in our
43:57minds we have separated the two
43:59therefore it is easy for us to continue
44:02to
44:03allow communities to suffer because that
44:05does not impact me
44:07it does not affect me i'm doing fine
44:09we're seeing it play out
44:11in epic fashion with kovid right now
44:14we see it playing out in in gun violence
44:17we see it playing out in the economic
44:19uh suffering of essential workers from
44:21this pandemic
44:22but if we had love for our fellow human
44:25beings
44:26if our leaders had thrown us into
44:27critical love we cannot just write a one
44:30trillion dollar check
44:31in the middle of a pandemic to be
44:33reactive to a crisis we can invest a
44:35fraction of that in advance
44:37to ensure that everyone could have equal
44:40access to health care equal access to
44:42pay
44:42and not suffer the way they are now that
44:45takes love
44:48so i have one more question and then
44:49we're going to move on to a number of
44:51questions that have come through the
44:53the q a so um i'm very much interested
44:56in this issue uh i think you're alluding
44:59to dr williams in the sense that
45:02we respond to issues in the world
45:05because we see them and it's very easy
45:08in this kind of society that's highly
45:10segregated to not see a lot of things
45:13and so the way that we represent
45:16ourselves culturally cultural
45:17representation
45:18visual narrative has a profound impact i
45:20think on the way we imagine the world so
45:21for instance
45:22um it's clear that you know based on the
45:25data
45:27um so many shows valorize the police
45:30right cops are the good guys and they're
45:32out to get the bad guys
45:34um and no other profession is valerie's
45:35like this uh not medicine not nursing
45:38and
45:38and i'm just curious from you all how do
45:40we create cultural representations
45:43that can powerfully affect people's
45:46minds
45:47and hearts in a way to see people as
45:50human beings as opposed to
45:52um you know opposing forces or people
45:55oppressing others
45:56because i think that the way we imagine
45:59the world is the way we
46:00can create the world and i think use the
46:02word utopian i don't have a problem with
46:04the word utopian i think
46:05i think we need our imagination to
46:06create a utopian world
46:08um but the way that we do create these
46:12narratives i think has a great uh
46:14influence on the way we view the world
46:16so i'm just kind of curious about your
46:17thoughts
46:20dr ray do you want to take um sure um
46:23so if i make sure i got you correctly so
46:26you're talking about these uh
46:28representations these
46:29cultural representations of people uh
46:32and how do we
46:33make sure that um once that they're
46:36positive um also accurate
46:38um and i think is that what you're
46:40saying
46:41yeah right that and that they're also
46:43kind of a representative
46:44and that they're richly textured so that
46:47we don't have these kind of
46:50again these very um superficial
46:52depictions of
46:53good police and and bad people
46:57but that you know the big so i'm just
46:59kind of curious about
47:00how do we how do we create a world that
47:01has these more richly textured
47:04more nuanced and more representative
47:05cultural uh representations
47:08absolutely um so i think one um one
47:11thing to do i'll give a little shout out
47:13to my medical humanities colleagues and
47:15i think
47:16one thing that we can do um is really
47:18make use of
47:19narratives right that we put um
47:22we put people of color we put women
47:25forward and we we let them tell their
47:27stories right two million times in
47:28in academia bioethics and other
47:30disciplines
47:31we're telling people stories right and
47:34you tell people stories you're telling
47:36it from your lens no matter how hard you
47:38try
47:38to put the the subject's view um and
47:42up front you're still telling their
47:43story through yours and i found
47:45that in my work what i try to do what
47:47other bio offices and
47:48medical humanities scholars try to do is
47:51let people tell their stories and i
47:53think you get
47:54richer representations right um you see
47:57this a lot happening right now
47:59um every time i go on social media i see
48:01these these different groups that are
48:02trying to change the representation say
48:04of black fatherhood
48:06right as going from this absentee
