Towards the Abolition of Biological Race in Medicine and Public Health: Transforming Clinical Education, Research, and Practice

Section 2: Cranial Capacities to Eugenics: How Medicine and Health Sciences Biologize Race

During my first semester of medical school at the Joint Medical Program, Professor Osagie Obasogie asked another student and me to co-lead a discussion designed to provide the historical and conceptual context for modern research ethics. Upon doing the readings assigned for the discussion, my colleague and I were shocked and angered that neither of us knew about the history of California eugenicists and their connections to Nazi Germany, despite both of us having grown up in the Bay Area and gone through undergraduate education in the UC system. We must be aware of this racist history in order to challenge its current implications in the institutions that we are a part of. I am grateful to the JMP for allowing me to integrate critical race theory into my medical education through sessions like this one, and I feel a responsibility to share what I have learned.
— Second Year Medical Student

The conceptualization of race as biology is rooted in colonization.

The conceptualization of race as biology is rooted in colonization.

Race began to emerge in society as a function of colonization, as European colonizers began encountering natives and importing slaves who looked different than themselves. Scientific racism emerged from theories of biological inferiority, including Carl Linnaeus’s polygenism (the belief that humankind evolved from two or more distinct ancestral types or races) and Dr. Samuel Morton’s efforts to compare cranial capacities of white colonizers, native people, and enslaved people. These flawed theories cemented societal conceptions of skin tone differences and nonwhiteness as biological concepts. The consequences of such frameworks during colonization and slavery resulted in the foundations of race as we know them today:

With slavery, however, a racially based understanding of society was set in motion which resulted in the shaping of a specific racial identity not only for the slaves but for the European settlers as well. Winthrop Jordan has observed: “From the initially common term Christian, at mid-century there was a marked shift toward the terms English and free. After about 1680, taking the colonies as a whole, a new term of self-identification appeared—white.”[1]

Such historical context laid the groundwork for racial inequality, including the expropriation of property from natives, denial of political rights, slavery and other forms of coercive labor, and explicit extermination and lynching of nonwhite people.

A clear thread can be drawn from the scientific racism of scientists like Linnaeus and Morton to institutionalized racism in science and medicine today. Considered the “father of taxonomy,” Linnaeus’s initial publication, Systema Naturae, in 1735, classified four “varieties” of human species: Americanus, Asiaticus, Africanus, and Europeanus. The classification system claimed Eurocentric superiority through the characteristics ascribed to each race: “Native Americans as reddish, stubborn, and easily angered; Africans as Black, relaxed, and negligent; Asians as sallow, avaricious, and easily distracted; while Europeans were depicted as white, gentle, and inventive.”[2] The classification system was then used to “validate” European subjugation of “lower” races.

Similarly, in his 1839 publication, Crania Americana, Morton put forth race-based interpretations supporting white superiority, racial hierarchy, and Black inferiority through his calculations of marked differences in cranial capacity and brain size. His conclusions were praised for their scientific rigor and used to provide a moral justification for slavery. Scientists who followed Morton’s ideologies of different human races being different human species were considered a part of the “American school.” In 1981, Stephen Jay Gould challenged Morton’s work, exposing inherent biases and flaws in data collection, analysis, and reporting.[3] While Linnaeus and Morton’s work has been repeatedly disproven, the categories of race in such research continue to be taught without critical analysis of their historical origins of racism.

Although Morton died eight years before Charles Darwin published Origin of Species, Morton’s colleagues in the “American school” used Darwin’s revolutionary theories of evolution to perpetuate their theory of social Darwinism.[4] Social Darwinists applied Darwin’s theory of “survival of the fittest” to humans, claiming that certain groups of people were “less fit” than others, and therefore less deserving of survival. New scientific theory was appropriated for racist social ends, and the social category of race was biologized to justify social hierarchies.

As these worldviews began to popularize and become normalized in scientific and everyday discourse, it paved the way for the eugenics movement of the twentieth century. Eugenicists repeated the arguments of social Darwinists before them. In both Europe and the United States, eugenicists aimed to encourage the reproduction of more “fit” races and extermination of those who were “biologically inferior”:

Eugenics was the pseudoscience aimed at “improving” the human race. In its extreme, racist form, this meant wiping out all human beings deemed “unfit,” preserving only those who conformed to a Nordic stereotype.[5]

Medicine must recognize that the eugenics movement played a central role in the history of race-based science. In the United States, eugenics took the form of forced sterilization, segregation, and antimiscegenation laws, all specifically aimed at the extermination of nonwhite people. In Germany, Nazi doctors practiced eugenics by slaughtering, torturing, experimenting on, and murdering millions of people.[6] The perpetrators of these crimes were trained physicians and often distinguished scientists, who were inspired and actively influenced by eugenicists in the United States. Adolf Hitler is recorded telling another Nazi, “I have studied with great interest the laws of several American states concerning prevention of reproduction by people whose progeny would, in all probability, be of no value or be injurious to the racial stock.”[7]

While their names are little-known, American eugenicists included race scientists on the University of California Board of Regents, and funding for their work came from corporate philanthropies like the Carnegie Institution and the Rockefeller Foundation. Organizations as well as individual doctors in the United States came up with their own “solutions” to exterminate inferior populations. For example, the Carnegie-supported 1911 “Preliminary Report of the American Breeders’ Association to Study and to Report on the Best Practical Means for Cutting Off the Defective Germ-Plasm in the Human Population” proposed eighteen “solutions,” including euthanasia.

When World War II ended, eugenics was declared a crime against humanity. During the Nuremberg trials, Nazi doctors and experimenters cited the influence they received from American eugenicists, but the Americans were not prosecuted. Instead, some of the exact same American scientists renamed their cause “human genetics.” They continued to collaborate with former Nazi eugenicists who had similarly avoided prosecution. For example, Otmar Freiherr von Verschuer, who founded a eugenics facility in Frankfurt, Germany, in 1935, reestablished his connections with California eugenicists from before the war and became a corresponding member of their newly founded American Society of Human Genetics in 1949.[8] This legacy underlies the practice of genetics and race-based medicine today.

In calling out this legacy, we do not claim that genetics and eugenics are equivalent. Instead, we call on clinical practitioners, researchers, and instructors to recognize the history that seeks to reappropriate agendas of racism and eugenics in more “neutral” terms that still have historical and contemporary ramifications. Uncritical use of race in genetics and other aspects of medicine stands to perpetuate causes of racism and inequality.

The flawed assumption that race has a biological basis is rooted in a racist history dating back to colonialization and slavery. With this history, we emphasize: race is not a biological concept, but rather a sociohistorical construct and concept. Under this definition, racial categories have no scientific basis but have rather functioned as a central axis to social relations and real material life outcomes in the United States.