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Race-Based Medicine and Justice as Recognition: Exploring the Phenomenon of BiDil

Published online by Cambridge University Press:  01 January 2009

JOON-HO YU ,
SARA GOERING  and
STEPHANIE M. FULLERTON
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Extract

In the United States, health disparities have been framed by categories of race. Racial health disparities have been documented for cardiovascular disease, cancer, diabetes, HIV/AIDS, and numerous other diseases and measures of health status. Although such disparities can be read as symptoms of disparities in healthcare access, pervasive social and economic inequities, and discrimination, some have suggested that the disparities might be due, at least in part, to biological differences based on race. Or, to be more precise, if race itself has no determined biological meaning, race may nonetheless be a proxy that collects a group of individuals who share certain physiological or genotypic features that affect health.

Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 18 , Issue 1 , January 2009 , pp. 57 - 67
Copyright
Copyright © Cambridge University Press 2009

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References

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20. Food and Drug Administration. FDA approves BiDil heart failure drug for Black patients [press release]; 2005 Jun 23. Available from http://www.fda.gov/bbs/topics/NEWS/2005/NEW01190.html (retrieved 2007 Aug 8).

21. Basil Halliday of BDH Clinical Research Services testified at the FDA advisory committee hearing, stating “If you have poor trial recruitment and retention, it then forces you to overlook the differential impact of disease by race, gender and ethnicity. Because clinical trials form the basis of modern medical practice, this overlook then forces a healthcare system that is then unresponsive to the needs of the people it is supposed to be serving. This perceived lack of responsiveness is then perceived as a lack of caring, which then affects trust. You mix all this together and what you end up with is the stuff of health disparities. I submit to you that with approval of BiDil we can at least begin to break this cycle.” See note 12, CRDAC 2005:237.

22. See note 12, CRDAC 2005:258, statement by Lucy Perez.

23. See note 12, CRDAC 2005:213–4, statement by Gary Puckrein.

24. See note 12, CRDAC 2005:211, statement by Gary Puckrein.

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29. Two issues that complicate this charge of exploitation are whether generics are equivalent to BiDil and what costs are experienced by consumers.

30. Although community organizations have not been directly criticized, the potential for conflict of interest has been raised. See note 25, Sankar & Kahn 2005; Saul S. U.S. to review heart drug intended for one race. New York Times 2005 Jun 13. Available from http://www.nytimes.com/2005/06/13/business/13cardio.html (retrieved 2007 Sep 14); Czap A. Color blind, or just plain blind? Alternative Medicine Review 2005 10(2). Available from http://www.thorne.com/media/editorial-10-2.pdf (retrieved 2006 Sep 20).

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34. See note 14, Fraser, Honneth 2003:3. Fraser refers to this dualistic formulation of justice as a “perspectival dualist" understanding. Charles Taylor, Iris Marion Young, and Axel Honneth have articulated similar concepts of recognition.

35. See note 14, Fraser, Honneth 2003:15.

36. See note 14, Fraser, Honneth 2003:15.

37. See note 14, Fraser, Honneth 2003:15.

38. See note 14, Fraser, Honneth 2003:36.

39. For more on this iterative process, which Fraser argues involves some circularity but not vicious circularity, see note 14, Fraser, Honneth 2003:44.

40. See note 14, Fraser, Honneth 2003:76.

41. See note 14, Fraser, Honneth 2003:93.

42. See note 14, Fraser, Honneth 2003:22–3.

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48. Not “targeted” in the sense that a drug is developed with the expectation that it will only work in a single racial group, but rather that drug design would prioritize the defined therapeutic needs of specific, underserved, racial identities.

49. See note 30, Saul 2005. In an interview with the New York Times, Waine Kong, executive director of the Association of Black Cardiologists, stated that the drug company was “aware of the political fallout if they did not have African American participation.”

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