best-selling author james patterson, former president bill clinton's discuss their thriller, the president's daughter about the perfection of the former u.s. presidents daughter by terrorist. watch american history tv every saturday and my tv every sunday on "c-span2". up next is book tvs monthly in-depth program with best-selling author and medical emphasis. washington, she is the other medical archives deadly monopolies in a recently published lodge about nonconsensual medical testing on african-americans members of u.s. military and prisoners. in washington, you write that an agent ten, albert schweitzer out of your life out of my life, change your life, how did that happen. >> i discovered that particular book and it quickly began

reading others and was struck by his spirit of how he melded his christian place in philosophical placement mostly a life devoted to service. and it is found that incredibly compelling. in sort of life that would be very meaningful read and so he's just totally intending person and what is interesting is that i got up as i got older, my admiration of him continued unabated but i became a little bit more nuance and people began pointing out things to be about his behavior and character which basically added up to the fact that he was not perfect it. and the rest of us are perfect for it. but coming to the realization, it was for me because at first i had an intolerance of any evidence of being less than perfectly actuated by a spirit of service that i began to realize that he is a human being

as we all are is really important to not expect perfection because when we dusted to be disappointed but rather to appreciate people not only achieve great things but inspired untold members of other people to also pursue a selfless agenda for their lives. so i i love him and us to love m and i think anybody's is. medical science perfectly. peter: will professionally, for that book in your own it person on the lead you. harriet: women before that on the book, i think that i was probably inspired by the film, starring audrey hepburn but very different for other rules, she was not sort of this, she was actually a none is deeply conflicted by her political release and passion and torn between being good none idea

some survey and quiet none. and it being hero pretty and summarily inspired the man so that i wanted to come up with an addition so it something that he thought that would united very well in high school, on the prizes and joined the health profession association and what is really what came to a rather rude halt, what about i entered college, i was 16 years old and us told universally that forget medicine, this unrealistic goal for you. i was even told by several people there there are no african-american women it doctors. it's not going to happen for you.or and course that was a lie but i believed it because i'd never seen one. and so like an instant derailing of this now chorus, was young and is used to being encouraging academics environment so i kind of exceeded into what they told me even though it was not true and of course i would never do that today.

but it was painful for me and the more so because i realized after a while it was only my story, it was having to a lot of people. peter: you write harriet washington that during your career as a medical researcher this money said, girl like you people don't get organs, they give organs. harriet: yes. the worst part is in large part he was right. peter: what is the back story to that. harriet: while my case, i was working on managing a prison control center and a teaching hospital in upstate new york and i loved the job it was wonderful we had been given some old fire campus for radiology and i was emptying it out in psalms mold patienter files that have been forgotten in the cabinet. having me, i read every one rated i will say that i was nosy, will say that i was being curious, read every single file

but was appalled to discover the files of the african-americans who needed kidney transplants seemed to be treated differently than the white patient. from one social profile, the nonpatients in the negro very prominently written on every page on the social profile so famous no mistake aboutha the ft you knew you were reading a file the black person they mostly seemed that are created from these two files seem pretty identical expo that the men and men were about s same age eldery gentleman who were in kidney failure they both had been employed and they both were there were bothot insured and ty both had families, all the kind of things of people look for in terms of social support and the physical and financial ability and yes, white patient file was filled with his determination to live in everything that was on the claim to an organ. the black person center had a

single line actually on the treatment goal was to help him prepare for his imminent demise. and it was by a physician the new. a kind man who seem to embody the same kind of qualities that i first admired and i was crushed. i'm so disappointed. of course i was not proof the race was a large part of it but it certainly was evident. and i was someone who had worked on that unit, nor corp. she's on the ptolemy, where have you been. of course but people aren't getting these organs are going to white people. in just the summer, read a book called i the organ thief in whih an other talk about one of the first organ transplants heart

transplant from a black man into a white many detailed the history some accurately and soma not good basically he illustrated how other black people and the bodies actually were used. the picture organs that would give the whites and same thing happened in this country. some things were happening south african when i remember as a high school student, during tha christian and his excessive heart transplant but no one ntseemed to talk about the fact that these were simply going into white people from black people in a country that was it was law. so there was that and some argue that some cases there still is pretty. peter: will you 2007 book, your "medical apartheid", in the book you quote martin luther king from 1965 and injustice in health is the most shocking and

inhumane civil rights abuse. what was he referring to. harriet: exactly that. doctor king had many concerns and we typically understandably hear about these concerns but he was equally concerned aboutrn economic disparities and healthcare allocation which he was pushing enough to recognize the systemic problem well before many of the people dead. then if you go back to a lot of accounts during that time, you'll sometimes find papers denouncing practicing in the south they were very overtly racist but turning a blind eye to their own racial disparities. doctor king was his view was much broader than b that. he felt it was happening here and he saw the political and economic in the health struggles

of people in this country were bound together. they were particularly linkedin he also saw how profoundly cruel that was and how it would dictate a personperson's entire life. the medical think determined by the racer being determined by the fact they were poor pretty. peter: and "medical apartheid" still bestseller and open the book with the story about doctor james sims, who was he. harriet: i talked about doctor sims early in the introduction. he's important to medu because e so will epitomize, classic figure in american medicine. we have decided that that we definitely determine people's medical theorist, the people who have achieved great things but when we use the term hero, we are not concerned about how they achieved these things, only that we think in the achieved to thes because sometimes we are

actually wrong and sometimes were describing the wrong person but doctor sims is the perfect example of that hand also have a doctor was viewed worldwide by whites of one way by blacks. many white people viewed him as an american gynecology and praise him a somebody you treated the slaves and the american medical association and for a lot of white women, he was viewed for a long time, they were told to view him as savior. he was able to cure devastating complication of childbirth in the victorian era. then i will go into gory details but is a horrible complication. the results inn a woman being incontinent. of urine and feces and living her life and perpetual pain and infections in just a horrible situation. doctor sims learned how to close it surgically.

