The New England Journal of Medicine (NEJM), an influential American medical journal that has been circulating for 212 years, published an article in December 2023 acknowledging that in its early days, it had connections with figures linked to slavery in the USA and contributed to the perpetuation of racist ideas. The column, written by four researchers from Harvard University, highlighted that the families of the journal’s founders made their riches by exploiting slave labor and that until the beginning of the twentieth century, the periodical published articles that referred to African Americans using prejudiced and dehumanizing language that would be considered intolerable today. “It is essential that this complicity be recognized. The journal’s engagement with slavery illustrates how medical theories, practices, and institutions influenced, and were influenced by, social and political injustices,” the authors wrote.
The journal’s historical link to slavery is well documented. It was founded in 1812 by a group of doctors from Boston, including John Collins Warren, James Jackson, and Walter Channing, whose families made their fortunes through businesses linked to the exploitation of slave labor, such as selling and transporting goods produced by enslaved people. The essay highlights that while the founders did not participate directly in these commercial activities or own enslaved people, they did benefit indirectly by inheriting the wealth of their parents and in-laws.
The most uncomfortable part of the article relates to the journal’s history of propagating racist theories, although the authors chose not to cite the most disturbing texts they found, to avoid reinforcing prejudice themselves. For example, in 1843, NEJM reprinted an article by surgeon Josiah Nott (1804–1873) that had previously been published in the American Journal of Medical Sciences, in which he stated that “the Anglo-Saxon and Negro races are, according to the common acceptation of the terms, distinct species.” The difference between “Caucasian” and “African” women, according to Nott, is like that between “the swan and the goose, the horse and the ass.” That same year, the journal published favorable reviews of craniometry, which associated skull anatomy with intellectual capacity and was used to promote racist policies. It reprinted an article from the Buffalo Medical Journal stating it would be “impossible for 83 cubic inches of cerebral matter, fed by negro blood, to compete with 92 of educated, Teutonic brain.”
Articles in the journal frequently normalized the inhumane treatment of African Americans. In 1857, a surgeon referred to a Black man with a testicular disease as “helpless to himself and useless to his owners.” While the journal made casual references to white supremacy, it occasionally showed respect for Black people. It once reported on a public petition requesting that an enslaved man who had helped many sick people be exempt from a law that prohibited enslaved people from practicing medicine.
Interestingly, the journal’s acknowledgement of its racist past seems to have arisen almost completely by chance. In 2022, David S. Jones, a science historian and professor of the culture of medicine at Harvard University, was participating in a seminar on Harvard’s history regarding slavery, where he heard Ibram Kendi of Boston University discussing an article published in NEJM in 1842. The paper he was talking about claimed that being enslaved was beneficial to the mental health of African Americans. The author, American physician Edward Jarvis, used data from the 1840 census to suggest that “idiocy or insanity” was 10 times more prevalent among free Black people than enslaved people. His exact words were that “slavery has a wonderful influence upon the development of moral faculties and the intellectual powers.” It was soon discovered that the data were unreliable, since some towns told census takers that there were more cases of psychiatric illness among Black people than there were Black people among the local population. The article was retracted a few months later at the author’s own request, but the association between slavery and mental health persisted in racist discourse.
Jones told the health-oriented news website StatNews he was so shocked by the seminar that before even leaving the talk, he sent an email to the NEJM editors asking if they would be willing to examine the journal’s relationship with slavery. To his surprise, the journal welcomed his question and agreed to give independent researchers access to archives dating back more than two centuries, allowing them to analyze how editorial decisions were made and the impact they had on the country’s medical culture. Jones and his team will publish further articles on equally sensitive subjects in 2024, such as how the editors treated Native Americans, the eugenics movement, Nazi-era medicine, gender prejudice, and topics related to civil rights.
The journal’s reckoning with its past follows similar initiatives at several American universities. Ruth Simmons, whose great-grandparents were enslaved, was named Brown University’s first African American president in 2001. Two years later, she appointed a committee to review the university’s historical relationship with slavery and propose reparations—a memorial recognizing the institution’s heritage was inaugurated on its main campus in 2014. Virginia Commonwealth University recently unveiled a display commemorating 50 Black people whose remains were found in an abandoned well in 1994, having been discarded by doctors at the institution in 1800.
These types of initiatives also focus on the present. In an editorial published in December, the editors of NEJM explained that the articles about the journal’s ignominious past seek to reflect on the lasting effects of prejudice. “Clearly, although the problems discussed in these articles have roots in history, many of our deep-seated preconceptions remain,” they wrote.
Evelynn Hammonds, professor of the history of science at Harvard and one of the article’s authors, explained to StatNews that prejudice continues to fuel the health disparities faced by Black Americans. “History matters,” she said. Not everybody gets the same healthcare in America. How did we get a system like that? It didn’t just pop up from nowhere.”
Republish