White Medicine, White Ethics: On the Historical Formation of Racism in Australian Healthcare

Abstract

The institutionalisation of racism in healthcare has had a detrimental effect on the treatment and health outcomes of Aboriginal and Torres Strait Islander populations. Institutional racism describes the ways that race has been encoded into medical education, funding regimes, health policy and clinical settings. Proposals seeking to address this situation tend to ignore the historical formation of racialised institutions and instead focus on the attitudes of individuals working in those institutions. Drawing on critical theory of race and whiteness studies, this article argues that colonial medicine and political liberalism co-produced a social ontology and epistemology that centres whiteness as the norm to the exclusion of racialised others. It contends that it is necessary to understand this history to adequately address its continuing effects in Australian healthcare system today. The article argues that bioethics, a field that ordinarily functions as a source of regulation and critique of medicine, has been unable to respond to institutional racism because it too is shaped by this history of whiteness. The article concludes by questioning whether a bioethics centred on racial justice and Indigenous sovereignty could provide a way forward.