but he did predicate of african-american women and he took black limited only black woman and he treated them trying different ways ofrs causing it t which meant that he was experimenting on them and doing surgeries on them from the painful and intimate predict and remember the black women lived n the victorian area just might limited had somebody operating under genitalia, frequently in t of witnesses is doctor sims would invite friends and the doctors come and watch him work wpretty soon he was abusing the black women, not white women by subjecting them and it's it'sble whatever the but also horrible the way american medicine, treated this behavior. even today you will find people defending doctor sims by claiming it that he is no and ccf there was no and it's easier than pretty well they are wrong,

there was predict there were a bit indifferent in that today, one would have to test and be written up in medical journals but during the victorian era, like the mid- 19th century, practice was often to experiment. try things out. asking the patient yes or no if theynt were white but not asking them if they were black simply procuring a person and then buying and selling and renting and borrowing them from their slave owner and summa doing what you wanted to do to their bodies. sent to different views of doctor sims on the one from black women who were enslaved by him and forced and painful intimate surgeries and white women it can rejoice because he had found this careful is horrible consequence of childbirth. it is really something that one finds repeatedly and if you in

the four centuries of history and repeatedly in american medicine you find bodies of black people appropriated and used in service of other people, white people without having any opportunities to say yes or no rated. peter: any right and "medical apartheid" the scientific racist are observed and in the 18th and 19th centuries, scientific races, was simply science. and yet was promulgated by the best minds of the most prestigious institutions of the nation. what was the role of these prestigious institutions. harriet: police institutions and of these men, the roman, their role was among other things, tol not only solve medical problems but to also tell the world, americans and the world african-americans were.

soon you have a swiss nationalist who was at harvard and was one of the best-known scientist in the worldld he was one of the same markets will come the groups of scientists who examined african-americans made certain proclamations about them, they said the african-americans had profoundly bodies and white americans in fact, my people belong to two different species. they were not truly homo sapiens. the had a missing link between animals and human beings. black people didn't feel pain the way whites did because their nervous systems were so primitive. and you know, simply unable to register pain. for anxiety or develop heart disease which back then was described often for anxiety. so african americans were profoundly different in beings, they were just people with different hair textures can help of these work beings who are not

really human and diseases that black art that white people have had. we note know it was held to beic the infectious disease about people had because they weree dirty, basically. even other publications that the doctor sims experimented on, was held to affect more slave women the right women and the reason was because white women were dirty. and the reason given for out lot of known elements like yellow fever, and they proclaim the black people die from yellow fever the way white people did. they suffered less from malaria. see the theories really profound, the identify people didn't suffer heatstroke that they could work for long hours that becoming tired. you take these beliefs together they actually constitute an profound apology for slavery. if you are plantar, confronted

with big fields and subtropical environment that was widely held an environment where people would get mother and if he had a very hot environments where most white people and native americans suffer heatstroke, what better boon than to be given a creature who didn't feel pain, to get heatstroke, didn't die from yellow fever and it you are assured that did not feel pain and was i would have certain illnesses. as i can boon from a wonderful thing. so with the doctors were doingng with these theories was they were supporting enslavement. they continue to support it as enslavement changed suddenly with abolitionist putting a lot of pressure demand this and other countries. pinning enslavement and so the medical theories became more and more frankly, hostile towards african-americans but the real

purpose was to support enslavement into linda moral medical support for practice. horrible situation and frankly you can still see aspect of it today pretty. peter: that's what i wanted to ask you about next, have you found proof of that mindset having effects today. harriet: while others have found proof and actually, sometimes it is really well-documented printed for example, pain. the belief that black people do not campaign which was used to justify of course forcing themst into enslavement and artwork and into medical research. it's okay to cut the genitalia of african-american women who had because unlike the white women they won't feel anything. so you would think that sort of belief would be long gone. the studies have shown a consistently we still believe

that the medical practice is stillt incorporating that belief in the most recent one was in 2016, in virginia, there's a study they found that 60 percent of medical students surveyed believe that african americans did not feel pain way whites did and they believe that i can americans required more radiology we do more radiations for treatments and ended whites. these beliefs are right on the 19th century greed and the affect people practice. they also found group of practicing doctors believed this. the snow we have doctors practicing in this country and graduating believe that african-americans don't feel pain. it's a very dangerous belief. and again, it is straight out of two centuries ago and if i can worry about that thanks we are not tracking that were not looking at pretty another thing now is our belief in racial diseases. and it sounds laughable but weav

have them still today predict where is back in the 19th century, just as doctors believed in the black people did not get die from yellow fever, malaria, today they also have the black people diseases only the head. things like africana and other diseases and things that invented it only affected and killed black people according to them. but today we believe that as well predict very common belief even today that sickle cell disease is a disease of black people. it isit not. the people who are at risk are people whose ancestors and currently proven area where mosquitoes were common. it never skied out carries malaria rated and of being or having the traits of sickle cell, not the disease but the traits, protective against

malaria. if you live in area and you have one sickle cell disease, then you are more likely to'r survive than people with sickle cell disease or people who do not have it. don't have this it gives you an advantage. but it is a matter of where you grown up, and not a matter of your skin color yet week in this country treat the sickle cell in the black disease. so even when coronavirus research began on it in france, french doctors quite promptly publish an article which they supposed that there belief that of africand people descent at reacting to infections about kindness and very differently than white people. the biological dimorphism is driving medical pots even though there's oftenth no evidence at l of the evidence is very poorly

understood as with malaria rated so we have not fully for centuries later change. peter: most recent above, from carte blanche the erosion of medical consent in the open that with a modern-day story about a doctor named doctor robert armstrong who has a pretty. harriet: so a doctrine texas practicing it was treating nursing home patients and employees and hydroxy and this medication was first obligated by donald trump. who had a profound interest coming in stocks and consortium that includes this pretty and in any event, this was made popularized by trump a lot of his political supporters so embraced it and he was actually

the person who opposed his nomination for president. that was in texas so that he began doing it to his patients and the employees nursing home patients and many of them were to old or too cognitively deteriorated to often form consent and you can't give informed consent if you have cognition problems if you're not thinking very well or if you're very well. in these patients on that category and as time goess cases to go to their next of can preview talk to the children of. talk to a lawyer, to make decisions for them and he didn't do that when asked about it, he said why didn't do that because i talked to the families about everything i wanted to give i would spend all my time talking to family studies totally not getting informed consent and he

