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Aashna Lal, The Hastings Center Thank you all for joining us today. Welcome to anti-black racism, health and health care. Please note that you are not audible or visible, but we encourage you to ask questions through the Zoom Q&A function. This session will be recorded and available later at the Hastings Center website, and it should be available later today. And now I want to introduce Michele Goodwin. Michele Rodger Goodwin is the Chancellor’s Professor of law at the University of California, Irvine School of Law and founding director of the Center for Biotechnology and Global Health Policy. She is the recipient of the 2020 2021 Distinguished Senior Faculty Award for Research, which is the highest honor bestowed by the University of California. She is an elected member of the American Law Institute and elected fellow of the American Bar Foundation. And she is an American Law Institute advisor for the Restatement Third of Tort Remedies. So welcome, Michele, and I’ll pass it on to you.

Michele Goodwin Thank you very much for that very generous introduction. It’s wonderful to be with you all. I am joining from Zurich, Switzerland, and I’d like to ask the panelists, Dr. Faith Fletcher, Dr. Patrick Smith, Dr. Keisha Ray, and also Virginia Brown. Dr. Brown, to all come on screen with me. And thank you all so much for being part of this very important conversation and also important undertaking that has taken place. Now, what we’re going to have is a conversation today, but before we launch into that conversation, I want to start with a round robin of my panelists. To have them introduce themselves slightly, doing something a little bit different, because I want to ask them what’s been critical to them in their careers as they introduce their background. And I want to start off with you, Dr. Faith Fletcher, as you undertook and led this effort.

Faith Fletcher Thank you, Dr. Goodwin, for moderating for us today. We’re so happy to have you as a person that has really influenced the direction of bioethics. So I am a public health sciences as well as trained in bioethics. And a lot of my work really focuses on stigma, marginalization, bias, all of these factors that really influence health care engagement. I generally employ a community engaged approach. Most of my work is empirical. I use that empirical work to really influence bioethics dialog around women’s reproductive rights as well as centering perspectives in addition to anti-racism and bioethics as well as public health. So happy to be here. We believe that health equity in disparities in health, in health care is really reflected in this report. And it reflects an interdisciplinary approach to really thinking about issues of ethics issues related to health equity. So thank you again for being here with us today.

Michele Goodwin Thank you so much. And I’d like to turn to Dr. Keisha Ray. What has motivated you in your career in addition to explaining about yourself? What’s been your motivation?

Keisha Ray Well, hello, I’m Keisha Ray. I have a Ph.D. in philosophy. Most of my bio was. Its work is about the social, sociopolitical and cultural determinants of black people’s health, including the the the past ways that racism affects black peoples overall or as a general inequities in health and access to health care. I also do a little bit of the ethics of biotechnology and about how can we talk more about social inequities in health, particularly those affect black people in medical school curriculum. I’m also the director of our Medical Humanities Program here at McGovern Medical School, and most of the motivation behind my work, some of it is personal. Some of it is directly related to my own experiences with racism in health care and how that influenced my that. It hindered me to do the work that I want to do. It hindered me to, you know, just live out those passions to play with my dog and those kinds of things. And so some of it is personal. Some of it is seeing family members who have been discriminated against and how that affected their health. And then also my students, I hear different stories from them when they are in the clinics, when they start that in their third year in medical school and some of the racism that they see and some that they experienced themselves in their own career. And so a lot of what I do is just motivated by wanting better for black people and wanting them to not die preventable deaths and the heartbreak that that sheds on entire families and communities and leaves a legacy in the black community. Thank you.

Michele Goodwin Thank you so much for that. And it’s so important. What you’ve raised is communications that you’ve had with your students, experiences that you’ve had yourself. And we’re going to turn to that because these are full lived lives that you all have. So as you write about these very important issues framed within the bioethics and public health context, the reality is that there is a duality as well that undergirds this reminds me of the work of Dr. W.E.B. Dubois, on one hand, writing as a pioneering sociologist about race in America, and yet at the same time, experiencing the blade and slice of racism in America from his own vantage point. And that kind of duality is very important. It informs the work. And at the same time, there’s also a kind of double effect because you’re also affected by exactly the work. All right. I’m going to turn now to Dr. Smith.