48:09person in the home to the actual
48:11statistics that say that they are very
48:13present at home and
48:14do a lot of child care and domestic work
48:16and that kind of thing so
48:18once you start letting people tell their
48:20own stories
48:21you start to see that it's not just
48:23these um these sort of cookie cutter
48:25representations that we see
48:27um or that the media tries to tell us or
48:29that we may think of
48:31but one that also we have to be willing
48:33to listen to the facts right
48:35too many times we have these views of
48:37people and if we actually look at the
48:39facts we say oh no that's actually
48:41not accurate so i think there's an
48:43openness to intellectualism that we have
48:45to have
48:46in openness to storytelling and openness
48:48to letting people tell their own stories
48:50whether we agree or disagree
48:53and then when it comes to police too
48:55again being open to the actual
48:57statistical information being open to
49:00the actual storytelling
49:02so that way it's not just i want to
49:04think of
49:05these indigenous latinx black
49:08neighborhoods is bad and the cops is
49:10good
49:10when there seems to be there's some
49:12fluidity there and there should be some
49:14openness in how we view each two of
49:16those groups
49:17um and again it's it's it has to be an
49:19openness we have to get out of
49:21just being so stuck in one narrative
49:24thank you dr ray so
49:25i'm getting the cue that we need to move
49:28on to the question so we have a number
49:29of questions i'm going to start off with
49:30this first question
49:31from our audience when the landmark
49:33institute of medicine report was
49:34published in 2003 it seemed to be a
49:36concerted effort to speak the language
49:38of health and healthcare disparities and
49:39shun the language of racism
49:41we now seem to be centering the language
49:43of racism
49:44and structural racism
49:48let me pull it down
49:56did the iom report set us back or was it
49:58an appropriate strategy for its time
50:00does the language of racism advance the
50:01goal of social justice better
50:06yeah i know i i um was responding to
50:10in the chat because i figure we have 41
50:13questions we're not going to be
50:16um and uh so thank you for this question
50:19uh from mark a former colleague uh
50:23so what i said is that i think the ilm
50:25report
50:26was a great start right it did highlight
50:29these issues of racial discrimination
50:32that was embedded in our systems and
50:34housing employment
50:36um and in healthcare it could have gone
50:39farther
50:40but i think even what it did was not
50:43uh actually then translated into some of
50:46our
50:47um social determinants of health goals
50:50for me as a former biologist racism
50:54is always better because when we use
50:56race we try then to connect it to
50:58some biological difference or some
51:01genetic difference and really it
51:03is about racism right and that goes
51:06uh that to uh patrick smith's points
51:10right about how it harms all of us
51:12uh when we have this misguided belief
51:16that somehow we are better than others
51:18so i think racism
51:20should be grounded in the social
51:23determinants of health framework but not
51:25just racism
51:26right when we look at those who are
51:29disabled
51:30when we look at those who are gay
51:34transsexual bisexual when we look at
51:36women when we look at those who are poor
51:39to me this is just about hierarchy and
51:41discrimination and to me that's a better
51:43discussion
51:44um than just trying to pinpoint
51:48um some socially constructed thing to
51:51say
51:51oh it's because you have dark skin no
51:54it's because of how the system
51:56views me and treats me
51:59let's move on to so we won't be able to
52:02get to the 42 questions but let me let
52:03me try to get a few more
52:05um many institutions are doing implicit
52:07bias training focusing on individual
52:09beliefs attitudes actions i'm concerned
52:11with too much focus
52:12on individual behaviors as opposed to
52:14understanding and overturning systems of
52:15oppression
52:16any thoughts oh absolutely
52:20yeah the implicit bias training
52:23for one or so so we all have implicit
52:26biases
52:27biases uh these are subconscious beliefs
52:30that influence our conscious
52:32actions uh for example if you're looking
52:35at an application for medical school and