also claimed that the people have been cured. but when local health officials examined the records they found something very different. there was not a good cure rate and a good number of people had gone on to become ill and die and despite getting this medication. so the larger question of course iois the larger issue is him for not obtaining consent in situations where consent has either been mandated by law and by practice or in cases where doctors or institutions decide it's more important to the expediency of the organization is more important in serving people's right to say yes or no. but as i discussed in the book of the larger question is also that 1996 that people being aware of it total lack of

transparency, we had two large changes in the law the decoy peoples rights to consent to medical research. and of transparency, people simply don't know this. we are seeing more and more experiments being conducted on people and around the chances they answer no. whether they wanted to be involved in medical research. and back in 1996 and i am so prickly puzzled by the fact that so few people, is have so little information about it printed that is why were the book because people have to know this. they have a right to know that there's a pattern in this country unless we arrested, i'm afraid it's going to continue and when they wake up to find out that we don'ts have the rigt to consent to many things that we would expect to have the right to consent to grade.

peter: what is that legal and medical definition of informed consent. harriet: there actually, nearly identical. informed consent has more than just asking someone to do a procedure or conduct experiments and having to say yes or no. good to tell them everything a person would need to know to make it reasonable decision until the what is there supposed to do now you propose to do it in detail and it was a known risk are pretty and their risks that you don't know of any can address those obviously but tell them risk that you didn't know and tell them the benefits that you will hopeful a rope and researcher cannot be sure there will be benefits. could just as easily be harmful but tell them why you think that it might be beneficial pretty also need to tell them anything and on about how it might affect them. fully retired, would be hungry,o unable to eat are unable to drive. all these things have to be revealed to the percent afraid

to them about lifestyle changes that result from it and tell themt what the purpose of the research is pretty scarry important printed and violated in the past. harnessing how important it is until you see violation of it so you tell them all that but you're not finished. once there in the research, as things change new information emerges, tell them that as well. ... ... >> it's in the code of federal

regulations in the section that deals with medical experimentation. but in 19962 exceptions were passed to the lot that is where the problems began. that was certain types of research in this country no one has to tell you any of these things they don't have to tell you you are in a research study. host: from carte blanche since 1986 being forced to participate in medical research has been permitted under the federal code of regulations provided certain conditions are met what are those? >> it is various one of them says if you are testing a new treatment you have to make a case it is better than the existing treatment.

the problem with that is the vague language. that permeates the law.s so what is better than? what that results of my opinion is when you want to test something new they tried to disparage the existing treatment nobody question but now you want to test scenario have to say the problem with saline to people who are losing blood is xyz. ilthe number would satisfy the oncondition you often not always have the condition you don't have to tell people they are in the study or get theirsi permission but sometimes you are told those that live in the area you are doing theg study so they are aware of the fact so they are shot in the chest they could end up in a situation where they have

artificial blood in their body he told that in general so they know that used to be called community consent but there is no consent involved now it's called community notification the problem is if you go to some areas like north carolina and 5 million people that could be affected but with community consent they only reached a tiny percentage of these people. but in seattle at one point they told people the same thing they were testing artificial blood if you are an accident or trauma victim we may put then artificial blood in you without asking. they were day lose by request forr exemptions. twenty-four hours a day every

day a bracelet that said i declined the study. in this case they ran out of bracelets for one year. nobody could get exemption from the study for that year so it really wasn't observed. even though they claimed that it was. those are essentially it that the conditions that rely on languagean like standard of care has to be flawed in some ways. you are hard pressed but that is exploited to push for the experimental administration without getting people's permission. host: we have barely scratched

the surface the guest this month is medical ethicist and scientist harrietet washington. the author of several books beginning in 2000 with living healthy with have a titus he. - - with hepatitis see. deadly monopolies that shocking corporate takeover 2011. infectious madness. 2015. a terrible thing to waste environmental racism and the assault on the american mind. 2019. the most recent book carte blanche erosion of medical consent. we will continue talking but we want to hear your voices as

well. several ways to contact harriet washington. what we have been talking about so far to think about

that henrietta lacks story. host: with everything we have talked about leads me to think of the henrietta lacks story. >> yes. first of all i am so happy she is now a household name. it's a very important story and i'm glad now so many americans know what happened to her. in the 19 nineties. i consulted with her husband who was still alive and her family because i was deeply concerned because in 1951 was suffering from ovarian cancer had her cells removed and

cultured, kept alive without her permission. her husband was vehement in no uncertain terms he had refused permission for her cells to be taken and the hospital did it anyway. this talks about appropriation which is the following people of color coming to the american shores. it happens all the time. so in her case her cells were unusual and turned out to be biologically very valuable in terms of providing a good medium to culture disease including the polio vaccine. yet her family was lied to first of all her husband. even about stringent objections i spoke to her son david many times in that link

and he told me that they found out by accident from a family member that the mother cells were being kept alive. one researcher at johns hopkins who had been frank and told them everything and it even included her mother story in the textbook but all others denied it and nature to the family by telling them at one point that you may have the same cancer you have so we need to get blood samples. that's not why because poor laboratory technique was causing the samples to be misidentified. and they needed to identify which were samples in which

were not and it was an international problem. her cells had been distributed so widely in her so valuable but they actually had samples and cultured misidentified. they thought they were looking at prostate cells that turns out they were he was cells but what is interesting when i read the original and to be racialized. most self-centered cultures came from white people because they would tend to take their own families body. but in this case i can only describe it as poor laboratory technique and cross-contamination so they blame the cells instead of the researchers that the cells were rapacious and aggressive taking over other cultures as if they were jumping around the laboratory so that they

were aggressive and not respecting boundaries. it is a horrible example of how the family was lied to the cells taken without anyone's permission very lucrative and a great deal of money involved. that's not true at all. because they didn't want to compensate the family. that the positive aspect of this is and the nih actually works with the family to moderate the distribution of the cells and include the family and their own fiduciary rights.

