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AfricaAm Bioethics Culture, Race, and Identity

African American Bioethics: Culture, Race, and Identity
By Lawrence Prograis, Jr and Edmund D. Pellegrino, 169 pp, $26.95.
Washington, DC, Georgetown University Press, 2007.
ISBN-13 978-1-5890-1164-9.

JAMA. 2007;298:1947-1948.

African American Bioethics is a collection of essays edited by Lawrence Prograis Jr and Edmund D. Pellegrino, from the Center for Clinical Bioethics at Georgetown University. Both of the editors have long-standing careers in clinical and research-based medicine and bioethics. Dr Pellegrino, the chair of the President's Council on Bioethics, has contributed substantially to the field of bioethics and has written extensively on the subject. The essays in this volume were contributed by various African American ethicists, physicians, and philosophers whose charge was to address African American perspectives of bioethical issues and to answer the question, "Is there a distinctive African American cultural perspective on bioethics?" This question was initially posed in 1992 at the First Conference of the African American Perspective in Biomedical Ethics, spearheaded by Pellegrino and by Dr Harley Flack, at which a panel of distinguished African American scholars discussed this and related questions, opening the door for intercultural dialogue. The editors of this current book felt that the change in demography of the United States over the past 15 years warranted a review of this subject, to determine if perspectives, culture, or the bioethical issues have changed.

The essays vary in their focus and discipline, ranging from clinical to philosophical discussions of topical issues. However, there are some major themes that tend to emerge in all of the essays. The major themes addressed in this book are the mistrust of the medical community by African Americans; the impact of culture on health beliefs, practices, and ethics; disparities in health care; and the ethics of technology in medicine.

In his introduction, Pellegrino addresses the basis of African American mistrust of the medical community and extrapolates the perspectives of recent immigrants as they become part of the nondominant culture in this country. He also discusses some of the skills that should be used by health care professionals to alleviate these concerns during encounters with patients. This issue of mistrust is believed by all of the authors to have an impact on how African Americans view health care and may account for some of the conflicts that occur between patients and clinicians. This is very well illustrated by Cheryl Sanders as she discusses the response of the African American US Postal Workers in Trenton, New Jersey, and Washington, DC, who were exposed to anthrax after the September 11, 2001, terrorist attacks. She examines the roles of religion and the concerns about medical experimentation in the decision of many of the postal workers not to follow the recommendations of the US Centers for Disease Control and Prevention.

18 Dec 2002 :: 14 Nov 2008
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