{"id":2951,"date":"2021-04-02T17:46:41","date_gmt":"2021-04-02T17:46:41","guid":{"rendered":"https:\/\/live-cornell-law-review.pantheonsite.io\/?p=2951"},"modified":"2021-04-02T17:46:41","modified_gmt":"2021-04-02T17:46:41","slug":"unequal-representation-women-in-clinical-research","status":"publish","type":"post","link":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/2021\/04\/02\/unequal-representation-women-in-clinical-research\/","title":{"rendered":"Unequal Representation: Women in Clinical Research"},"content":{"rendered":"\n<p>The underrepresentation of women in clinical research throughout history is a well\u2011recognized problem.  Progress has been made, but there is still room for improvement and it must be recognized that not all women have been or continue to be treated equally in the context of clinical research.  On the one hand, there is a long history of paternalism and lack of respect for women\u2019s autonomy that has resulted in the exclusion of women from research, particularly pregnant women and women of childbearing potential.  The potential consequences of this are many, including harm to women\u2019s health because diseases and treatments can affect men and women differently.<\/p>\n\n\n\n<p>On the other hand, there is also a long history of women of color being unknowingly or unwillingly subjected to unethical medical experiments and procedures.  This includes experimentation during human enslavement, carried out most famously by doctors like James Marion Sims, who abused and terrorized Black women who he rented as slaves.<sup class=\"footnote_referrer\"><a role=\"button\" tabindex=\"0\" onclick=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_1');\" onkeypress=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_1');\" ><sup id=\"footnote_plugin_tooltip_2951_1_1\" class=\"footnote_plugin_tooltip_text\">1<\/sup><\/a><cite class=\"footnote_tooltip\"><span class=\"footnote-inner\">1. <em>See infra <\/em>section I.B.1.<\/span><\/cite><\/sup><script type=\"text\/javascript\"> jQuery('#footnote_plugin_tooltip_2951_1_1').tooltip({ tip: '#footnote_plugin_tooltip_text_2951_1_1', tipClass: 'footnote_tooltip', effect: 'fade', predelay: 0, fadeInSpeed: 200, delay: 400, fadeOutSpeed: 200, position: 'top center', relative: true, offset: [-7, 0], });<\/script> He performed myriad gynecological experiments on these women, often without providing them any anesthesia.  It is a glaring reflection on the multiple cruelties of slavery as well as the American experience of medical experimentation.<\/p>\n\n\n\n<p>However, the horrors experienced by women of color in the medical setting are far more extensive, spanning into the nineteenth, twentieth, and twenty\u2011first centuries.  Famously, throughout the Jim Crow period, Black women became the unwitting subjects of eugenics platforms, legally blessed by the 1927 Supreme Court decision <em>Buck v. Bell.<\/em><sup class=\"footnote_referrer\"><a role=\"button\" tabindex=\"0\" onclick=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_2');\" onkeypress=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_2');\" ><sup id=\"footnote_plugin_tooltip_2951_1_2\" class=\"footnote_plugin_tooltip_text\">2<\/sup><\/a><cite class=\"footnote_tooltip\"><span class=\"footnote-inner\">2. 274 U.S. 200 (1927) (upholding a Virginia law authorizing a state\u2019s right to forcibly sterilize a person deemed unfit to procreate).  Buck was considered a victory for America\u2019s eugenics&nbsp;&#x2026; <span class=\"footnote_tooltip_continue\"  onclick=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_2');\">Continue reading<\/span><\/span><\/cite><\/sup><script type=\"text\/javascript\"> jQuery('#footnote_plugin_tooltip_2951_1_2').tooltip({ tip: '#footnote_plugin_tooltip_text_2951_1_2', tipClass: 'footnote_tooltip', effect: 'fade', predelay: 0, fadeInSpeed: 200, delay: 400, fadeOutSpeed: 200, position: 'top center', relative: true, offset: [-7, 0], });<\/script>  In Mississippi, the frequency and normalization of sterilizations are revealed by the term \u201cMississippi Appendectomy\u201d becoming associated with the practice.