52:37you see what is
52:38uh stereotypically a minority
52:41racially like a black sounding name you
52:43may downgrade that application based on
52:44that so that's your implicit
52:46bias uh playing out
52:49and how you will impact someone's future
52:50career uh and we all have these
52:53and understanding that is just a start
52:55is what you do with that information
52:56it's like okay you know you have
52:58implicit bias what are you going to do
52:59with that
53:00in regards to training the training has
53:02been shown to only
53:04to be most effective if it's approximate
53:06to some sort of event
53:08so if you're on admissions committee you
53:10get implicit bias training just before
53:11you review all the applications
53:13that is effective as opposed to getting
53:15it once a year
53:16eight months prior to that so it needs
53:19ongoing
53:20reinforcement for the implicit bias
53:22training and then again we're gonna move
53:24on to the next step which is really
53:25talking about
53:27systemic racism and structural racism
53:28within our
53:30uh to have healthcare but any large
53:32organization any large
53:34system so there's individual
53:35responsibility but also
53:37education to understand how structural
53:40issues are also
53:41impacting uh marginalized groups
53:45so uh i i've never personally been
53:47satisfied with just the implicit bias
53:48training without talking about
53:49how that impacts the other two can i
53:53chime in
53:53yeah go ahead please um so just quickly
53:56i know we have many questions so i i
53:57a part of the question too i think is
53:59really important to think about is
54:01um the implicit bias training has its
54:03benefits but
54:04if you have implicit bias training but
54:06the culture at the institution
54:08that is holding the implicit bias
54:10training is not also anti-racist
54:13then fixing individuals will do nothing
54:16if you don't start from the top up and
54:17fixing the institution so
54:19again i don't want to be you know be the
54:21broken record but i want the policy to
54:23start at the
54:24top and then i want the implicit
54:26training um that will mean even more
54:28because you have to change the culture
54:29you can't change a culture at a medical
54:32school
54:32or at a shoe store anywhere that says we
54:35believe
54:36black lives matter and we're going to
54:38give our employees this implicit bias
54:40training
54:40if they don't also institute policies
54:42that say not only do we believe it but
54:44we support it and we're going to make it
54:45happen
54:48um i think this next one maybe dr smith
54:50you can address this one
54:51this question says vanessa northington
54:53gamble
54:55medical historian former director of the
54:57national bioethics center tuskegee and
54:58countless public health researchers have
55:00acknowledged
55:01the bioethics will make slow progress
55:02without the inclusion of the black
55:03church
55:04now that the panel has established the
55:06multitude of ways that black lives
55:07matter and bioethics including in
55:08policing medicine please comment on the
55:10role of the key cultural component
55:12black religion and the black church yeah
55:15thanks uh keihan for that question and
55:17uh whoever asked that question here you
55:20know that's uh i think a very
55:22uh important observation now obviously
55:24let me just go with how
55:26it should go without saying but needs to
55:27be said that um
55:30black spaces are very diverse right so
55:32you have a very strong
55:34yes religious and spiritual component
55:36but also a very strong traditional black
55:38humanist
55:39also were emerging and so there's no
55:42kind of monolithic way of thinking about
55:43it
55:44but i do think it's still correct to say
55:46that the spirituality
55:48and the religiosity that's expressed
55:50oftentimes in black church spaces
55:52is still something that plays a very
55:54important role in
55:55health and human black health and uh
55:58well-being of people who are in those
56:02in those traditions and so some would
56:03suggest that there's this
56:05what's called like a priestly aspect and
56:07then there's a prophetic aspect priestly
56:08aspect really deals with just spiritual
56:10issues just
56:11helping you to withstand the onslaught
56:13of the psychological dynamics of
56:16white supremacy and all these kinds of
