Defense Date

5-8-2025

Graduation Date

Winter 12-19-2025

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Joris Gielen, PhD

Committee Member

Gerard Magill, PhD

Committee Member

Peter Osuji, PhD

Keywords

race-based medicine, precision medicine, technique, race in medicine, ethics of race

Abstract

This dissertation proposes that race-based medicine acts as a form of structural racism that is ethically indefensible. While it may be claimed to be a neutral diagnostic tool, the medical use of race as a biological proxy only further enforces the very hierarchies it purports to remediate, reinscribing inequity from conception to death. Building off Jacques Ellul’s work on Technique, we interpret race-based medicine as a self-perpetuating system that values procedural expediency over moral accountability. In nine chapters, the analysis follows the ways this technique is manifested in genetics and assisted reproduction, where commodified racial selection preserves social hierarchies; in maternal mortality and pain treatment, where implicit bias and paternalism render minority suffering invisible; and in research ethics and medical education, where race continues to structure inquiry and pedagogy. Taken together, these practices create a resilient architecture of inequality that warps the science and the ethics of care. Viewing this from a bioethical perspective, this dissertation shows how the persistence of racial categorization is incompatible with the principles of justice, autonomy, and nonmaleficence. It concludes by advocating for a two-tiered reform: a microethical emphasis on clinician-patient communication as an immediate corrective, and a gradual shift toward precision medicine based on genetic individuality, rather than racial typology. In the end, this study recasts race-based medicine not as a matter of scientific advancement, but as a moral failure that must be dismantled if medicine is to serve all patients equitably and with integrity.

Language

English

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