Patrick Smith All right. Thank you so much, Dr. Goodman, for for being here and all of you here. My name is Patrick Smith. I’m at Duke University. I direct the bioethics program at the Center for Bioethics Humanities and History of Medicine at School of Medicine. And I also teach bioethics and theological ethics at Duke University Divinity School. And so for me, what motivates me in many ways is just I come from a family that where some of the members were involved in the civil rights movement, had an uncle who was a long time seriously in Birmingham when he would travel the country, he would often come and visit wherever at various cities. And if any of the relatives were nearby, he would call us and ask us to meet him for lunch, dinner or whatever the case may be. And so he would often ask, what is it that we’re studying, working on, researching, and often tell him. And then he would sit there and nod and kind of look as if he’s somewhat unimpressed by all of that. But then he would just simply say, just don’t forget about the people. And that’s something that always stuck with me, that as I think about the kind of work that I’m engaged in, dealing with these issues of healthcare disparities, questions of bioethics, that at the end of the day that all of that will be for naught if I were to forget about the people. And so when I started into this work of bioethics, I started as the ethics director of a hospice care center. I was helping. I was thinking myself helping others think about what does it mean to kind of value life at the end of life. But being when I started working with particular populations and communities, it became very clear to me that we can’t ask the question What does it mean to value life at the end of life without asking the question? What does it mean to value life before the end of life? And that’s what really opened up. I think the parameters for me to think about these questions of bioethics in bringing social ethics and particularly aspects of religious ethics to bear on conversations in bioethics, to think about questions of health justice.

Michele Goodwin Thank you so much for that. And we’re going to round out then with Dr. Virginia Brown. Also the same question that I put to the panelists.

Virginia Brown Hi. Good afternoon, everybody. Thank you for the chance to be here. And she’s as Michele said after good with said I’m Virginia Brown. It’s hard to figure out how to how to describe. So I’ll do my best by saying this. I’m an ethicist. Okay. At the core of what I do, I’m a medical sociologist by academic training. I’m a public sociologist, most importantly. What does it mean? Where how do you take academic information and bring it to the community in a bi directional way? That makes sense. I’m a community engaged scholar in the Department of Population Health Adult Medical School here in Austin, Texas. So in that role, we do a lot of PR work. So how. How do I think about health, health care inequity using this training in lots of different ways? So a quick answer in my in my research in particular, I look at protecting the autonomy of people who live with serious mental illness, using a document that can give in advance people’s preferences and of care during a mental health crisis. It is about health. It is about at your most vulnerable in a mental health crisis. How do you protect yourself? All of this is informed. You ask the fundamental question, sort of, you know, how did you get into this? Quite by accident and then very deliberately. I found myself working for Mary and Grace, S.D. I was in the Department of Family Medicine at Howard University College of Medicine, and I was working for Mary. And our families go back a hundred years. And I remember sitting in her office one day just it just I remember sitting there realizing that this is social justice work. My family has been long pioneers in the legal battle of desegregating Philadelphia and writing some of the original law. So that’s always sort of been part of the flavor. But this is like how you grew up. That’s how I grew up. Right. And it is what it is. But it was very clear to me that one of the areas that had not experienced that was health and health care. That that that freedom that had been fought for and continued to be fought for did not extend to this place. So, as I said, it was all of a sudden and then very deliberately, that’s when I went back to graduate school. That’s when I started on this path. It’s my second career, so I came to it with a very deliberate framing over time, and I’m delighted to be here talking with you all and working with my marvelous colleagues. It’s been a great, great experience.