56:18things that you have have all these
56:20symbols and
56:21images uh that you are less than
56:24the priestly aspect of this tradition is
56:26to help
56:28remind people of who they are and that
56:30they are not
56:31what others are saying they are right so
56:34to speak and really giving them the
56:35resources so for me um i had an uncle
56:38who was involved in the civil rights
56:39movement in birmingham with
56:40fred joseworth and king and many others
56:43and it's
56:44very difficult for me to think about
56:46that movement getting
56:47any traction whatsoever apart from some
56:50type of spirituality that was
56:52helping them to stand up straight so
56:55that people cannot ride their backs
56:57now are these the only resources that
56:58can do that absolutely not
57:00but this was a key component of
57:03wrestling with these issues and so
57:05to the question right in terms of the
57:07role of kind of this
57:08black cultural component of the black
57:09church i think you've got mechanisms of
57:12trust that are built in
57:14and i will say for the record right as
57:16i've said in other spaces
57:17uh that particular tradition has not
57:19always lived up to its ideals right in
57:21the way that it has often marginalized
57:23people within its community as well but
57:26the best of that tradition
57:28uh brings with a kind of trust a kind of
57:31solidarity
57:32uh it also reminds it puts things on the
57:35radar screen
57:36for bioethics to uh reimagine in other
57:39words centering things like justice
57:41maybe as opposed to
57:42uh autonomy taking seriously the larger
57:45social dynamics of our uh interconnected
57:48networks
57:49uh in ways that maybe other approaches
57:51to biolytics have not done
57:53emphasizing the embodied aspect of our
57:56material lives right
57:58in ways that some aspects of bioethics
58:01have abstracted these philosophical
58:02principles in different ways
58:03probably more i could say uh but i'll
58:05just kind of stop there
58:07to say that yes i do think there is a
58:08contribution that needs to be made from
58:11that sector
58:11and also by what this needs to engage
58:13those resources
58:14even if they are not the only spaces
58:17where those resources can come from
58:20next question as a student in the
58:22healthcare field physical therapy what
58:24have you all seen or not seen from
58:25educational institutions that have
58:27addressed issues of structural racism
58:28and police
58:30follow up how can students use their
58:31position to advocate for changes
58:33in said institutions so you all are
58:35educators you all teach students um
58:37i think this is a great question what
58:39what is your response
58:42dr williams yeah keon i will say that
58:45the
58:46students that i interact with now you
58:49know where i'm at university of chicago
58:50but even all around the country when i
58:52when i travel this this generation is
58:55so much more socially aware and socially
58:58courageous
58:58about these issues of any inequality
59:00that i think it's a very exciting time
59:02to be an educator to to to
59:05talk to them hear their ideas uh about
59:08how to uh
59:10to improve structures
59:13i learn from them every single day and
59:15i'm excited to see what will happen when
59:16they move into positions
59:18of leadership and start really working
59:21to uh
59:22to reconstruct these the structural the
59:25structural racism
59:26that is impacting uh so many of our
59:30patients that we care for so for a
59:32student i think right now
59:33you're in a great time where you can
59:35actually speak out and
59:37feel welcome feel heard and actually
59:40make a difference and uh you know i'm
59:44really honored to be
59:45to be around these group students with
59:47every chance the chance i get because it
59:48reminds me
59:50of how far things have come
59:56next question to what extent is the
59:57normative dimension of knowledge
59:59production which miranda fricker links
1:00:01to epistemic injustice an obstacle for
1:00:03creating more racially diverse bioethics
1:00:04do we need new concepts and categories
1:00:07to fully combat structural racism if so
1:00:09what role do you see a globally diverse
1:00:11bioethics playing specifically
1:00:12what's relation between sub-saharan
1:00:14african bioethics and black biotics in
1:00:15the u.s
1:00:18um i can take the first part of the
1:00:20question um
