Anti-Black Racism in Healthcare Interactions: Opportunities for Bioethical Engagement Restricted; Files Only

Abstract

The field of bioethics has played a limited role in addressing racial injustices rooted in anti-Black racism within U.S. healthcare. In this thesis, I argue that bioethics is well-positioned to confront this ethical issue more directly, given its values-based approach to moral conflict and its foundational commitment to justice. Despite the significant contributions of Black bioethicists, their work remains marginalized within mainstream bioethics. This omission poses challenges for early-career professionals entering a healthcare system marked by racial inequities. Drawing on my experiences as a nurse witnessing anti-Black racism, my graduate education, and extensive research, I examine both the strengths and limitations in existing bioethics literature and practice.

I identify key strengths, including the potential to expand traditional theories of justice, apply moral courage in practice, and more meaningfully engage with care and narrative ethics. I critique foundational bioethics for its failure to account for the moral harms of racism and to integrate this reality into guiding principles. To address these limitations, I highlight interdisciplinary frameworks from public health and theories from philosophy to illustrate how bioethics can evolve.

I propose a three-part approach to advance this work that calls for practical guidance across bioethics curricula, scholarship, and practice that: (1) integrates antiracist pedagogy into core bioethics coursework; (2) promotes virtue-based interventions that cultivate moral courage; and (3) expands the role of healthcare ethics consultants to actively support antiracist practices within institutions. Together, these opportunities aim to position bioethics as a more engaged and relatable field in the pursuit in advancing health equity through active confrontation of anti-Black racism.

Table of Contents

Introduction…………………………………………………………………………………...1

Section I: Process and Definitions………………………………………………………..2

Thought Process Behind Inquiry…………………………………………………….......2

Definitions and Context of Key Terms…………………………………………….........8

Section II: Witnessing Anti-Black Racism in U.S. Healthcare As A Nurse……… 11

Vignette One:………………………………………………………………………............12

Observations……………………………………………………………….................... ..13

Ethical Concerns………………………………………………………….......................18

Vignette Two:………………………………………………………………………............19

Observations………………………………………………………………...................... 20

Ethical Concerns…………………………………………………………… ....................22

Reflections…………………………………………………………………………..............23

 

Section III: Historical Significance……………………………………………………….25

 

Section IV: Strengths and Limitations in Current Bioethics Literature………….27

Principle of Justice…………………………………………………………………............28

Capability Theory of Justice………………………………………………....................30

Health Justice: Respect for Communities…………………………………................32

Virtue Ethics………………………………………………………………………..............35

Moral Courage……………………………………………………………........................35

Ethics of Care………........…......…………………………………………………………..40

Narrative Ethics…………………………………………………………………….............42

Limitations…………………………………………………………………………..............43

 

Section V: Contributions from Other Disciplines……………………………………..44

Public Health Critical Race Praxis…………………………………………………........44

Epistemic Injustice…………………………………………………………….................46

Structural Injustice…………………………………………………………………...........47

Section VI: Opportunities for Bioethics’ Engagement……………………………….48

Three-Part Approach………………………………………………………………...........48

Antiracist Pedagogy…........……………………………………………………..............48

Interventions in Moral Courage………………………….………………...................52

Antiracist Healthcare Ethics Consultation….……...……………………................54

Conclusion………………………………………………………………………………….....57

Positionality……..……………………………………………………………………….......59

Bibliography………………………………………………………………………………......60

About this Master's Thesis

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School	Laney Graduate School
Department	Bioethics
Degree	M.A.
Submission	Master's Thesis
Language	English
Research Field	Ethics Health Sciences, Medical Ethics Health Sciences, Public Health
Keyword	Moral courage Black bioethics Interpersonal racism Health justice Structural racism Antiracist pedagogy
Committee Chair / Thesis Advisor	Lavery, James V., Emory University
Committee Members	Zhang, Ju, Emory University Mabel, Hilary, Emory University

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