Michele Goodwin I so appreciate that. Now to level set for our conversation and for the audience, we’re going to have a deepened conversation, not just pre formatted questions, because I think that that’s not really the full value of what it is that you all can offer. And I hope that you’ll bear with me as we have that deep in conversation, because I so appreciate the deep knowledge that you bring to these issues and even just how you’ve level set right now in terms of what brings you to this, the passion behind it, your family’s histories are really so important. But again, just a couple of things on the table that are important. I want to turn first to face and if you don’t mind, I, I so think it’s important and it’s really the legacy of all of our four parents and so forth that we understand the importance that has been earned by the titles you have. But I hope that you’ll allow me to call you by your first names and call me by mine too, as we engage in the conversation. Okay. Because I acknowledge that our grandmothers worked really hard such that they would not be called girls and our grandfathers, too. Not boy. And I think that that is an important part of our legacy. There’s a Supreme Court case, actually, where Mary Hamilton fought a black woman, fought to be called by her name in US court and not just simply girl. So I just want to level set with that, but I want to start first. Would you say in leading this report, not only why you did it, but what kind of energy did it take to actually do this such that people understand that it’s not just academic.

Keisha Ray Thank you so much for that question, Michele. That’s an excellent question. I you know, I think that my chair recently and I want to highlight that I am an assistant professor at Baylor College of Medicine in the Center for Medical, Medical Ethics and Health Policy. And my chair was describing actually the report recently, and she said, you know, how long have you been working on this? And I started thinking and I was like, actually, all of my life. So as Virginia is saying, it’s just the combination of lots of different life experiences and our career paths. So for me, beginning my work in bioethics, completing Ph.D. studies in public health, the pandemic really helped us to see that health care disparities were exacerbated. And this was a public health crises that clearly has ethical dimensions, ethical dilemmas, especially for individuals that are underserved and marginalized, even so, especially those that are disproportionately impacted by the pandemic. So in my perspective, in my work and I would like the other panelists to also comment on this, I was like, where are where bioethics in this conversation, leading this conversation around these help and health care disparities? I also was especially interested in understanding the feedback, the lived experiences and the expertize of black bioethicist in the scholarship as well as in the media. So we weren’t seeing enough of that early on in the pandemic. So I think it just required this concerted effort, this organized effort to really amplify and elevate the work of black bioethicist, our lived experiences. You describe this insider outsider perspective that we all embody, and many of us working on the report embody negotiating our positions at our institutions, being overly burdened by my work, and also dealing with experiences in our families, chronic illness, people that were disproportionately affected. So we just came together and it was the time. It was the season. Many before us have really laid the foundation for doing this work, which is the intergenerational focus. And it was this the season that really allowed us to carry out the work that had already been started. So again, in this report, we really acknowledge we make mention to previous efforts of other black bioethicists highlighting the unrecognized and even undocumented scholarship in the underside of scholarship, a black bioethicist. So if you look at this report, you’ll see that there are many different forms of writing, empirical, theoretical narrative, really representing the versatility of black scholars. We’re very different. We have different approaches to our work, different ways of being, different ways of knowing. So we were able to bring all of those components together and I think create what we hope to be a seminal report on anti-racism and bioethics.

Michele Goodwin And we’re going to build on that. And I want to turn to you as well, Patrick, in terms of your role with this report and why this report. And then we’ll go a little bit deeper because as you’ve mentioned, say, the role of anti-racism. And it strikes me that there’s terminology which we could use today, which would have been apropos five, ten, 15 years ago. But people would have been stared at five or ten years ago to talk about white supremacy in health care during a time in which people said, well, we’re post-racial. Oh, what’s this talk about white supremacy? And that’s something from a century ago. And so it also seems that now and in fact, with people who have died because of recent efforts undergirding white supremacy, it’s now on the table to be discussed in nuanced ways. But but, Patrick, I want to put that question to you, too. Why this report?