1:00:22so what i think i i'm not necessarily
1:00:25i don't necessarily think that bioethics
1:00:27needs new principles
1:00:28but i do think that we have to expand
1:00:30the way that we think about them that
1:00:31they can't be
1:00:32narrow if we talk about you know the
1:00:34basic justice um
1:00:36uh autonomy those kinds of things right
1:00:39it's not necessarily that those aren't
1:00:41are aren't appropriate anymore they're
1:00:42still principles that i think are
1:00:44are very much relevant but i do think
1:00:47that
1:00:47sometimes bioethics um and even and
1:00:51other healthcare professionals too can
1:00:53sometimes think of
1:00:54justice as very narrow or think of
1:00:56autonomy as very narrow beneficence is
1:00:58very narrow
1:00:59and so thinking about how these
1:01:02uh principles intersect with ethnicity
1:01:05how they intersect with race how they
1:01:06intersect with this
1:01:07intersect with the social determinants
1:01:10of health i think that's what
1:01:11we need to keep working on um when we
1:01:13talk about autonomy thinking about
1:01:16um what does autonomy mean for this
1:01:18particular group or for this particular
1:01:20nationality right
1:01:21autonomy means so many different things
1:01:23for different cultures and backgrounds
1:01:25and so i think that's where we have to
1:01:27sort of be
1:01:28a little bit more yielding
1:01:34and perhaps this is linked to this
1:01:37question that was
1:01:39just asked
1:01:42let me see if i can find it here
1:01:48so the conversation so far has felt
1:01:50sociological more than anything i would
1:01:51like
1:01:52to uh hear questions around the inherent
1:01:54western paradigms present bioethics how
1:01:56is the field confronting the fact that
1:01:57bioethics is rooted in western
1:01:59philosophy um
1:02:02so maybe dr smith you can respond to
1:02:05that
1:02:05yeah could you could you restate it
1:02:07again yeah yeah let me let me see if i
1:02:09can pull it up here
1:02:10um
1:02:15just bear with me for a moment
1:02:20dr ray if you were able to kind of get
1:02:21the thrust of the question do you want
1:02:23to
1:02:23if you want to jump in as well i'll feel
1:02:25free
1:02:26okay yeah it's towards the top um if you
1:02:29can
1:02:32bam viewer
1:02:36um yeah i'm not i'm not seeing it
1:02:40um let me read it yeah please go ahead
1:02:42okay so the conversation so far has felt
1:02:45sociological more than anything
1:02:47i would like to uplift questions around
1:02:49the inherent western paradigms present
1:02:51in bioethics
1:02:52how is the field confronting the fact
1:02:54that bioethics is principled in western
1:02:57philosophy
1:02:58how do we fight systemic racism the
1:03:00result of white supremacy
1:03:01without the inclusion of non-western
1:03:03philosophies
1:03:07yeah um i'm not sure that we
1:03:10that we can right it depends on what we
1:03:13mean in terms of like non-western i mean
1:03:14there's a sense in which
1:03:16uh many of the resources that we draw
1:03:19from
1:03:19um are going to come from a myriad of
1:03:22different sources
1:03:24right uh so in that sense there may not
1:03:26be a kind of
1:03:27a pure kind of line of when i think
1:03:29about the fact that
1:03:30as i read african-american philosophy i
1:03:32have to acknowledge the fact that yes
1:03:34there
1:03:34there's an african dimension to that
1:03:36there's also an american dimension to
1:03:37that right
1:03:38in some ways that's unavoidable and
1:03:39again just go back to james baldwin this
1:03:41is one of those lessons that he often
1:03:43taught us as well
1:03:44but i do think these various
1:03:45perspectives of those who've been on the
1:03:47underside of how some of these
1:03:50philosophies western philosophies have
1:03:52actually played out
1:03:53becomes a clue if you will to give us
1:03:55some tools and resources to begin to
1:03:58dismantle the negative impact and the
1:04:00systemic structures that have been in
1:04:02place
1:04:03on some of these ways of thinking
1:04:05philosophically
1:04:06as well i encourage uh students who are
1:04:08studying philosophy they
1:04:09oftentimes read a lot of political
1:04:11philosophy and moral philosophy
1:04:12i encourage them okay we'll read uh the
1:04:15racist and misogynistic
1:04:17um uh comments of a you know a con and
1:04:20lock and all these others to
1:04:21see that it's very difficult to