it only applies to hers unfortunately that's what i would like to see applied were widely that but those who were treated in a similar manner but but they have no way of understanding or knowing and those with the appropriation of cells and lying and withholding income and credit fromnd the family, today we are facing a very different appropriation. no longer unusual cells like henrietta lacks. no other cells have the quality that hers had that companiess find large amount of normal cells very valuable.

they take those cells after surgery to acquire them for many and we take is for valuable procedures. and we are vulnerable either without our knowledge or our understanding of what it meant when we sign a consent form. and then to focus on the monetary. we are significant but when i talk to her family that is not the prime consideration. she has given something very beneficial to medicine thatd had not been acknowledge. that is what consumed them.

it intact about the money involved a lot of the journalist perhaps well-meaning in the monetary value that wasn't the families concerned that a her son said they want to know it's a black woman hope thing the world but when i told him of those things that have transpired he wanted to see for h himself he wanted he went to the johns hopkins medical librarian they would not let him in. so he cannot read information about his own mother. so yes he is very significant but time is moved on. because of thend patent system now it is our own tissues that are on the option block.

that is more of a financial value and maybe more importantly the lack of control of the way our tissues are used. and the lack of agency. but if you're patient in the hospital with that consent form to sign before surgery most people sign it because they need the surgery and do not notice some of those forms have to deal with their tissues taken out of surgery in fact the language has things in it like to take your discarded worthless tissues. if they were worthless they would not wantld them. and because they are being discarded doesn't mean you lose all interest in what happens to it. but thendi you may be invested

but one example if you have a therapeutic abortion that was mandated by her health status but if you are antiabortion then they take the abortus and they do something with it that has to do with preserving to support abortion see when i want your tissues use that way you can have the interest in discarded tissues and that is something researchers would do well to incorporate in their decisions. host: you mentioned you talk to the family in 1984. but not until 2010 that henrietta lacks became a common name and the american

culture because of her back to scripps book. >> that's right. host: did you think about writing the story earlier? >> i did want to. i wrote a brief article about it for a now defunct newsmagazine. i wanted to write more about it and i was approached by the baltimore sun to do a sunday magazine piece about the peace and was so focused on what i thought were most important to me i focused on the ethics of the tissues and the failure to acknowledge the important role of the african-american woman in american medicine and the ethics of distribution and things like that, weighty issues. the response from the

baltimore sun was this is too heavy. humanize her more. what do you mean? it seems so sad. i'm thinking it is sad. can't you write about her dancing? or wearing makeup or something to humanize her? is that i don't want to do that because it's important ethical issue i don't want to dilute that. and then they also asked me pointed questions to me they were very pointed and with the cultural divide so there is a moment in baltimore that had gone through several name changes african-americans refer to itnu as monument mall i guess official name was mont damon so i refer to it as the african-american name they were adamant i should change it and they said i talked to

the family they didn't even know that was the official name of the mall most people know about as monument mall so most african-americans thought of it by that name. so i realize there was a cultural friction and disconnect and it would not be bridged. i would not writete about her eudancing. or wearing makeup because that would delete what happened. but i would not impose the wrong name of the mall. it seemed like it was a cultural problem i said forget it. i don't want you to run the peace. they ran a piece afterwards and in that piece began by talking about her nails painted red and it focused on her dancing. that's the peace they wanted

to write. but the editors i spoke with seem to be the wrong focused and then the import that it happened and also to be intent on having family members say things they were not saying. i realized it would not happen and that climate or those editors. although the important thing of rebecca's book that now everybody knows who she is very grateful for that but i would have written a very different but. one of the things i know is a medical ethicist through my training is that the claims made in the book and elsewhere

about the lack of ethical regulations during this time in the claim that there were no medical ethics back then they could do basically whatever they wanted, that is not true. there is the same error and i pointed out in detail the number of court cases that established of the right to informed consent as a right not only in us law but hospital practice. they keep claiming they did not exist so these are observed when it comes to write whites but not black people. so to say they didn't exist

and then observing when it came to african-americans. would have written a very different book. host: currently lecturing in bioethics at columbia. former page-one editor "usa today" research fellow of medical ethics at harvard. the first call comes from bayside new york. >>caller: i just got c-span reinstated after three years i didn't know about your book. and then to take care of my parents elderly people how

badly they are treated in hospitals. does your book contain advice i met somebody who had recently come back from colorado those advanced directives didn't mean anything if you are not informed about how bad the patient is or what they intend to do. so i said to her should i carry them with me because what happens ifd you're in a car accident you are unconscious and brought to the hospital and they don't know that you have them how do you get that protection? she told me people in colorado are getting tattoos for proof there is some kind of protection. >> this is an excellent

question. i talked about advanced directives and their limitations. but it's very hard in my opinion what can one person do? you are confronted not only with laws but also a lack of transparency and has been highly and due to necessity you are even less likely to see your loved one in the hospital or talk face-to-face. getting information is more difficult. this is a problem that needs to be felt in the law. and to navigate. so to change the laws and to

make the jerk onion decisions about giving or withholding care. without the input of family members or representatives or other people to substitute their consent for the person who cannot give consent it's an excellent question affecting people even more with the pandemic. host: the most recent book carte blanche. the next call from atlanta georgia. >>caller: hello i am a native rastafarian. and i knew ron in college. >> that is my late husband.

we must talk. >>caller: what a great guy. the reason im calling im on prep as a black man i don't see a lot of black gay man taking advantage of prep in the cdc and local organizations and african-american arab black gay men that there is trust so to be on prep then you have to deal with aids or hiv. a and compared to the white counterpart of gay men they are 80 percent on prep. it is a disparity and no one can really answer the question have black gay man living in

atlanta and newf york city a high prevalence of hiv in those communities why wouldn't you be on prep? host: can i ask you? have you gotten the covid vaccine or are you planning to? >>caller: yes. i am already vaccinated. thank youdy for asking. host: harriet washington you write in medical apartheid as part of his question, black fear of medicine. >> yes. that is often justified. also talking about and then these go hand-in-hand you cannot talk about african-american behavior without talking about for the healthcare system that has routinely and consistently failed them or even abuse

them. people that wantf to avoid certain types of care. that abuses people and for seeking medical care i talk about the very persistent beliefs they don't feel black people don't feel pain the way white people do 70 come to hospitals they are routinely turned away as drug-seeking so in that case is a black person afraid of healthcare or the healthcare system? having said all that there is the fact and those don't get the types of healthcare often

and those that are avoiding the car care are african-american gay men are they avoiding pepper not trusting prep or is it held out to them as an option it's important to find out what's going on in those studies designed to find out we can't know what is happening and i'm really glad that you brought up the vaccine because it is a parallel case we have been reading all last summer daily headlines saying african-americans and what clinical trials and to join the clinical trials. and if the data were published and what i saw in the data was