Patrick Smith Yeah. Why this report? Yeah. I mean, for. For me and for. For the other areas as well. It was really important to engage this intergenerational conversation. Right. The idea is that we have to be very clear about what we wanted to do, is that we know that black voices are often erased in these conversations. We want to make sure that we acknowledge and highlight those. But even as many of us now in this day, in this contemporary moment, with Black Lives Matter movements, with George Floyd, with a number of different things where we’re getting a little bit more airtime, people are maybe hearing us. We have more spaces, perhaps to us to highlight these issues and to sound off and to encourage and to generate a call for people to be responsive professionally and ethically about these things. We recognize if we have enough of a historical memory that what we’re saying has been said before. Right. And many others have gone before us and they are have said these things in these spaces, in biopics. Many times their voices were marginalized or not taken as seriously. And I think that they were able to agitate, to plant the seeds in a particular way that allow the fruit of what we are able to do at this moment based on their work before. So, you know, one of the things that we often talk about, you know, is this notion of the sitting at the feet phenomena in kind of our cultural tradition, right, to pay homage and respect to the elders, those who have come before sitting at their feet, just learning from them, being encouraged by them. Right. We wanted to take that seriously. We think about the notion of, you know, the African terms and cofa. Right, literally to retrieve, right to go back and take that which has been forgotten so that it can help provide a pathway to the future. Right. So these saying we want to see this as a Sankofa moment at the same time that uses every moment of time in history together that highlights the interconnectivity of various communities together at one point in the present, reflecting back to have a pathway towards a future that is marked by a greater sense of health justice. And so I think for for me, for many of us, we recognize that we simply stand on the shoulders of giants that we can see further in horizon, not because of our own brilliance or greatness. As brilliant as my coeditors.

Michele Goodwin Are brilliant, but I get.

Patrick Smith It. But, but, but in terms of but we do build right off of the work of so many others and we just wanted to highlight that. And the other thing, Michele, I just want to add is that, you know, one of the things we often recognize is that many of the younger scholars of color doing work in bioethics as they are leaning in finding their own voice, some of them may be unfamiliar with some of these voices as well. And we thought it was really important to just make sure that a new generation of scholars who are doing work in this area are familiar with some of those resources that can help them perhaps and serve them well, as they are trying to lean in in their own way, find their own voice and adapt these resources for the present that we’re in now for more equitable future.

Michele Goodwin I’m really glad that that you mentioned this latter point in terms of future generations are having the tools at their disposal and connecting them with that history because if you don’t, who will? And I think that that has really that kind of duality as well, that faith also spoke to the privilege of carrying history forward, but also the burden of doing it to that. But for scholars of color in these areas, that sadly, the legacies of those who came before would not be carried on, which is really to the detriment of a soul. And another point that you made, Patrick, before I turn to this matter of anti-racism, in asking Keesha and Virginia to speak to it, is that you’ve mentioned how pioneers were also perhaps didn’t have at their disposal the kinds of privileges that you all have now that that I have. And in the context of law, I think about it within the context of constitutional equality. If people often think about Thomas Jefferson, George Washington and others as being the real purveyors of equality, and yet I think about the black mothers and grandmothers in Alabama and in Georgia who were beaten as they attempted to vote, who protested for equality for all, who made a constitution come alive, when in fact, they were dispossessed of it. So, you know, the point that you raise, who are the people who actually really do the work that ends up being meaningful, I think is really implied. And it’s something that still we have to address across medicine, law, public health in many different areas. And so leading to that, I want to start off with you, Keisha, and then go to Virginia about this question of anti-racism, particularly in a backdrop where now there is a push back against history of push back about learning about the plight of indigenous people, Asian people, at a time in which we’ve seen such a dramatic rise of Asia, anti-Asian hate in America, a pushback against critical race theory, this kind of notion that anti-racism itself is the problem rather than the problem itself being racism. So Keisha, let me start first with you about this terminology of anti-racism. What is really meant about that in this context and why is it explored as it is in this report?