1:04:24disentangle these political philosophies
1:04:26from these underlying notions of white
1:04:28supremacy
1:04:29uh that are sometimes intermeshed with
1:04:31them even if we don't understand it or
1:04:33realize it and so i do think that
1:04:36other voices other perspectives give us
1:04:39give us some clues for our gesture
1:04:40towards the kinds of resources we need
1:04:42to kind of undermine that but if not
1:04:43three or
1:04:44others want to jump in uh i'll use it um
1:04:47yeah i know i would just say i think
1:04:49part of the problem too is that you know
1:04:51as philosopher uh um i'm just like dr
1:04:54smith
1:04:55we're not always trained in other in
1:04:57things other than western philosophy i
1:04:59know my own background is western
1:05:00philosophy
1:05:01uh predominantly and so i think too we
1:05:04have to educate ourselves in order to
1:05:05help our students or in order to even
1:05:07think about
1:05:08non-western ideals and how that may um
1:05:10better bioethics and how they may better
1:05:13um the way that we think about racism
1:05:15and white supremacy and police brutality
1:05:17and even the the health of the black
1:05:19community so i think there's a
1:05:20there's a duty there too and something
1:05:22to think about for
1:05:24philosophers themselves and how and by
1:05:25what this is themselves
1:05:30so i'm looking at the time we have about
1:05:3210 minutes left
1:05:33[Music]
1:05:35so i'm just reviewing questions here
1:05:39um let me get to this question here
1:05:41recognizing that structural racism is
1:05:43deeply embedded
1:05:44in many institutions including policing
1:05:47how should bioethics and really i think
1:05:49healthcare in general
1:05:51engage in these issues should the focus
1:05:53be on reform efforts to bring about
1:05:55concrete though incremental changes
1:05:57or should the focus be on more
1:05:58fundamental social transformations which
1:06:00might be harder
1:06:01to achieve so this is something i think
1:06:03this is kind of linked to
1:06:05the the debate we've been hearing for
1:06:06the last couple months about
1:06:08you know abolish the police defund the
1:06:11police reform the police and
1:06:12so i'm excuse what your thoughts are
1:06:14with regards to this issue how
1:06:16how can bioethics and healthcare
1:06:17professionals respond
1:06:19is incremental reform appropriate or do
1:06:21we need more radical change
1:06:24i would say that we need both um
1:06:28that you know i think it's important for
1:06:31to begin to address it to empower more
1:06:34communities and vulnerable individuals
1:06:38to be a part of it meaning that they
1:06:41already have some of these answers
1:06:44and we have not been listening to them
1:06:47and so we really need to begin
1:06:49to put them in places of power so that
1:06:52they can make the changes that they
1:06:54want to see in their community um i
1:06:57think
1:06:57that to me is the first part but i think
1:07:01that we need some time in a sense of
1:07:05getting to utopia or to the place that
1:07:07we want
1:07:09because we have been so harmed
1:07:12by structural racism that i think
1:07:15oftentimes we can't even imagine
1:07:17the things that we can create um
1:07:20but does that mean that we need to stop
1:07:22no it just means that we need to work
1:07:24towards the things that we want to
1:07:26accomplish
1:07:27by having everybody's voice um and
1:07:30empowering people and whether that means
1:07:32in the police
1:07:33or whether that means in healthcare i
1:07:35think
1:07:36uh right now particularly in covet 19 so
1:07:39much of the discussion has focused on
1:07:41experts
1:07:42um and not really listening to the
1:07:45people who are most
1:07:46impacted uh well let me take that back
1:07:49we haven't really listened to the
1:07:50experts which is part of the problem
1:07:53right oh but we are not also listening
1:07:56to the communities right who are
1:07:58impacted to the people who are working
1:08:01who are living in close quarters
1:08:03we are not listening to them we are not
1:08:05providing them with the access they need
1:08:07and so that could be one of the changes
1:08:09that we make
1:08:12any other thoughts because i think this
1:08:14is really a big question for a lot of
1:08:16people
1:08:17um so professor your beast is both
1:08:18incremental and radical what what are
1:08:20the rest of your thoughts
1:08:23i i like the way she put that that you
