Advocating for Change: Neuroethics and Race

By Jane Cooper, Zamina Mithani, and J. Wesley Boyd 

Image courtesy of Pixabay

Highly influential events around the world in the first six months of 2020 — from COVID-19 to multiple high-profile murders of Black civilians in America — have sparked a reimagination of how both individuals and institutions must consider race, power, health, and marginalization in society. Systemic and endemic racism has a direct bearing on bioethical issues, including the basic principles that have undergirded so much of bioethical thinking such as justice, beneficence, and nonmaleficence. Given this, why has there not been a stronger emphasis on advocacy within bioethics? Why has bioethics as a field largely been silent about the ways in which institutions systematically have oppressed and perpetuated the racism which plagues our society at large? 

We are certainly not the first to call out bioethics on this matter. Many other scholars have expressed their frustration with bioethics’ (lack of) engagement of race and other marginalized identities.  Bioethical literature addressed the issue of Black Lives Matter (BLM) after the 2015 police killing of Freddie Gray when Keisha Ray wrote about the importance of seeing the BLM movement as a bioethics issue, and in the more recent writings on the bioethics.net blog and Hastings Centre blog. Despite Ray’s piece and others, bioethics as a field has mostly been silent on BLM. Unfortunately, we believe this silence is due in part to the fact that, as Catherine Myser has claimed, there is a “white normativity” in bioethics. This is the idea that institutions embody subtle practices and thinking that center whiteness as “normal” and “right,” which then replicates dominant white cultural ideology in bioethical discourse. An example of this in bioethical literature is considering race in “’euphemistically tinged abstractions’ as ‘health care disparities,’ ‘minority health care,’ or ‘social justice.’” These abstractions can be considered part of a larger “amnesia” that bioethics has towards racism, where the act of forgetting to include race in discussions enables bioethicists to “feign ignorance” and removes them from agency as perpetrators of racism.  

Image courtesy of Pixabay

In our forthcoming paper in the American Journal of Bioethics, we discuss a multitude of tools that bioethics has, and should engage with, to promote justice and equity within the profession and beyond. We draw on work ranging from Critical Race Theory and the practice of counter storytelling to a Foucauldian discussion of power. Overall, we encourage bioethics to consider a much wider variety of voices about justice than bioethics has historically considered and attune itself much more closely to the voices that have historically been overlooked, in the Critical Race Theory practice of “centering in the margin.” The power we have to make ethical claims of justice must be balanced by the responsibility we have to embody and practice justice within the institutions that we live in—be they in technology, academia, or clinical practice.  

All the above also apply to the narrower field of neuroethics, which has its own seminal cases that relate to ethics and race/marginalization. Other authors in this blog have done an excellent job in highlighting the specific histories of racism within neuroscience and psychology. For example, at the height of the US’s “War on Terror,” psychiatrists and other health professionals were engaged in military “enhanced” interrogation program practices, which violate a multitude of ethical standards. We also have data on racism's impact on neurological health, such as the racial disparities in Alzheimer's Disease diagnosis and access to mental health care. Discussions on environmental neuroethics have also acknowledged the impact of climate change and environmental stressors on the overall health of the brain. This is particularly applicable in light of environmental racism seen in the disparities in access to green space, clean air, and clean water that exist for low income and communities of colour. These discussions will only broaden as we continue to learn about the profound mental health impact that COVID-19 has wrought on communities of colour — owing to both infection and mortality rates and economic depression. In the coming few years, as we advance in the kind of neurotechnology that incites our dystopian imaginations, we must ask ourselves whether technology promotes an equitable society. These discussions are already beginning on artificial intelligence, as the racial biases of its creators continue to be laid bare. This is an important area for ethics to weigh on to ensure equity and to fight against bias. 

Image courtesy of Pixabay

In conclusion, we believe that bioethics (and neuroethics) needs to actively reject and denounce injustice, as a way to practice the bioethical principle of justice. This means that bioethics ought to speak out against racism and injustice, from police brutality to racially biased clinical trials, to dehumanization based on ethnic origin and religion. As bioethics and its associated disciplines — like neuroethics — reach unprecedented prominence and influence in political and social spheres, directing its focus to equity and justice has become all the more urgent.  

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Zamina Mithani, MBE, is currently a Medical Student at the University of British Columbia in Vancouver, Canada. She received her Masters of Bioethics from Harvard Medical School and is interested in the intersections between culture and ethics, as well as hospital, pediatric, and psychiatric/substance use dilemmas within the larger umbrella of clinical ethics. She can be reached at @zamina_mithani on Twitter.

Jane Cooper, MBE, is a current Law Student at the University of Toronto, focusing on Human Rights and Environmental Legal studies. She holds a Bachelor of Science (Honours) in Biology from Queen's University, and a Master of Bioethics from Harvard Medical School. She can be reached at @JaneKCooper on Twitter. 

 

J. Wesley Boyd, MD, PhD, is a faculty member in psychiatry and medical ethics at Baylor College of Medicine and also on faculty in the Harvard Medical School Center for Bioethics. He obtained an MA in philosophy and a PhD in religion and culture, along with his medical degree, at UNC Chapel Hill.  He has taught extensively in the humanities, bioethics, human rights and psychiatry in multiple institutions.  His areas of interest include social justice, access to care, human rights, asylum and immigration, humanistic aspects of medicine, physician health and well-being, the pharmaceutical industry, mass incarceration, and substance use. 

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Cooper, J., Mithani, Z., and Boyd, J. W. (2020). “Advocating for Change: Neuroethics and Race." The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2020/10/advocating-for-change-neuroethics-and.html