Keisha Ray Right. So I think, you know, in particular, we focused on anti-black racism. Right. But that doesn’t mean that there are sort of overlaps. Right. There is there’s different kinds of racism that we that have been addressed in all of the different articles in this special issue. There’s interpersonal racism addressed are structural. There is institutional. And I think what we’re seeing and one of the reasons that makes this special report so special is that it really talks about how these sort of forms of oppression and how they sort of intersect and how they intersect in ways that then create poor health. And so it creates this sort of connection to the past, and it doesn’t make what’s happening right now singular, insular. It says that America is very foundation. The foundations of health care, the foundations of even how we talk about health have these anti-black origins, and they have these white supremacy origins. And they’ve sort of left this trail that we’re still dealing with today in health care. So in these clinical settings, but then also in our own academic institutions and our own bioethics organizations and the way we practice and whose research matters and what research gets pushed to the forefront. And so when we talk about anti-black racism, it’s it’s really about this moment of having so much information, right? We’re in an age where there’s everything is at our fingertips. But at the same time, the more information there is, like you said, the more misinformation there is, the more pushback there is, the more that you see this resistance. And I think it’s because people are starting to feel that we are at this moment in time that we are sort of saying we’re demanding more. Right. We’re demanding a change. You were demanding that that we address anti-black racism within and all of its legacy, all of sex. And I think some people feel threatened. I think people feel like the very just sort of foundations, very threads of America are being changed. And we’re saying, yes, absolutely. That’s what needs to happen. Right. But some people feel like, you know, once you start talking about anti-black racism, that they they just want to hold on so tight to the status quo. They want to hold on so tight. And the status quo is just another way of talking about white supremacy, really, is to say that white supremacy origins are feeling threatened. And so I think it’s really about how by what? Just particularly those that work in the areas of race. And that tends to be blocked by authorities who work on anti-black racism in health care and and in bioethics. I think this is a moment for us to really say, okay, let’s survey the information that’s already out there. And like Patrick saying, there’s lots has been done before us. But that doesn’t mean that the work is done. And I think there is room for the the scholars like us that are practicing now to contribute. And there’s tons of room for the people, the students that are coming up. Right. And so I think that for black bioethicists to really say, how do we make a way for us, it’s how do we make a space for us to do the kind of work that we want to do in the work that we know is needed. But then also, how do we make a way for those students coming after us to continue to do the work and continue to to put a dent in this anti-racist, anti-black racism? And so it’s really about this community. And I think that’s one of the reasons why I was happy to join the other editors here is because I think so many times we we talk about anti-black racism, but part of that that we discuss is the authors is keeping us separate, right? Keeping us doing the work alone in our office is publishing chasing that ten year rate, chasing that promotion. When part of the joy and part of how you get things done is organizing as community. And I think one of the just really great things about this special issue is it created a community. There are so many authors that we’re doing this work and I didn’t even know about. So I see their name and I see their papers and I go look them up and see what other things that they’re doing. And I’m like, Wow, this is great. So really just this idea of community, I think is one really great way to combat this anti-black racism that you see in the academy.

Michele Goodwin So I’m going to turn to you, Virginia, to help us even further unpack what we’re talking about when we talk about anti-blackness. But before I do, for the benefit of the audience, for those of you who don’t yet have your hand on this special report, I suggest you get your hands on the special report. I want to just take you through some of what we have in this special volume. So give me just a moment, because I just want to call out some of this this work, you know, starting off with in the introduction, addressing anti-black racism in bioethics, responding to the call on the shoulders of giants, a reckoning with social justice, bioethics rooted in justice, the ways forward speaking volumes, the Encyclopedia of Bioethics on racism and anti-Blackness as a chronic condition. I need you all hear me as I walk through just these titles alone of what we have in this special report next to this critically important. I mean, we could do a whole weekend retreat just around any one of these issues. Take, for example, is trust enough anti-black racism and the perception of black vaccine hesitancy? I mean, talk about that just in a period of COVID and beforehand. And then also and again, I could just go through all of these and I do want to just list out these titles because they matter. And I want you all to go to them and think about them. The courage to see anti-black racism and geographics and even taken up issues that are intersectional. And all of these are intersectional and interdisciplinary. Woman as ethics. As a contribution to the fields of bioethics and testimonies and healing. I’ll come back to some of those other titles as well. But I do just want for the viewing and listening audience for those who are engaging to just understand the depth of what is in the special report. And so, Virginia, if you could help further center what anti-blackness, what what you think about within the context of anti-blackness and why that’s important, when sometimes people might say, well, doesn’t that just segregate out black people in a way that’s not helpful to the discourse?