1:08:24need incremental and radical
1:08:26uh change um but i think the even bigger
1:08:30issue was
1:08:30when she marked about because we were
1:08:32having an academic discussion
1:08:34it's what we're good we're really good
1:08:35at we're good at getting experts
1:08:36together
1:08:37to have this discussion about police who
1:08:40are not involved in this panel
1:08:41we're talking about marginalized
1:08:42communities who are not involved in this
1:08:43panel so we're very good at
1:08:46studying the communities talking about
1:08:48the communities
1:08:50but in the end is there been real any
1:08:53real sustainable change
1:08:54based on what we have done so we need to
1:08:57widen that tent
1:08:59uh instead of saying here's the answers
1:09:01we have for you
1:09:02bring bring people to the table and say
1:09:04okay this is your
1:09:06real experience what it is what are the
1:09:08problems that you see and
1:09:09how can we be a part of the solution and
1:09:12that is something that
1:09:13uh those of us that are in academics
1:09:15with the experience
1:09:16expertise need to step outside of our
1:09:20professional titles
1:09:21and make those sort of connections and
1:09:23long-lasting contributions that can have
1:09:25sustainable
1:09:26intergenerational change or else we'll
1:09:29keep repeating the cycle over and over
1:09:31again
1:09:33this is why the emphasis that many have
1:09:35been writing about in terms of
1:09:36communities
1:09:38being involved in bioluminescence and
1:09:39biologically engaging particular
1:09:41communities become extremely important
1:09:43just to underscore these comments of dr
1:09:45urban
1:09:46and dr williams dr ray did you have
1:09:49anything to add to this
1:09:50um yeah um i'll just briefly say that
1:09:53i think how bioethics thinks about white
1:09:56supremacy
1:09:57should be the same way that we think
1:09:59about anything that jeopardizes humanity
1:10:01as i said um you know early on
1:10:03um if we think of racism white supremacy
1:10:06in a way that jeopardizes the very
1:10:08principles that we hold dear
1:10:09then we would see it as something that's
1:10:11worth our action and we have to look at
1:10:14look to um our our
1:10:17governing bodies to take stances and for
1:10:20us to support those stances and to
1:10:21actually
1:10:22do action right go out and participate
1:10:25in advocacy go out and write for people
1:10:28other than
1:10:28academics but right for the general
1:10:30public right if we're going to
1:10:32be um champions of intellectualism and
1:10:35champions of change and we have to step
1:10:37outside of this ivory tower like dr
1:10:39williams said
1:10:40um and and see that these bigger threats
1:10:44of white supremacy as in the same way
1:10:46that we would see
1:10:48anything that was that threatened human
1:10:50life
1:10:53so we have just a few minutes and maybe
1:10:55we can just build on this question
1:10:56because
1:10:57from what i'm hearing from all of you is
1:11:00an expanded role for academics whether
1:11:03it's academic ethicists academic
1:11:05physicians
1:11:07legal academics philosophers um
1:11:12to engage more deeply and less
1:11:15superficially
1:11:16and and so and i think you hinted at
1:11:18this dr ray with regard to what does an
1:11:20activist academic look like what does
1:11:24that look like so we can
1:11:26bring on i mean you mentioned about
1:11:28writing for a broader audience but
1:11:29you know we're trained to look at things
1:11:31i mean like dr william said we're good
1:11:33at studying issues
1:11:34and analyzing issues and talking about
1:11:37issues
1:11:38but but what is our professional role
1:11:41beyond that
1:11:42and and perhaps leave it at that
1:11:45yeah i think two part of this is a
1:11:47training right we can say
1:11:48yes we haven't been trained in advocacy
1:11:50right i don't know about you but that
1:11:52was not a part of my bioethics education
1:11:54right
1:11:54but it's something that we can come to
1:11:56and now that we are aware that this
1:11:57needs to be a part of our role
1:11:59now we influence the generations that
1:12:01come after us and at the montgomery
1:12:03medical school whenever i have
1:12:05my classes about raise that question
1:12:07always comes up amongst my students
1:12:09now what can i do as a medical student
1:12:11we talk about advocacy
1:12:13we talk about institutional changes
