Over its long history, the health care system in the United States has faced many new rules that referred to service delivery, patient-practitioner relationship, the use of equipment, and others. One should note that the attitudes toward illness and the ill also altered depending on opinions that were widespread in society. Significant shifts have happened over the post-Civil War period to the present. Thus, the principal purpose of this paper is to explain why some sick people were considered guilty of contracting their illness, while others were seen as innocent victims and how their roles developed.
The development of society is closely connected with that of medicine. When racism and discrimination were widespread phenomena, they were present in the health care industry. In the late 19th-early 20th century, white and wealthy Americans believed that it was necessary to control the inflow of immigrants and the poor. It was so because those individuals were considered responsible for the spread of favus or trachoma in America (Warner & Tighe, 2001). In addition to that, Terence Powderly, Commissioner-General of Immigration, admitted that all immigrants are a burden for the United States and American taxpayers (Warner & Tighe, 2001). Furthermore, he insisted on the fact that the immigrants were responsible for the spread of the diseases under consideration. It was so because Americans had not been familiar with either Favus or Trachoma “until the tide of immigration swelled up” (Warner & Tighe, 2001, p. 242). As a result, American officials decided that it was a useful solution to prohibit selling steamship tickets in Asia and Europe to people suffering from any of the diseases. It indicates that the US thought that sick immigrants were enemies of the nation’s well-being.
In the same period, there existed a belief that African Americans were responsible for the spread of tuberculosis among whites because African Americans were servants in wealthy homes. L. C. Allen insisted on the fact that the “disease among the negroes is a danger to the entire population” (Warner & Tighe, 2001, p. 250). Racism played an essential role in Allen’s supposition because he considered African Americans guilty persons who spread the illness among whites irrespective of the fact that tuberculosis did not have any racial preferences. In addition to that, Allen tried to explain that the abolition of slavery had adverse consequences for the health of African Americans. He stipulated that free representatives of that minority group lived in dirty conditions and witnessed “more sickness and inefficiency and crime” (Warner & Tighe, 2001, p. 250). The ideas above reflect Allen’s subjective view of the problem.
However, Allen also demonstrated humane opinions as to how to solve the issue. Instead of offering to isolate African Americans or expel them from the country, the Georgia Physician explained that it was necessary to cure them. He admitted that it was rational to invest in the education of African Americans to help them prevent the spread of the illness under consideration. However, Allen’s proposal reflected superiority over this minority group because he indicated the necessity to provide those people with “individual drinking cups and nice lunch baskets made with their own hands” (Warner & Tighe, 2001, p. 252). Consequently, the Georgia Physician thought that African Americans were responsible for the spread of tuberculosis, but they required supervising assistance to solve the problem.
In the mid-20th century, African Americans witnessed a better approach to their problems, but a few severe issues still existed. Doctors feared that syphilis was common in the black community. When health care professionals did not know how to cure the disease, they organized an experiment to find a useful treatment method. The Tuskegee Study would become one of the least ethical medical tests in American history. The experiment was organized by the US Public Health Service to study how untreated syphilis develops in African Americans. For that purpose, the scientists selected 600 males and monitored their health cconditions A few facts explain why the study is considered unethical. Firstly, the selected African Americans were exposed to suffering without getting adequate treatment. They did not obtain penicillin when it became a drug of choice for syphilis. Secondly, the experiment lasted for 40 years instead of six months as it had been promised to the participants. Finally, the study was unethical because its participants did not give informed consent, while subterfuge played an essential role in it (Warner & Tighe, 2001).
The Tuskegee Study case indicates another shift in attitudes toward the sick. Medical professionals acknowledged the fact that the given minority group suffered from the disease, and it was decided to address the problem from a scientific point of view. However, the prejudice that existed in society did not allow the researchers to consider African Americans victims of the medical condition. On the contrary, the participants were blamed, which explained the unethical design of the experiment. Even though the Tuskegee Study raised a few essential issues, it demonstrated that some steps toward the elimination of racism in America occurred. It relates to the fact that the experiment can be considered positive because the scientists chose to focus on African Americans when there was much syphilis throughout all parts of the population in the US.
The situation above contributed to the fact that society started considering various diseases the universal problem that could affect everyone irrespective of their race, gender, and age in the second half of the 20th century. This belief resulted in the case that an American community began to discuss illnesses to prevent them from spreading. Syphilis and poliomyelitis are the most suitable examples that reflect the changes in society.
On the one hand, Warner and Tighe (2001) stipulate that it was necessary “to lessen the stigma” of syphilis to protect the nation from it (p. 449). On the other hand, polio became a significant topic, and many philanthropic efforts were taken to contribute to the publicity of the illness. The battle against polio was similar to that against smallpox because the two significantly relied on vaccination (Fresh Air, 2011). However, one of the most significant differences in contrast to earlier attitudes referred to the attempt to explain that infected individuals were not guilty. Thus, both medical and social changes were necessary to solve the problem.
The events above took place in the mid-20th-late 20th century and indicated that infected people were no more seen as guilty persons. However, the situation with AIDS demonstrated that some individuals obtained specific attention from the government. It relates to two AIDS posters produced in the 1980s. These historical documents show the government invested its efforts in modifying individuals’ behavior to prevent the disease from spreading. Even though those people were not considered guilty, they should have been controlled.
The efforts to remove negative attitudes toward people with illnesses were necessary to cure them adequately. Once that occurred, it was possible to mention that the United States became more democratic. Since then, the health care industry has done much to eliminate racism and prejudice from its practice, but it is not possible to state that the goal has been achieved. It was impossible to imagine that modern practitioners would blame representatives of a particular minority group for being infected with a specific disease. However, the current crisis with COVID-19 shows that negative issues are still present because some Americans have blamed China and Chinese immigrants for the spread of this new illness. Modern medicine draws much attention to diversity, offering equal service to patients of all races, genders, ages, backgrounds, but there is still room for improvement.
In conclusion, it is impossible to mention that the position of sick people in society has always been the same over American history. Initially, the health care industry was full of prejudice and racism. That is why every African American or representative of a different minority group with a disease was considered a guilty person. Consequently, such individuals should have been isolated from the American community. As society developed, the attitudes toward the sick also changed. In the late 19th-early 20th century, the first attempts tried to solve health problems, but they did not treat infected individuals adequately. Significant improvement happened in the mid-20th-late 20th century when the US started considering every infected person a victim.
Thus, the gradual development of social attitudes has resulted in the fact that the modern health care system is better compared to its state in, for example, the early 20th century. However, it is challenging to state that the American health care system is democratic and accessible to everyone. Infant mortality, life expectancy, and other health outcomes vary widely between Americans of different regions, races, and classes. In addition to that, successful experience with polio and smallpox is not a conviction for modern people because some of them actively oppose any vaccination (This American Life, 2008). Thus, American officials should do their best to provide the population with better medicaservicesce.
References
- Fresh Air. (2011). How the “pox” epidemic affected vaccination rules [Audio podcast].
- This American Life. (2008). Ruining it for the rest of us [Audio podcast].
- Warner, J. H., & Tighe, J. A. (2001). Major problems in the history of American medicine and public health: documents and essays. Houghton Mifflin.