Virginia Brown Oh, I have so many thoughts. I don’t think that we say that to our Jewish brothers and sisters. Okay? I don’t think we lay claim to their centers, their work. They’re writing about the Holocaust and conditions to this day as not being scholarly enough or whatever. So I had to say that to say the following. When we think about anti-black racism, it is a call and a request for people to understand that you are only one in your specialty group moment away from experiencing racism. So if you can’t understand this, you don’t understand who you are in the greater scheme of things. So I want to tell a quick story and then list five important points. This past weekend I had a conference thing that we did for my program and one of my students was just saying, sort of matter of fact, you know, after it was over, because that conversation was a collaborative inquiry, we were talking about, you know, engagement and what does community engagement mean? And my students said to me, having gone to work where they were asked to take the vitals of a patient in a room, the student was said by the patient in the bed, Oh, look, it’s an Oriental. I’ve had one of them. And my student was nonplused, had no idea. No idea how to respond. It was like, how did you eat me? Or Did you have Chinese food? Like, you know what’s going on here? And and, you know, she was she was looking to me and I do have permission to share that story. I want to make sure everybody’s clear on that, that if we don’t understand the dynamics and the dimensions that racism can fall into, we will be blind to what happens. We will be blind as citizens. We will be blind as teachers and trainers and educators of the next generation if we don’t understand this fundamentally. So I tell that story to say these key things when we think about why this report, why the conversation around anti-black racism is to to talk about openly and actively the policies, practices and structures that conflate black scholarship as service. Okay. That conflate black scholarship is identity work, not a scholarly endeavor that this is not diversity, equity and inclusion work. Please don’t look to us for that. That’s a very different path. This this study, this work that we’ve done is about how anti-blackness has infiltrated the world of health and health care and that we want to bring formerly marginalized voices to the center and addressing that and equities that exist and to to shed light on this, to make sure, as Kiesha talked about, how the range and breadth and depth of black scholars is lifted up and acknowledged, as Keith said, is as as faith mentioned and as as Patrick has talked about how we bring that, go back and gather the past and bring it forward. And and most importantly, for those of us who are, you know, trying to hang out on that ten year line, trying to get to that hard promised land, that that much of the work that we do, especially in the School of Medicine where I sit, is prioritizing empirical work is the only epistemology that is valued and that is known. And that is that is incomplete way of understanding that it is the lived experiences of people that help shape what we investigate and that that’s critically important. So trying to draw attention to these areas is critically important. And thank you for that question, Michele.

Michele Goodwin I you know, I think the outcomes help to tell us so much and who gets to talk about those outcomes and how right when we think about the glaring rates of maternal mortality in the United States. Right. And how if you’re a black woman in Mississippi, you’re 118 times more likely to die by carrying a pregnancy to term than by having an abortion. What causes that? What is underneath that and how? Nationally, black women are three and a half times more likely than their white counterparts to die during pregnancy in the United States. And how that only magnifies in certain states and counties. So that’s a national figure. But then, you know, you look in some places and it’s ten times more likely, 15 times more likely, 17 times more likely. Or you look at rates of cardiac death or back to Mississippi. But but really, this could be anywhere because we can talk about Georgia, Alabama, we could talk about New York City. Right. How 80% of the cardiac deaths in the state of Mississippi during pregnancy happen to be among black women? Right. And we could go all across the country looking at the highest rates of access and how that happens to be black people. And so to the point that you’re making about why centering this is also in part of a legacy that’s undeniable that the chains and threads of American slavery, as hard as it may be for people to conceptualize, still live and linger with us that those vestiges have not been completely taken away, and that, in fact, if we were better students of our history, then we would understand that those shackles did not fall just because slavery was abolished. With the 13th Amendment being better, students of history would actually inform us how one form of slavery died. And then thousands of laws were made to keep black people shackled to second class citizenship. And a failure to understand that a failure to read that in our history does a disservice to everybody.

Virginia Brown It today today in this moment we are still trying to help our student learners. We call them undergraduate. They’re our medical students and our residents to understand that black folks experience pain, too. So please don’t tell me that. Oh, as I heard in a meeting a couple of years ago, at least black folks didn’t get caught up in the opioid epidemic. Oh, only because our pain was not being treated. Because we magically didn’t experience at the same rate and same level and deserve it being treated. These are things that we are still working on undoing and it is out of the painful legacy of being enslaved in this country and the myths and stories that were told that allowed in the psyche of Americans to to subjugate another set of human beings.

