Black feminist essayist and poet, Audre Lorde, wrote the above words early in her battle with breast cancer.1 She understood that honoring human life involves more than the tallying of statistics. Everyone counts, not simply in the sense of arriving at an accurate numerical total, but rather in the sense that everyone matters. Each of us, as a unique, precious human person, deserves to receive the particular attention that is owed to all human beings.


Breast Cancer Black Woman Healthcare Quality Latina Woman Social Ethic 
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  1. 1.
    Audre Lorde, The Cancer Journals (San Francisco: Aunt Lute Books, 1980), 54.Google Scholar
  2. 2.
    Reprinted with permission from Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson, eds., Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, Institute of Medicine (Washington, DC: National Academy Press, 2003). (Citation abbreviated hereafter as Smedley et al., Unequal Treatment.)Google Scholar
  3. 5.
    “Study: Disparities in Care Kill 80,000 Blacks,” published on CNN.com (March 10, 2005), online: www.cnn.com. Satcher made these statements in an article published in a special issue of the journal Health Affairs: See David Satcher et al., “What If We Were Equal? A Comparison of the Black-White Mortality Gap in 1960 and 2000,” Health Affairs, March/April 2005, 24(2):459–464.CrossRefGoogle Scholar
  4. 11.
    Lawrence D. Bobo, “Racial Attitudes and Relations at the Close of the Twentieth Century,” in America Becoming: Racial Trends and Their Consequences, vol. 1 (Washington, DC: National Academy Press, 2001), 273. Neil J. Smelser, William Julius Wilson, and Faith Mitchell (Citation abbreviated hereafter as Bobo, “Racial Attitudes and Relations at the Close of the Twentieth Century.”)Google Scholar
  5. 14.
    J.Z. Ayanian et al., “Unmet Health Needs of Uninsured Adults in the United States,” Journal of the American Medical Association 284, no. 16 (October 25, 2000): 2061–2069, online: jama.ama-assn.org. Copyright © (2000) American Medical Association. All rights reserved. (Citation abbreviated hereafter as Ayanian et al., “Unmet Health Needs of Uninsured Adults in the United States.”)CrossRefGoogle Scholar
  6. 15.
    In this effort, my aim bears some resemblance to others such as Robert N. Bellah et al. and Patricia Hill Collins who engage their respective disciplines with the similar purposes—social transformation. In Collins’ case, she does Black feminist social theory specifically for the sake of the empowerment of Black women. See, e.g., Robert N. Bellah et al., Habits of the Heart: Individualism and Commitment in American Life (Berkeley: University of California Press, 1985);Google Scholar
  7. Patricia Hill Collins, Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment, 2nd ed. (New York: Routledge, 2000).Google Scholar
  8. 16.
    “Vulnerable populations” is a specific term used in healthcare research and can have a few different meanings. One manual for protecting human subjects in research defines it in this way: “Group/individual that cannot give informed consent because of limited autonomy (e.g., children, mentally ill and prisoners). Also refers to subjects who may be unduly influenced to participate (e.g., students, subordinates and patients).” Cynthia McGuire Dunn and Gary Chadwick, Protecting Study Volunteers in Research: A Manual for Investigative Sites (Boston: Center Watch, Inc., 1999), 224. (Citation abbreviated hereafter as Dunn and Chadwick, Protecting Study Volunteers in Research.) Healthcare researcher Lu Ann Aday defines the term somewhat differently: “Vulnerable populations are defined as being at risk of poor physical, psychological, and/or health risk.” She then identifies nine specific vulnerable populations and groups them within three types of needs: “physical needs— high risk mothers and infants, the chronically ill and disabled, persons with AIDs; psychological needs—the mentally ill and disabled, alcohol and substance abusers, the suicide- or homicide-prone; social needs—abusing families, homeless people, and immigrants and refugees” (italics is in the original).Google Scholar
  9. Lu Ann Aday, At Risk in America: The Health and Health Care Needs of Vulnerable Populations in the United States (San Francisco: Jossey-Bass, 1993), xviii. While Aday’s definition is a bit broader than the first, both lack any mention of race, and socioeconomic class is only present by way of inference (homeless, refugees). In this project, I explicitly emphasize these vulnerable communities: Persons and communities of color, those in poverty, and/or the lower socioeconomic classes and those who do not speak or understand English.Google Scholar
  10. 19.
    See John H. Evans, Playing God: Human Genetic Engineering and the Rationalization of Public Bioethical Debate (Chicago: University of Chicago Press, 2002);Google Scholar
  11. John H. Evans, “After the Fall: Attempts to Establish an Explicitly Theological Voice in Debates over Science and Medicine after 1960,” in The Secular Revolution, ed. Christian Smith (San Diego: University of California Press, 2003).Google Scholar
  12. 20.
    See Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 5th ed. (New York: Oxford University Press, 2001). (Citation abbreviated hereafter as Beauchamp and Childress, Principles of Biomedical Ethics.)Google Scholar
  13. 21.
    Allen Verhey, Reading the Bible in the Strange World of Medicine (Grand Rapids: Eerdmans, 2003), 18. (Citation abbreviated hereafter as Verhey, Reading the Bible in the Strange World of Medicine.)Google Scholar
  14. 23.
    Lisa Sowie Cahill, “Can Theology Have a Role in ‘Public’ Bioethical Discourse?” in On Moral Medicine: Theological Perspectives in Medical Ethics, 2nd ed., ed. Stephen E. Lammers and Allen Verhey (Grand Rapids: Eerdmans, 1998), 57–62. (The anthology will be abbreviated hereafter as On Moral Medicine.)Google Scholar
  15. 26.
    See Paul Tillich, Systematic Theology, 3 vols. (Chicago: University of Chicago Press, 1951);Google Scholar
  16. Paul Tillich, Dynamics of Faith (New York: Harper and Row, 1957).Google Scholar
  17. 27.
    Gregg Bloche laments, Notably missing from the national political agenda, though well-documented in the research literature, are the larger problems of population-wide racial gaps in health status and access to medical care … [T]here is no serious prospect of public action to ameliorate these disparities…. The more intractable problem of racial disparities in health status has attracted some of the research attention recently paid to social determinants of health, but our politics has not focused on these disparities as a problem in urgent need of a public policy response. ((M. Gregg Bloche, “Race and Discretion in American Medicine,” Yale journal of Health Policy, Law, and Ethics I (2001):97–98. [Citation abbreviated hereafter as Bloche, “Race and Discretion in American Medicine.”]) Extracts appear with permission from Yale Journal of Health Policy, Law, and Ethics. All rights reserved.)Google Scholar
  18. 35.
    I would like readers to know of an important book that specifically explores end of life care issues for inner-city poor and interviews several people in the end stages of disease. See David Wendell Moller, Dancing with Broken Bones: Portraits of Death and Dying Among Inner-City Poor (New York: Oxford University Press, 2004).Google Scholar

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© Aana Marie Vigen 2006

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