10 percent of people and then 12.3 percent of the population. and no african-americans wereri signing up and there was no full-scale abandonment. and who is tracking white americans? were they signing up were only 50 percent? so why are we so often calling it avoidant or adversative behavior when the reality it could be just as easily lack of access? and that vaccine trials were there and not being acknowledged.

and now to following this let's assume it is exactly as you feared and they are avoiding it. and to be offered. and that they understand the advantage to them and if therewh are any fears and find out what they are. and then to address them. it's a matter of doing a little research to find out what's really going on and then if they are avoiding it why are they avoiding it? and then to zero in and raise at the way it should be that is an excellent question. thank you for asking. >> go to c-span shop.org and

there you can purchase one of her books and part of that purchase price supports the c-span mission. please go ahead with your question or comment. >> i was calling about the racial bias i recently found out that if i get a blood test for blacks and also others why is that? so how many diseases that could be cured?

because she did more for medicine than anybody that ever lived. >> that's exactly what her family is concerned about a from 1994 as i began telling the things that is what they said. that she was a benefactor to the entire world why don't they admit this or talk about this? it's a very good question something i have asked repeatedly about many people including medical researchers who tend not to get their do. excellent question but blood test is this? it is news to me. i have no idea any were administered on a racial basis still tell me more. host: he is gone.

i apologize. >> i wish i knew what test he was talking about if you want to come back or text and let us know. is something that i know anything about. as a lot of people know early in the design of blood storage it was indeed categorized by race with blood from african-americans being cap separate from white americans. and charles was working on blood storage in the uk but didn't want to work in the us for that reason and it was based on the initial superstition. no medical basis at all. but it is shocking to think that could still be happening today. host: please include your first name and your city if you text in, ron.

for those of you who cannot get through on the phone line try social media and finally the phone numbers for the remaining our with harriet washington. good afternoon new york city. >>caller: two questions. but talk about vacillating on vaccine and those that refusing to get the vaccine shot and at the end of her

article it is the duty of people to get the shot how individuals are told that they have a moral responsibility to participate do we have a duty or moral responsibility to take the covid vaccine? then you talk about working in order to sell the body to the and adam missed and there is one documented instance of that can you explain where and when that happens. host: why did you pick up carte blanche? >> i saw that ms. washington would be on your show so i rushed out to get it. i have her other book medical apartheid and i understand she is wonderful. host: are you a medical professional. >>caller: no i am not. >> before you go. we eat your question about

refusing the coronavirus vaccine. >>caller: the title is called vacillating on vaccines and she is asking the question why are new yorkers still refusing to get the covid vaccine? at the end she implies you have a duty. >> okay. thank you. >> the only documented working a murder to sell the body to people doing anatomy in the hospital it took place in baltimore that it has been well documented and of course i don't remember offhand the particulars but it was a white woman living in a black neighborhood and was involved with a black man.

this was well documented and that many black bodies have also been used it was very concerning that it happened a long time ago and it still being done today. in terms of any moral responsibility for accepting the coronavirus vaccine that is tricky there are people that argue there is a moral responsibility in the point is that the better protected are people who cannot accept vaccinations.

so by accepting vaccination against coronavirus you're not only protecting yourself but other people including people who cannot receive the vaccination for some reason maybe they are immunocompromised, too young, allergies also vaccines are not infallible. they may not work for certain people certain individuals the better the chance we have as a community and country to avoid illness altogether. you should be vaccinated to protect other people and it's hard to argue with that. but going from that to say that it is imperative that we should force people to get vaccines or force them to be vaccinated is quite a step. sometimes it should be

undertaken. if it is something we should mandate by law mandating it by law is something we should consider i'm not sure that we should do it americans we love our freedom invoked in the name of freedom of speech and people would not see as freedom of speech are being told we have to do something but yet that is a tool in public health that we don't use often enough. i'm not prepared to say vaccines should be mandated that masks should be. for the simple reason it is protective we know that to be

protective and right now we rely upon institutions to enforce it so how many videos can you see people and a whole foods refusing to wear a mask and exposing other people before you realize a whole foods people are not equipped to enforce this? the tool that we need to consider using more often in the case of vaccination i'm not quite sure especially because a lot of the claims about people refusing vaccines i find to be serious african-americans in particular are accused of vaccines just like a those accused of clinical trials but did those not getting vaccines a lot of it is due to lack of

access we actually had policy that separate african-americans for vaccination and practices because you punish people for things that are not their fault policy dictates people that are 85 and older get priority. and then face the fact in this country african-americans, hispanic americans, native americans are young populations and much less likely to reach the age of 85. ninety -year-old to our white versus 90 -year-old that are black. if you have a policy that prioritizes people who are 85 and older your operating against people of color.

we should be doing it but we have to prioritize people of color higher rates not punishing people that are not there doing. >> have you gotten your vaccine and what type of research did you do if you did or did not quick. >> i got my vaccine but i'm the first one to admit all i was happy to get it they are produced very quickly and very effective but how much research can one really do?d of necessity the vaccines were indeed generated more quickly and without the same meticulous data that we require further vaccines. we don't have the luxury of next five or six years.