1:12:14because i'm very big on
1:12:16you can start one where you are change
1:12:18your institution
1:12:19and then work for broader change and so
1:12:22i think we need to start
1:12:23being um and looking to people who have
1:12:26been advocates and look to them for
1:12:27guidance
1:12:28let them lead the way and let us give
1:12:30them support
1:12:32i think for me just to jump in one of
1:12:34the um
1:12:36papers that i always go to in terms of
1:12:39bias in the health care system
1:12:41was a doctor who amplified the
1:12:44experiences
1:12:45of his patients right and so as
1:12:48an activist scholar what i try to do is
1:12:51amplify the voices of the people in the
1:12:53community
1:12:54um because i feel then people will
1:12:57listen
1:12:58um and respect that and so i consider
1:13:01myself
1:13:02as an academic activist because that's
1:13:05what i try to do
1:13:07but i think that's what we can do in
1:13:08bioethics and medicine
1:13:11and other fields and i say um in the
1:13:13police what has been
1:13:15great is that they are amplifying right
1:13:18the voices of the communities
1:13:20and the disempowered to say enough is
1:13:23enough so i think that's one of the ways
1:13:25that we can start
1:13:28williams dr smith any final thoughts
1:13:30about how
1:13:31we as academics can um engage and
1:13:35and see more fruitful and and deeper
1:13:38change
1:13:40sure i believe academics are in a
1:13:42perfect position to be
1:13:43activists and first we
1:13:46have to define what activism means to us
1:13:48as an individual
1:13:50and i've always figured that if you do
1:13:52something that will invite
1:13:53backlash by which you what you say or do
1:13:56or of course you advocate that makes you
1:13:58an ad an activist
1:14:00so this panel today having a biotics
1:14:02discussions about police brutality and
1:14:04racism
1:14:05uh that could be a form of activism
1:14:07right you can
1:14:09write op-eds for non-academic
1:14:14uh journals you can write a paper about
1:14:16racism for an academic journal which
1:14:19one of the major academic journals
1:14:21medical journals on the
1:14:23planet as of a couple years ago only had
1:14:26mentioned racism about
1:14:27two dozen times in their entire history
1:14:30so
1:14:30things like that that push the
1:14:31conversation and
1:14:33can lead to potential personal and
1:14:36professional repercussions
1:14:37where you will possibly lose more than
1:14:39you will gain by your success
1:14:41that to me is activism and you can
1:14:43define that for yourself so just do
1:14:45you just do do you what makes you feel
1:14:47comfortable
1:14:49now just hit that bell give me the last
1:14:50word here yep absolutely my uncle used
1:14:52to say something
1:14:53to me when we meet before he died he
1:14:56would travel sometimes we would sit down
1:14:58and he would ask what i'm doing what i'm
1:14:59working on i'll give him all that to
1:15:01give me stuff i'm doing
1:15:01he'll say something like he'll just
1:15:03pause and look at me kind of unimpressed
1:15:04and say
1:15:05just don't forget about the people right
1:15:07don't forget about the people and this
1:15:09was something that had stuck with me and
1:15:10uh to use an academic trope right this
1:15:13notion of an organic intellectual a
1:15:15person who is
1:15:16yes cultivating the life of the mind but
1:15:18embedded in particular communities in
1:15:20the life of that community
1:15:21whose research questions emerge from the
1:15:23particular needs of that community
1:15:25and bring these things together i think
1:15:27is a form of activism is something that
1:15:29many of us
1:15:30who are doing this kind of work can
1:15:32certainly be a part of
1:15:34i think i'm going to leave it there i
1:15:36want to thank you all so much
1:15:38for i think a wonderful conversation dr
1:15:40patrick smith
1:15:42dr keisha ray professor uh rukaiyerby
1:15:45and dr brian williams all of you been
1:15:47wonderful
1:15:48appreciate all your insights and your
1:15:49knowledge and your wisdom thank you all
1:15:52for joining us it looked like at one
1:15:53time we had um well over 500 attendees
1:15:57so thank you all for joining us today
1:15:59and this
1:16:00is being recorded and the recording will
1:16:02be made available on bioethics.net
1:16:04so wanted to thank you once again

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