Harriet Washington speaking to a class at Amherst College
Presidential Scholar Harriet Washington visited Christopher Dole's “Medical Anthropology” class.

“Medical researchers are not the best people to criticize their own work,” says the bioethicist and science journalist Harriet Washington. “Police can’t police themselves. Writers should not edit themselves. It’s only good logic to have something exterior to look over what you’ve done.”

Washington directs her words to Gabi Valdivieso Calderon ’24, who has asked about the role of IRBs, or institutional review boards, which vet and review medical studies on human subjects. It’s the last Tuesday of September and there’s a pummeling rain outside Room 201 in Chapin Hall, where Anthropology 245, “Medical Anthropology,” is meeting. The students here, many of them pre-med, have prepped for Washington’s visit by reading a chapter from her latest book, Carte Blanche: The Erosion of Medical Consent.

About those IRBs: they’re mostly stocked with scientists, though the FDA demands they also include laypeople who represent the community being studied. Then again, only one such community representative is required by law.

students ask questions during Harriet Washington's visit to their class
Gabi Valdivieso Calderon ’24 (left) asked about the role of IRBs, or institutional review boards, which vet and review medical studies on human subjects. At right, student Harrison Drebin ’22.

“How can one layperson protest against all these scientists?” Washington asks rhetorically. “They have no authority!” She proposes that IRBs get split 50-50 between scientists and laypeople, given American medicine’s long history of research transgressions, especially towards those in marginalized communities: “That’s more fair, and it gives real voice to the people affected.” 

Washington writes a great deal about what’s fair and what’s definitely not in the way medical research is conducted. She has published several other books that lie at the intersection of health and race, including Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, which won the National Book Critics Circle Award. She has been a research fellow in medical ethics at Harvard Medical School and lectures on bioethics at Columbia University. 

This was Day 2 of Washington’s week as Amherst’s first Presidential Scholar, a program that brings prominent voices in anti-racist scholarship and policy to campus for short residencies.

It was a packed week, with some 20 events on her plate: She spoke to several other classes, in the biology, chemistry, psychology and anthropology/sociology departments; sat for a student Q&A at the Science Center; met with students from The Amherst STEM Network magazine; offered insight to a faculty search committee for anthropology and sociology appointments; and gave a talk at Johnson Chapel, the first held there since the pandemic began.

Students listed to Harriet Washington who visited their class during the fall 2021 semester
Students in Christopher Dole's class “Medical Anthropology” class listen to guest lecturer Harriet Washington.

Back in Chapin 201, this Presidential Scholar covered much ground, speaking about everything from the Nuremburg Codes on medical study voluntary consent; to the ignominious Norplant contraceptive studies in Latinx communities, which caused permanent sterility to some subjects; to philosopher Jeremy Bentham’s concept of utility; to the 1964 Declaration of Helsinki, a set of ethical principles about human experimentation, “which has been modernized and in my opinion eviscerated over the years,” said Washington.

Weakening of principles was a theme in Carte Blanche, too: “The book is an attempt to detail how consent is slowly being erased from research,” she told the class. “But informed consent is only one of many thorny issues here.” So are semantics, loopholes and how companies “manufacture futility,” as a pretext for testing their subjects but saying it’s too expensive to then treat them.

As for the idea of “voluntary consent” it is often, in reality, induced consent, said Washington. To illustrate that point, she brought up a medical study on impoverished boys in Harlem, N.Y. The researchers offered $200 to mothers if they signed up their sons, promising the study would improve the boys’ lives. “That’s an unfair inducement to poor women,” she told the study’s lead researcher, who countered, “No, the $200 is a token of our generosity.” To Washington’s mind, this well-off, Harvard-educated man “was coming at this from a very different place.”

students ask questions during Harriet Washington's visit to their class
Phyllis Oduor ’23 (left) asked about the ethics of medical studies in the developing world. Viet Cuong Nguyen Ba ‘24 (right) poses a question.

Likewise, pharmaceutical companies “are very casual in their approach to informed consent,” said Washington, answering a question from Phyllis Oduor ’23 about studies in the developing world. 

The class ended as Christopher Dole, professor of anthropology, asked Washington about her next book project. It will follow the history of several African American physicians, including James McCune Smith, born into slavery and America’s first Black man to get an M.D., though he had to practice outside the country at Scotland’s University of Glasgow. 

Future Presidential Scholars include Kwame Anthony Appiah, the ethicist, New York Times Magazine columnist and former Princeton philosophy professor; Viet Thanh Ngyuen, novelist, MacArthur Fellow and critic-at-large for The Los Angeles Times, who teaches at the University of Southern California; and Chanda Prescod-Weinstein, assistant professor of physics and astronomy and core faculty in women’s and gender studies at the University of New Hampshire, and a monthly columnist for New Scientist