so we did the right thing not to do that but it also means we relied upon the companies on certifications their efficacy which is not the quite the same things so so in my opinion it was the only logical step so look at the alternative. the longer people take to embrace the vaccine it's not 100 percent guaranteed there would be no problems that is an unrealistic goal but it is 100 percent guaranteed if you don't take the vaccine much higher rate of becoming infected and infecting someone else and falling victim to a variant that could be much

worse than we see now they are in the way and see talking to doctor and one of the problems to say i will wait and see what happens is the longer you wait the more chance you will experience those to a variant that is worse than what they have now. and spread that variant. it is a dangerous thing to wait and see. it is very clear the best possible courses to take the vaccine. host: massachusetts general hospital and boston. so taking that vaccine is the only logical route it's a thing to do i'm glad we have that option if it hasn't been

made abundantly clear by now it's important to realize they understood that that's why we're in the clinical trials despite all the headlines to the contrary and that's why i'm convinced it is a lack of access hampering african-americans from getting the vaccine. african-americans you don't want to take the vaccine but those are at work by the people who want the vaccine having a hard time getting it. host: attack sent in but iab have heard there are different test standards for diabetes for black people than other races to determine whether someone has diabetes. >> i don't know about diabetes

but if someone is in a disease state. you are right about that and to determine the treatment that should be given. and unfortunately you are right that races factored in that should not be factored in. if you read medical journal articles when describing a patient it's almost immediately one of the first things to say and why? shouldn't you be describing the patient with their symptoms are what they are n experiencing with their own history that is a deep logical flaw in our thinking and the algorithms that contain this flawed that a diagnosis would

be different for black or white spoke to patricia williams i was w on a panel with her and she described very eloquently what you are saying. she had an a osteoporosis test and the doctor tried to run the results and it wasn't working and cannot get any response from the testing mechanismey they kept saying no response possible and tell the doctor decided he would take the fact she was african-american out of the equation and then immediately they had a value for her. something being done in american medicine it begins of incorporating the person andbe the assessment and that is wrong it should not be there all it does is skew results in that is problematic. i wish i could see this is

changing quickly i see changing racially slowly. host: this text was sent i am a behavioral health psychiatric nurse. one of the things i've noticed of working on the psychiatric unit sat patients of color, especially black patients higher on - - higher doses of psychoactive meds compared to white patients that exhibited similar symptoms that always bothered me. >> you are absolutely right it has been a very long time looking at the psychiatric unit in the emergency department african-american patients are more likely to be diagnosed us with a psychosis the same symptoms that give a white person a less serious illness so the symptoms tend

to be interpreted much more dramatically with much more severe illness the same behavior as white people they tend to be given higher doses of medication than whites when i ask a psychiatric nurse why itit was black people received higher doses he looked at me was perfectly serious and said we have to understand african-americans have more muscle mass and it's harder for them to metabolize it. i knew that was sheer bs and i was shocked to hear her say that but that is the same kind ofat thinking that i talked about that i saw in the 19th century with doctors deciding

that some medications at work on black people at all and with others they needed a higher dose where they needed more radiation for their cancers. it is complete fiction with no basis in fact but yet something that needs to be challenged.nd and who knows somebody is working within the profession to getpi kindred spirits about if they want to continue doing this. host: have you considered going back to medical school are starting medical school? >> i am of that old now. i probably would if i were younger. host: eugene oregon. >>caller: good morning. ms. harriet i have a question for you i am a 74 -year-old

mostly apache and other heritages at the age of 22 months old i had polio it doesn't affect the face butos most of my body was paralyzed. i feel i was experimented on quite a bit. host: why do you say that? be 14 since september 2019 a has seven face procedures prior to that i was in the hospital from 22 months of age pretty much continuously through nine yearsn old. >> oh my goodness. >>caller: most of this is paid for by the march of dimes so there was money there to cover whatever they wanted to do with me.

i was in isolation. host: is this just looking back experiments were done on you or is this something you have proof of? >>caller: that is my question. how do i research this? i was in isolation so i don't know what other patients were going through. host: thank you. that's a good question. >>caller. >> it's difficult to prove that line has been used in research without one's knowledge it's very difficult to prove. but looking at old records it's a really good start that old records are sometimes unavailable they might ever have been digitized all too often what i found over and over again in researching

events that records are lost when i hear that records are lost i almost immediately have a negativebe reaction thinking maybe they are lost on purpose but the reality is if you go into it with your eyes open you may not have access that will get approach might be finding a sympathetic ear because they are very practiced and skilled the freedom of information act is something anybody can file but as most journalists know there can be small changes in the way that you file that so rather than going into this on your own get a journalist interested that could help you

but if not it's a matter of educating yourself. you know the institution where you were treated or where the surgery was done and you can act for information on your own case regulations might prevent you but other cases that you should be able to find out about your own but then what kind of procedures were done or experiments conducted in that can be very difficult. if you live in california it's easier because california has the m sunshine laws to make it easier for you to find out about governmental activities. otherwise it's a fishing expedition that can take a long time. talk about 2019 the chances

might be better to find out what happened on your facial procedures. maybe contact the institution and asking them. some people contact institution to get in a non- confrontational way i'm interested in knowing more of the procedure you didid on me and attack it'sou you know where then you consider doing the freedom of information act compelling the institution to give you more information. i wish you all the luck in the world. it can be done but again i would urge you to get the assistance of a journalist that maybe could do these things in a more skilled manner than the rest of us can. host: we have ron from san diego back on the line. what type of medical test were you talking about? >>caller: i was talking about blood test. they have an algorithm where

when you take the test they use the algorithm to determine if you are black than they have one for black and others. >> but you don't only define it to also look at the new england journal of medicine and also the v.a. and then to investigate this facial bias in the new england journal of medicine that we can go to the mat and see. host: we will leave it there and hear from harriet washington. >> yes. the algorithms are in play

here but i wanted to know what kind of test. there are many types of blood test. is there one in particular. host: i apologize. i let ron go to get in more calls i apologize to both of you for that. susan from cambridge massachusetts. >>caller: thank you for taking my call mentioning doctors that don't belong in the pantheon and with a headache medicine. and with the psychosomatic illness. industry books that i know.

and then to the cia that used on migrant patients without consent. and with the policy of the psychosomatic illness. so the t research on psychosomatic illness and he took the torture techniques and then to use them at the cia record say came out terrified. and that he thinks the headaches were gone but they didn't know if that was because. host: can you put it period on this?

