Description:

The Master of Arts in Medical Humanities & Bioethics

presents

A Montgomery Lecture

Black Birth Matters:
The Weathering Hypothesis as a Challenge for Justice in Clinical Practice

Bioethicists frequently appeal to concepts of justice in their moral frameworks. For example, bioethical principlism holds that four principles – respect for autonomy, beneficence, nonmaleficence, and justice – are sufficient for characterizing and resolving ethical dilemmas in medicine, using a process known as specification and balancing. Justice is usually appealed to in discussions of allocating health resources, such as allocating organs for transplant or allocating hospital beds in a pandemic. This presentation describes the weathering hypothesis put forward by Arline Geronimus to explain observed disparities in maternal and fetal outcomes for pregnant, black women and their babies. This talk also suggests that weathering presents a challenge to traditional appeals to justice in clinical bioethics; because, once a hypothesis like weathering has been substantiated by scientific observation, this creates an obligation to change health care practices to promote justice. That is, with the ample empirical support for the weathering hypothesis, I argue, hospitals and clinicians incur an obligation to alter practices to reduce these observed disparities precisely because they are unjust. This talk concludes by considering how hospitals and clinicians might alter practices to mitigate the effects of weathering and how ethical they might be.

Thomas V. Cunningham, PhD, MA, MS
Director, Bioethics
Kaiser Permanente