B. Miss Evers Boys and the Tuskegee Syphilis Study
The 2003 Institute of Medicine (IOM) Report, Unequal Treatment, documented the depth of racial and ethnic disparities in U.S. healthcare, using a variety of outcome and process measures. Medical education through the advancement of culturally competent curriculum has the opportunity to address the existing gap in U.S. healthcare among racial and *188 ethnic populations. This can be accomplished by shaping an “ethical conscience” infused with CRF theory. Professor Patricia A. King notes that the “social and ethical issues that the [Tuskegee] experiment poses for medicine, particularly for medicine's relationship with African Americans, are still not broadly understood, appreciated, or even remembered.” CRF has the potential to close the gap of racial and ethnic disparities through the application of a transformative remedy that utilizes a reproductive justice framework under the auspice of medical education. Cinemeducation provides a venue to use film as part of the classroom curriculum to “promote enthusiasm for learning, highlight themes, enhance discussion and reflection, and sometimes, help illustrate specific teaching points on clinical topics, social and health care policy issues, cultural differences, and science.” However, the showing of a film to teach or integrate medical ethics does not replace “thoughtful reading and analysis of essential texts.”
A CRF lens would allow one to see the HBO movie, Miss Evers Boys, erroneous act of imputing power and privilege to Eunice Rivers, the sole Black nurse involved against the U.S government sponsored PHS study of untreated syphilis on unsuspecting Black males. Public misconceptions about the Tuskegee Syphilis Study are not only prominent in the media, [but can] “carry serious implications for attitudinal and behavioural outcomes related to the healthcare of African Americans.” Miss Evers Boys is a “widely popular interpretation of the events of the study.” Dula *189 correctly points out that “the film actually opens a broader discussion regarding many ethical concerns.” The fictional account of Miss Evers Boys will become “fact” unbeknownst to the viewer/student if not explored critically in curricular delivery to teach about the Tuskegee Syphilis Study. There is a deconstructive approach to critically examine some aspects of the movie, in both historical and fictional contexts. Ironically, the “dramatizations of the Study. . .focused in large measure on the role of the woman who worked with the participants for practically its entire duration.” However, in fact, the 1973 lawsuit (amended on August 1, 1974) filed by Attorney Fred Gray on behalf of four categories of plaintiffs (living syphilitics, living controls, personal representatives of the estates of deceased syphilitics, and personal representatives of the estates of deceased controls) did not include Nurse Rivers or the Tuskegee Institute as defendants in the case. Gray reasoned that:
Miss Rivers was powerless to have either begun, continued, or stopped the program. She worked in an environment where all of her superiors were white, while she worked directly with African American men. Even after penicillin became available, Nurse Rivers had no voice as to whether or not [the] men would be given penicillin.
*190 Gray noted that during the beginning era of the experiment in the 1930s, the Tuskegee Institute was an African American educational institution struggling to survive, and its cooperation was being sought by the federal government; It began as an outgrowth of the Rosenwald Fund survey, and was financially backed by Tuskegee Institutes' significant benefactor. “[Gray] felt the same about the Tuskegee Institute as [he] did about Nurse Rivers - that the Institute and its officials were misled, betrayed, and taken advantage of [by the federal government].” The surviving Tuskegee Study participants' objections to Miss Evers Boys lay the foundation for a deconstructive inquiry setting forth “CRF Critical Teaching Points,” which ultimately address how law intersects with the collective racial histories of the racialized groups in the U.S. “The entire film shifts the responsibility for the Study from the federal government to an African American doctor and an African American nurse. [The] Study was conceived, financed, executed, and administered by the federal government. The African American medical professionals who participated in it were victims as were the 623 African American participants.” As to the role of Nurse Rivers in the Tuskegee Syphilis study, inasmuch that it is erroneously depicted in Miss Evers Boys or a fictionalized account, it should be noted that the oft-cited historical account of the study, Bad Blood, by James H. Jones, “devotes a major portion of [the book] to describing Nurse Rivers' work and the trusting relationships she established with the men in the study.” Hammonds argues that:
[Jones] spends far too little time documenting [Nurse Rivers] relationship with the black and white male physicians who supervised her. Castigating [Nurse Rivers] for “ethical *191 passivity,” Jones seems almost personally aggrieved that Nurse Rivers was unable to stop the experiment. [Jones] does not call to account the male physicians who had much more power and authority than she. Thus, in [Jones'] rendering of [“a historical account” - added by author] the story, the black woman nurse becomes the center of the ethical dilemmas raised by the Tuskegee Study. The person who in fact had the least amount of power to resist or question the study is blamed.
As Susan M. Reverby puts it, “Tuskegee's symbolic importance makes it culturally difficult, however, to consider the seeming ‘facts' of the study alone. Especially after the 1997 presidential apology, media and cultural attention have refocused on Tuskegee and its racial assumptions and made the facts still more elusive.” It is an inherent goal of CRF Teaching Points to allow students to critically analyze the elusive and obvious facts, in order to derive a conclusion that ultimately seeks to right historical and present day wrongs by providing culturally competent curricula. As to the Tuskegee Syphilis Study and its biomedical significance in U.S. medical history, Herman Shaw, the 95-year-old survivor who attended the White House Presidential apology sums it up best: “We were treated unfairly. To some extent like guinea pigs. We were not pigs. We were hard working men, not boys and citizens of the United States.” CRF has the potential to enhance medical educations' goal of satisfying cultural competence accreditation standards by applying a reproductive justice *192 framework.