in 2016. host: we will leave it there there is a lot of information there anything you want to respond about? >> i'm very sorry about your brother it sounds horrific it also sounds this doctor has only been the subject of three books and other publications and i am glad this has been exposed i'm very sorry what has happened with your brother. host: good afternoon you are on booktv on c-span2 with harriet washington. >>caller. good afternoon. this is my first time to call. i am curious about the president of nigeria. i don't know him but he has been to the doctors in england a couple of times and i am wondering why he has selected

the united states for his medical problems i don't want to know what his problems are so can you tell me why he's going over to england all the time? host: so what is behind your question? is it a distrust of us medicine? >> yes. that would be the answer. >> i'm afraid i cannot help you. i have no idea what he is suffering from why he prefers doctors in the uk to the us. i cannot help you. i'm sorry. host: we have not talked aboutrr a terrible thing to waste environmental racism and the assault on the american mind what is the definition of environmental racism? >> if you ask ten people you get ten definitions but i

think it is the exposure to toxins whether pathogens are heavy metals this is racially mediated in this country and people of color are exposed that much higher rates even profoundly poor white peoplee are less exposed to environmental hazards than middle-class black people. although not recognized as such. and those are also racially mediated. because lead poisoning is a success story but i'm a black hispanic children it is a scourge. but also the cognition over time.

so we have these racially disparate sources of profound cognitive brain problems due to the failure to regulate hazardous materials effectively. host: could lead paint be part of the problem? >> yes. led is a t heavy metal we know and has a variety of ailments there isn't very many that is harmed by lead but we know it damages the brain so in terms of paint, gas even lead lined water pipes. that causes all the destruction in places like flint or pittsburgh or most major american cities that would be the iconic source of

toxicity. host: your book came out in 2011 and we reference this a little bit talkinghi about henrietta lacks but in this book you write in 1980 colleges and universities secured 260 patents per year. and then that was 3000 per year with hundreds of millions of dollars for colleges and universities. what happened? >> but the colleges and universities make a few hundred million dollars so basically in 1980 businesses convinced congress people that they needed to exploit a

patent development in universities. and then to come up with molecules that universities are not in the business of producing products out industry said let us by the statins we will create more medicines that are needed and generate a lot of industry with those federal patents lying around not helping anybody the government saided good idea and as a difference of that law passed similar laws corporations are now controlling medical research and what drugse are developed a determine what will be discouraged and ignored

corporations are focused on the bottom line. they are not making decisions and that's why today we have for example that's why we have 20 drugs for erectile dysfunction in almost no new drugs for malaria the latter is a killer but erectile dysfunction they are willing to pay a lot of money money for so basically in 1980 we turn the control of medical research over to corporations and it was not a good deal. host: why do drugs cost more in the us and other countries is that because they are not subsidized quick. >> it's because drug companies will charge that people will

be willing to pay to stay alive is no accident the most expensive drugs are for the most dangerous diseases. if you have a drug that might save you from dying of cancer, the companies know you are willing to pay almost $1 million per year for that drug or the insurer is so that's what they charge but in the developing world you don't have people that can pay that kindha of money either the drug company will not sell the drug there or that people cannot afford it. in this country they go bankrupt in the developing world they just die. host: what about generics quick. >> a lot of generics are made by the same company that make the patented for-profit brand. so generic joins are approximately 20 percent lower. but the problem is they are

not the answer because what will happen is that in this country they are not that much cheaper and then they come up with another drug that is on patent that might do the same thing that is advertised as better than neil drug your drug might work perfectly well maybe even better than the new one but the new wine is pushed in the one that doctors arees under pressure to prescribe's everything about generic drugs not some countries for a very long time you have drugs and have different patent systems so for example in this country what is patented is the actual composition of the drug in another country what you

patent may be the manufacturing process so then you can reverse engineer much more cheaply to places where people cannot afford the drugs unfortunately the wto passed laws forcing poorer countries to respect western patents.it even of the patent system has written into it basically the escape closet is perfectly legal for the us or any other country to say we'll take the patent away from the company is selling the drug for a lot of many will give it to a company that promises to make the drug for something less than people can afford that when companies have done that the us is very quick to accuse

them o intellectual property theft and castigate them to do something criminal it is frowned upon the government and our companies don't want to do this and won't do this so basically it is the escape clause is not made available to us so drug prices are maintained at the artificially high level and the prices to be clear have nothing to do with the cost of the drug companies claim the rationale of the market and they are but not nearly as expensive to merit the prices that are asked for them. so the reality is the cost is one thing that the prices are something based on what people are abley to pay and can pages stay alive.

host: a lecture at columbia daughter of two soldiers author of six books we like to ask the authors what they are reading and if this is something that interest you weom will show you right now the books at harriet washington and her favorite books and what she is reading. here are some of her favorites earth, the warden by anthony, the beggar's opera, other store stories by samuel delaney and she is currently reading thomas mann. went through a lot o host: and went through a lot

of books there but you gave this note to our producer and said i just finished reading 30 plus books as a national book critics circle board member. so i am taking a break. that is a lot of books. >> it is a lot of books. that i lucky to be in this group of people of books we reinforce each other's sickness. [laughter] so reading thate list of books so much wine struck you that you want to talk about? >> arrowsmith. i cannot completely explain the fascination that i read it at least once a year most years more often but it's weird because the book was

published in the 1920s sinclair lewis was given a nobel prize based on this book but it's embraced more by scientists and literature people which i find interesting and on the face of it it is straightforward, it talks about a young man who becomes a medical researcher but before he engages in period research looking at public health or private practice and a lot of aspects of medicine which reveals something about his personality and in this wonderfully amusing the deep sardonic perception that in one s hand is also very true. it's hard to describe except

sinclair lewis invented part of the american continent it did not actually exist but it is recognizable and real and did that for american medicine in the 1920s and the way that resonates today and talks about things the signal event if there is a pandemic epidemic breakout in a tropical island. the protagonist has to decide if he will give half the people on the island what he hopes is a cure or a vaccine and that the other have to go unvaccinated to serve as a control he does this and justifies it but the dilemma that we face today today we are faced with will use some people in the world as test

