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This chapter describes the complex and sometimes contradictory nature of race and gender preferences among middle-class Black women. First, the author presents a case study of Tammy, a focus group respondent whose great-grandfather was involved in the Tuskegee Syphilis Study. Although her case illustrates underlying assumptions of the race concordance hypothesis (that Black patients want Black providers), her story also points to the persistence of structural discrimination and limits of using race concordance as a strategy to overcome it. Second, Tammy’s case is contrasted with women who complicated the underlying assumptions of the race concordance hypothesis by emphasizing the intersection of race, gender, and other identities (e.g., disability, age, sexual orientation) on the formulation of preferences and the futility of race concordance as a strategy to mitigate the effects of a rushed, impersonal, and neo-liberal healthcare environment.

This chapter discusses the issues of medical research and racism as seen in the film Miss Evers' Boys (1997). The film is a fictionalized account of the Tuskegee Syphilis Study (formally known as “The Tuskegee Study of Syphilis in the Untreated Negro Male”), in which the government enlisted over 400 Macon County, Alabama, black men in a study that lasted from 1932 to 1972. The movie is largely an account of Nurse Evers' (Alfe Woodard) relationship with four of the men. The film has opened a broader discussion regarding many ethical concerns and suggests several questions for consideration. These include maintaining the line between care and research; unequal power relations that the institution of racism maintains and in relations that permeate the medical system; communication between black patients and white doctors; and health disparities between whites and the nation's minority populations and poor people.

This chapter focuses on justice. Part one begins with a discussion of how justice is articulated in Principles of Biomedical Ethics. This is followed by two classic cases concerning justice: the Seattle Dialysis Committee and the Tuskegee Syphilis Study. The former deals primarily with clinical ethics, and the latter with research ethics. Together they illustrate how justice is often understood in bioethics. Part two focuses on Bonnie Miller-McLemore’s pastoral image of the living human web. The essential features of this image include the following claims: (i) human suffering needs to be understood in context; (ii) psychology, while valuable and necessary, cannot by itself make sense of the whole of individual human experience; and (iii) other perspectives and disciplines, therefore, are needed, such as sociology, anthropology, philosophy, economics, and more. Part three correlates justice and the living human web.