In a bold move, the New England Journal of Medicine (NEJM), with a history spanning 211 years, has initiated a series examining its own involvement in perpetuating slavery and its enduring impact in the United States. Joining other publications and medical organizations in confronting their troubling histories, NEJM aims to shed light on biases and injustices it may have supported. Commissioning independent historians to review its content, the journal intends to publish articles uncovering its role in historical wrongs.
In the inaugural series installment, physicians and historians scrutinize NEJM’s complicity in U.S. slavery and medical racism. Notably, the founders of NEJM, John Collins Warren and James Jackson, hailed from families that profited from slavery, emphasizing the journal's entanglement with the institution. The analysis further exposes instances where NEJM allowed the publication of racist ideas under the guise of scientific research, influencing political narratives during the period.
Science recently spoke with Evelynn Hammonds, a historian of medicine, science, and public health at Harvard University and co-author of the analysis, to delve into the significance of addressing the journal's past and the necessity of medical journals examining their histories.
Key Takeaways:
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Historical Examination Long Overdue:
- Hammonds emphasizes that the examination of NEJM’s history in the context of American medicine should have happened earlier. The wake of events like George Floyd’s murder prompted questions about the deep-seated racial inequalities in various institutions, making it crucial to explore historical issues now.
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Founding Years and Slavery-Related Questions:
- NEJM commenced in 1812 in Massachusetts, a time when slavery was still legal in many parts of the U.S. Despite being launched after slavery was outlawed in Massachusetts, the journal published articles by 19th-century physicians comparing the bodies of white and Black individuals. These physicians sought to document perceived differences, particularly focusing on pain tolerance.
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NEJM’s Role in Studying Race in Medicine:
- NEJM continued publishing articles that perpetuated the basic premise of health disparities between races. The journal accepted the comparative assessment of Black and white bodies as a legitimate medical question, reflecting the racial biases of the time. Notably, there was no direct denunciation of slavery in the published content.
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Evolution of Views Over Time:
- As the 20th century unfolded, more systematic critiques emerged, predominantly from Black scholars and physicians who challenged the comparative approach to understanding racial differences. Critiques by African Americans gained traction post–World War II, eventually leading to a shift in focus within NEJM, with authors responding to critiques and questioning innate differences between races.
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NEJM's Ongoing Journey:
- The series represents the beginning of NEJM's introspective journey. Hammonds acknowledges that there's more work to be done, but the journal has demonstrated a commitment to interrogating its past. Future publications are expected to draw on this work, potentially influencing medical theory and practice.
Conclusion: The NEJM’s initiative to confront its historical complicity serves as a testament to the growing acknowledgment of past injustices within medical institutions. As the series unfolds, it has the potential to contribute significantly to ongoing discussions about racism in medicine and shape a more inclusive and equitable future in the field.
