The Dangers of Difference

In view of the suspicion Tuskegee so justifiably engenders, calls for participation by African Americans in clinical trials are worrisome. question of whether to tolerate racially differentiated AIDS research of new or innovative therapies, as well as the question of what norms govern participation by African Americans in clinical research, needs and thoughtful attention. A generic examination of the treatment of differences in medicine is beyond the scope of this article. However, I describe briefly what has occurred since disclosure of the Tuskegee to point out the dangers I find lurking in our current....An appropriate strategy should have as its starting point the presumption that blacks and whites are biologically the same with to disease and treatment. Presumptions can be overturned of course, the strategy should recognize the possibility that biological differences some contexts are possible. But the presumption of equality acknowledges historically the greatest harm has come from the willingness to impute differences rather than the willingness to overlook them. For some, the presumption to be in any way defeasible is troubling. Yet I do believe that fear should lead us to ignore the possibility of biologically responses to disease and treatment, especially when the goal is achieve medical benefit.