Jim Crow Medical Ethics in Virginia

The Hippocratic oath continues to this day as a model of ethical conduct for medical professionals. It has come, generally, to be regarded as a precept that no harm be done in the practice of medicine and remains to the present as guiding the healing arts.

The early 1900s in Virginia witnessed a number of racial legislative enactments that cast a shadow that creates overcast today. In 1902, Virginia passed a new constitution that included a host of Jim Crow provisions.

In 1924, the General Assembly passed the Racial Integrity Act, which reinforced racial segregation by prohibiting interracial marriage and classifying as “white” a person “who has no trace whatsoever of any blood other than Caucasian.” The act, an outgrowth of eugenics and scientific racist propaganda, was pushed by Walter Plecker, a white supremacist and eugenicist who held the post of registrar of Virginia’s Bureau of Vital Statistics. The act required physicians and hospitals to include information on all birth certificates the person’s race as either “white” or “colored.” The act classified all non-whites, including Native Americans, as “colored.” Marriage certificates were subject to the same requirement.

The Racial Integrity Act was ultimately gutted in 1967 following Loving v. Virginia.

Also in 1924, the General Assembly passed the Virginia Sterilization Act, prompted by the pseudo-science of eugenics, which US advocates adopted from Germany. Although challenged to the Supreme Court in 1927 (Buck v. Bell), it was found to be constitutional and became a model of similar statutes throughout the nation. The opinion held that a patient may be sterilized “on complying with the very careful provisions by which the act protects the patients from possible abuse” and such state action requiring compulsory sterilization of the unfit, including the intellectually disabled, “for the protection and health of the state” did not violate the Due Process clause of the 14th Amendment to the United States Constitution.

Between 1924 and 1979, Virginia sterilized over 7,000 individuals under the act. It was never declared unconstitutional, but in 2001 the Virginia General Assembly passed a resolution apologizing for the misuse of “a respectable, ‘scientific’ veneer to cover activities of those who held blatantly racist views.”

Between 1924 and 1979, Virginia sterilized over 7,000 individuals under the act. It was never declared unconstitutional, but in 2001 the Virginia General Assembly passed a resolution apologizing for the misuse of “a respectable, ‘scientific’ veneer to cover activities of those who held blatantly racist views.”

The following excerpts are taken from The New York Times, September 20, 2020, of a book review: The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South by Chip Jones:

In May 1968, the family and friends of Bruce Tucker, a 54-year-old African-American factory worker, became worried after he failed to come home from work. When they finally got a cryptic phone call from a friend who had seen Tucker being rushed into an operating room at the Medical College of Virginia, they made their way to the hospital, only to find out he had been taken there with a head injury and had since died. It was the funeral director, not hospital staff, who alerted Tucker’s family the following day that his heart and kidneys were missing.

Tucker’s heart had been implanted into the chest of Joseph Klett, a retired 54-year-old white man, and one of the first patients to receive a heart transplant in the United States.

Virginia law required that at least 24 hours elapse between determination of death and declaring the body to be abandoned by family. But in Tucker’s case, the surgeons needed to harvest the organs while they were maximally viable for transplantation and ignored this rule, instead invoking the novel concept of “brain death.” The hospital staff insisted that they had done everything to locate Tucker’s family to obtain consent, even speculating that no one claimed him in order to evade the cost of his care.

The future Virginia governor L. Douglas Wilder, then a Richmond lawyer in private practice, represented the Tucker family in a case against the Medical College of Virginia that excluded African-Americans from the jury and ended in victory for the hospital and the researchers involved in performing the transplant.

In the 19th century, Black patients received care at medical schools, clinics and hospitals by serving as “teaching material,” and the appropriation of Black tissues, organs and bodies was commonplace. In Virginia, limbs were removed solely to train medical students in amputation technique.

A local newspaper, reporting on the extraordinary medical achievement, noted that Tucker “was a Negro.”

It is now the 21st century, but historical discoveries continue to draw out attention to a chilling past of medical ethics violations in the Old Dominion. Recently, a cache of unidentified human remains was discovered in Richmond’s East End Cemetery displaying some evidence of medical experimentation. The grounds are the subject of a historical restoration project.

Recently, a cache of unidentified human remains was discovered in Richmond’s East End Cemetery displaying some evidence of medical experimentation.

A preliminary analysis by the Virginia Department of Historic Resources reached a conclusion that at least some of the individuals were taken from their original graves and subjected to medical dissection before being reinterred in the cemetery grounds.

In 1994, during construction of a medical sciences complex on Virginia Commonwealth University’s medical campus, the remains of 53 people were found in what had been a well. Experts later determined that those remains, most of them belonging to African Americans, were likely stolen from graves or hospital deathbeds and then used to train medical students.

Virginia has made neither Hippocrates nor humanity proud of this history.

 



Categories: CIVIL RIGHTS, Health Care, Issues, Local, politics, State

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