<sup class=\"footnote_referrer\"><a role=\"button\" tabindex=\"0\" onclick=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_3');\" onkeypress=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_3');\" ><sup id=\"footnote_plugin_tooltip_2951_1_3\" class=\"footnote_plugin_tooltip_text\">3<\/sup><\/a><cite class=\"footnote_tooltip\"><span class=\"footnote-inner\">3. <em>See<\/em> Harriet A. Washington, Medical Apartheid 202\u201106 (2006).<\/span><\/cite><\/sup><script type=\"text\/javascript\"> jQuery('#footnote_plugin_tooltip_2951_1_3').tooltip({ tip: '#footnote_plugin_tooltip_text_2951_1_3', tipClass: 'footnote_tooltip', effect: 'fade', predelay: 0, fadeInSpeed: 200, delay: 400, fadeOutSpeed: 200, position: 'top center', relative: true, offset: [-7, 0], });<\/script>  The term reveals the mistruths told to Black women and girls, as well as the callousness and neglect used to obtain consent for the real surgeries taking place.  Most recently, during the COVID-19 pandemic, allegations of sterilizations at immigrant detention centers only further the concerns related to these matters, particularly as they affect vulnerable, poor women.<sup class=\"footnote_referrer\"><a role=\"button\" tabindex=\"0\" onclick=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_4');\" onkeypress=\"footnote_moveToReference_2951_1('footnote_plugin_reference_2951_1_4');\" ><sup id=\"footnote_plugin_tooltip_2951_1_4\" class=\"footnote_plugin_tooltip_text\">4<\/sup><\/a><cite class=\"footnote_tooltip\"><span class=\"footnote-inner\">4. <em>See infra<\/em> note 56.<\/span><\/cite><\/sup><script type=\"text\/javascript\"> jQuery('#footnote_plugin_tooltip_2951_1_4').tooltip({ tip: '#footnote_plugin_tooltip_text_2951_1_4', tipClass: 'footnote_tooltip', effect: 'fade', predelay: 0, fadeInSpeed: 200, delay: 400, fadeOutSpeed: 200, position: 'top center', relative: true, offset: [-7, 0], });<\/script>  This history has contributed to women of color\u2019s distrust in the government, research institutions, and the medical system in general.<\/p>\n\n\n\n<p>These two historical wrongs are distinct, yet related in that they both harm women\u2019s health, dignity, and autonomy.  As this Article will discuss, much progress has been made to increase women\u2019s overall representation in clinical trials, but there is far more work to be done with respect to the representation of women of color, and people of color in general.  The primary focus of this Article, therefore, is the inadequate representation of women of color, and people of color more generally, in clinical trials.  <\/p>\n\n\n\n<p>To read more, please click here: <a href=\"https:\/\/live-cornell-law-review.pantheonsite.io\/wp-content\/uploads\/2021\/04\/Whelan-Unequal-Representation-Women-in-Clinical-Research.pdf\"><em>Unequal Representation: Women in Clinical Research<\/em>.<\/a><\/p>\n<div class=\"speaker-mute footnotes_reference_container\"> <div class=\"footnote_container_prepare\"><p><span role=\"button\" tabindex=\"0\" class=\"footnote_reference_container_label pointer\" onclick=\"footnote_expand_collapse_reference_container_2951_1();\">References<\/span><span role=\"button\" tabindex=\"0\" class=\"footnote_reference_container_collapse_button\" style=\"display: none;\" onclick=\"footnote_expand_collapse_reference_container_2951_1();\">[<a id=\"footnote_reference_container_collapse_button_2951_1\">+<\/a>]<\/span><\/p><\/div> <div id=\"footnote_references_container_2951_1\" style=\"\"><table class=\"footnotes_table footnote-reference-container\"><caption class=\"accessibility\">References<\/caption> <tbody> \r\n\r\n<tr class=\"footnotes_plugin_reference_row\"> <th scope=\"row\" class=\"footnote_plugin_index_combi pointer\"  onclick=\"footnote_moveToAnchor_2951_1('footnote_plugin_tooltip_2951_1_1');\"><a id=\"footnote_plugin_reference_2951_1_1\" class=\"footnote_backlink\"><span class=\"footnote_index_arrow\">&#8593;<\/span>1<\/a><\/th> <td class=\"footnote_plugin_text\"><em>See infra <\/em>section I.B.1.<\/td><\/tr>\r\n\r\n<tr class=\"footnotes_plugin_reference_row\"> <th scope=\"row\" class=\"footnote_plugin_index_combi pointer\"  onclick=\"footnote_moveToAnchor_2951_1('footnote_plugin_tooltip_2951_1_2');\"><a id=\"footnote_plugin_reference_2951_1_2\" class=\"footnote_backlink\"><span class=\"footnote_index_arrow\">&#8593;<\/span>2<\/a><\/th> <td class=\"footnote_plugin_text\">274 U.S. 200 (1927) (upholding a Virginia law authorizing a state\u2019s right to forcibly sterilize a person deemed unfit to procreate).  <em>Buck<\/em> was considered a victory for America\u2019s eugenics movement, \u201cdeliver[ing] a clarion call to Americans to identify those among them who should not be allowed to reproduce\u2014and to sterilize them in large numbers.\u201d  Adam Cohen, Imbeciles: The Supreme Court, American Eugenics, and the Sterilization of Carrie Buck 2 (2016).<\/td><\/tr>\r\n\r\n<tr class=\"footnotes_plugin_reference_row\"> <th scope=\"row\" class=\"footnote_plugin_index_combi pointer\"  onclick=\"footnote_moveToAnchor_2951_1('footnote_plugin_tooltip_2951_1_3');\"><a id=\"footnote_plugin_reference_2951_1_3\" class=\"footnote_backlink\"><span class=\"footnote_index_arrow\">&#8593;<\/span>3<\/a><\/th> <td class=\"footnote_plugin_text\"><em>See<\/em> Harriet A. Washington, Medical Apartheid 202\u201106 (2006).<\/td><\/tr>\r\n\r\n<tr class=\"footnotes_plugin_reference_row\"> <th scope=\"row\" class=\"footnote_plugin_index_combi pointer\"  onclick=\"footnote_moveToAnchor_2951_1('footnote_plugin_tooltip_2951_1_4');\"><a id=\"footnote_plugin_reference_2951_1_4\" class=\"footnote_backlink\"><span class=\"footnote_index_arrow\">&#8593;<\/span>4<\/a><\/th> <td class=\"footnote_plugin_text\"><em>See infra<\/em> note 56.<\/td><\/tr>\r\n\r\n <\/tbody> <\/table> <\/div><\/div><script type=\"text\/javascript\"> function footnote_expand_reference_container_2951_1() { jQuery('#footnote_references_container_2951_1').show(); jQuery('#footnote_reference_container_collapse_button_2951_1').text('\u2212'); } function footnote_collapse_reference_container_2951_1() { jQuery('#footnote_references_container_2951_1').hide(); jQuery('#footnote_reference_container_collapse_button_2951_1').text('+'); } function footnote_expand_collapse_reference_container_2951_1() { if (jQuery('#footnote_references_container_2951_1').is(':hidden')) { footnote_expand_reference_container_2951_1(); } else { footnote_collapse_reference_container_2951_1(); } } function footnote_moveToReference_2951_1(p_str_TargetID) { footnote_expand_reference_container_2951_1(); var l_obj_Target = jQuery('#' + p_str_TargetID); if (l_obj_Target.length) { jQuery( 'html, body' ).delay( 0 ); jQuery('html, body').animate({ scrollTop: l_obj_Target.offset().top - window.innerHeight * 0.2 }, 380); } } function footnote_moveToAnchor_2951_1(p_str_TargetID) { footnote_expand_reference_container_2951_1(); var l_obj_Target = jQuery('#' + p_str_TargetID); if (l_obj_Target.length) { jQuery( 'html, body' ).delay( 0 ); jQuery('html, body').animate({ scrollTop: l_obj_Target.offset().top - window.innerHeight * 0.2 }, 380); } }<\/script>","protected":false},"excerpt":{"rendered":"<p>Much progress has been made to increase women&#8217;s overall representation in clinical trials, but there is far more work to be done with respect to the representation of women of color, and people of color in general. The primary focus of this Article is the inadequate representation of women of color, and people of color more generally, in clinical trials.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[47],"tags":[191,192,229,661,680,681,682],"class_list":["post-2951","post","type-post","status-publish","format-standard","hentry","category-online","tag-clinical-research","tag-clinical-trials","tag-covid-19","tag-underrepresentation","tag-women-of-color","tag-women-on-the-front-line","tag-womens-health"],"acf":[],"_links":{"self":[{"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/posts\/2951","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/comments?post=2951"}],"version-history":[{"count":0,"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/posts\/2951\/revisions"}],"wp:attachment":[{"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/media?parent=2951"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/categories?post=2951"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/publications.lawschool.cornell.edu\/lawreview\/wp-json\/wp\/v2\/tags?post=2951"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}