subjects to improve the health of other people? it is a perennial dilemma. in the ways that you can recognize today it's a wonderful book i cannot recommend it more. you will recognize a lot of things and with some revelations with the american medical landscape one of the best i have read. host: when i noted in your writing is george bernard shaw seems to make an appearance every now and then. >> a doctor friend of mine said he's a great doctor hater but i don't think he was. there is a a few things he sounded very well that i have 52 african-americans when i wrote medical apartheid was that he talked about the fact

that for ame lot of people in medicine it's a tragedy you have to trust doctors and researchers yet we don't trust them. it's a horrible dilemma and it's a real dilemma and an american dilemma. it's what people face every day. so i think shah was right on the many and i think he hated doctors i think he had a clear a few that they were highly skilled and idealistic that human beings flawed like the rest of us. host: we have 15 minutes left good afternoon you are on booktv. >>caller: thank you for letting me speak and congratulations to miss washington for fabulous books.

they are amazing there is a doctor in 1985, harold freedom freeman was a cancer surgeon who came up with a procedure called navigation are he help people get from the community to cancer care. and then became the first african-american president of the american cancer society but also a member of the colombian university medical school faculty as well but it never spread across the countrync and still reluctant to use the procedure e-mail they are so effective. does miss washington know about his work you know why people are reluctant to use this approach. host: why arepp you familiar with harold friedman? >>caller: i came across his work anded was incredibly impressed with his research

showing that in five years he had transformed us 70 percent mortality rate into a 70 percent success rate. host: are you in the medical field. >>caller: yes. i am trying to help people get exams for cancer and other health treatments and to get vaccinated as well. >> thank you. thank you for bringing up doctor friedman. i know him i am aware of his work for you are right. it's extremely important. groundbreaking work. again he's very prescient and saw things during the eighties and nineties that people are realizing just now and famously said looking at the life expectancy of a black man and harlem is the same as a man in bangladesh.

you cannot compare the health of people in new york as if all new york people are edtreated well because the reality is different and navigating the system what is interesting about that is the reversal up and tell then thecu focus had been system centered. and are they doing x or why but took the point of view from the patient how do they get the medication do they get to the hospital? once he gets there how does he find out or navigate how do i get to the right clinic or caregiver? he recognized hospitals were

opaque and then it had more to do with system failures and patient failures and that's a very hard view to take historically when there are the respect from the point of view of the surgeon. what was being done from their point of view? are they doing xyz? to invert that to look at the system to either navigate or improved that is a huge sea change it has been hard for people to make it i have noticed anecdotally that it

seems to be more the norm in parts of the uk especially a place like london it's more of an appreciation that navigation has to take place. and then treated appropriately. and archive calendar. and african-americans won't sign up or follow through or to be complicit with it and then to be invested in the system. and then proselytizing another

american cancer society president i had that same and diverted perspective how are we failing them? so that is the big difference between them how do we make them fit within the healthcare system that is flawed so that's a hard thing for people culturally and just so you know, the habit of practice. habitually it has been set up for the convenience of the surgeon and a high status practitioner. getting people to completely invert that is a a big ask. it can be done. it is very successful and i hope that the success these people have had will be for

others paying attention doing things differently. host: is this your office at home where you do your writing? >> this is what passes for an office. radio myy writing. i have a huge bookcase to the left and a smaller one over here and all of my equipment. it's my little space capsule. host: carte blanche just came out this year. when did you start? how much was research and writing? >> i don't know about the research and writing. that is a hard thing to piece out for me. because research is continual. i really don't know how they

tend to work on it for one year but the pandemic intervened i changes in publishing so it was published one year later than it should have been. and it is a relief to write a smaller book i'm used to writing huge door stoppers. this was more focused and smaller and i enjoyed that. host: are you ever surprised we your research takes you? >> constantly. that's a good thing when a larger more broad surprises is that but 2002 i used to love gone conspiracy theories very differently. i would hear from people w that

would tell me something to be utterly fantastic i prided myself to keepse an open mind the more i have learned now when i hear the most fantastic things the reaction tends not to be this cannot possibly be so two i will look into it. honestly i did not play that could have happened it has expanded my idea of what people are capable of we hear stories and that tendency is

to judge that likely veracity. but i think to myself i am hearing from some person and they may not have that much education or be that sophisticated and you are more likely to think conspiracy theory or something that's not true. and to be vastly credentialed. so the bottom line is have a better appreciation of a conspiracy theory. education, income, social standards social status and we know more about history and

defense. and then excavating history based on whoho the people are. host: just a couple minutes left please go ahead. >>caller:he what a great segue. and with those logical inconsistencies but hopefully those discussions follow up to propose covid natural herd immunity. and it is textbook. and then with that trump covid genocide and in this case specifically by intent, eugenic genocide. host: let's get an answer. herd immunity and genocide and

president trump. >> one of the problems is that they often incorporate some small degree of accuracy that it is actually real and if you so much fiction into them. and with lingering credibility that's what happened with the term herd immunity it does exist. is not what these people are talking about and more to the point it ist very dangerous. for a disease to rip through a community is suicidal. virulence is complicated there is an excellent book called

playing time that goes into great detail that when you allow a disease to proceed unchecked so for example that disease going to the population unchecked will kill many more people we have already lost so how many more will die? because it becomes more virulent if we have a variant that is more dangerous. vaccinet it more quickly. it is a suicidal supposition. and it's also frankly illogical. it doesn't make sense to a person that has no training or

education. t people will find this kind of, or should find this kind of ideological. and yet it is being proposed. it is really important to not rely on things that sound ideological but the experience of epidemiologists who understand the things that can occur. what is most important is ife yu ask someone like doctor anthony felt -- fauci, they will explain this concept, and yet you have people thanks to the internet being catalyzed with these dangerous rumors. i'm glad you brought it up, because you have to be careful not to listen to these things.

>> host:. has been our guest for the past two hours on booktv. she's the author of six books. the mostst recent being "the erosion of medical consent." thank you for