Michele Goodwin Although you’re speaking directly about that legacy of Marion Sims. Which carries forward. Right. You know, those horrific experiments carried out on the enslaved black woman that he kept on his property in the back of his home. And as he wrote about having his epiphanies in the middle of the night and then snatching them from the depraved conditions in which he kept them, and using his cutting tools, his knives and other things, and cutting into their bodies and denying them anesthesia. These legacies continue forward. And to your point, and I’m going to turn to you, Patrick, about the intergenerational play of of this work. But to your point, though, Virginia, about the opioid crisis, it seems to me that embedded in that is something else, which is that the way in which we police black people’s bodies is there are on the one hand we have coming out of that opioid crisis, this concern so much so that government would go to sue the pharmaceutical companies and those who are shareholders behind this. And yet a very different response in the 1980s and nineties when through various reasons losing jobs, homes, etc., that black people who often did not have medical insurance turned to alleviate and self alleviate their pain. And those are people who are still serving jail sentences because they did that. Just very different social responses and government responses that also have a lot to do with public health. And so, Patrick, what this report, as you’ve mentioned before, it has an intergenerational look and appeal. And I know that you’ve explained a little bit about why. So, but I want you to unpack that even more. So why does it matter that we are intergenerational as we look at the conditions of anti-blackness in bioethics and in health care generally?

Patrick Smith Yeah. Thank you, Michele. You know, it’s interesting piggybacking off of some of the other comments that have been made and you so eloquently laid out how racism just continues to evolve in our body politic in so many different ways. And I’ve often thought about this idea of a racialized imagination. Right. We’re trying to route with the deal with these symptoms and the consequences, which we absolutely have to do. We have to give attention to how this plays out on the ground. At the same time, we have to highlight this racialized imagination, the fact that all of us have been racialized, whether we like it or not. And simply changing the laws and the policies of our country doesn’t immediately root out the racialized imagination, such that when we think about the context in which we find ourselves or we think about the various traditions that we’re part of. When I say traditions, I’m not talking about religious traditions necessarily, just traditions, right? The Latin word for Duco, that which is carried over. Right. We think about that, that we are all part of communities. We’re part of a larger society that carries over values and ideas and ways of thinking and moving and being in the world. Our organizations and institutions, right institutions have the benefit for all of their faults, right. Of preserving and transmitting values. Right. And what happens is this idea of the racialized imagination is still at work from one generation to the next. We see how these things just continue to evolve as they well, we dealt with slavery. And so all of this is much ado about nothing, right? But we are failing to recognize the way the racialized imagination is still at work, causing these deep health disparities among particular communities of people. And I think we have to continue to, again, push and understand this so we can see the connection, that this is not something that just kind of pops up at moments, but something that may be deeply rooted in. Let me speak for the context of the North American context in the North American context. So therefore, the spadework needs to be done to root that out. Right? But that’s going to require quite a bit of work. And we think empirically, you know, I’m not expert in socio epigenetics. Right. But we also know that the the burdens. Right. That have been received in in one generation in our bodies. Right. Carry over and have an impact to the next generation. And so this is not just in the realm of ideology, but it has real life consequences for our bodies, for our communities, how we live and the quality of our very lives. Right. Not just particular communities, I think, but all of us as well.

Michele Goodwin You know, it’s interesting that you that you mentioned that in the epigenomics and so tied to so much of this is, you know, sort of the the storytelling that has been among black people intergenerationally speaking to these. Matters. And it’s fascinating that not until, you know, there is there are biotechnological advancements that then prove exactly what intergenerationally black people have been saying for a very long time. Right. And I think about that within the context of genomics. I think about that within the context of studies released by 23 and me a couple of years ago studying the DNA of African-Americans and tracing and finding significant, significant aspects of European ancestry in the DNA of African-Americans. And that being traced to the line of males, right. As yes. Anchoring the stories that black women have said for multiple generations of the sexual assault and sexual violence that was carried out on black women during the period of the during the period of of enslavement here in the United States. So I really so much appreciate you mentioning that. I want to turn to Faith and then Virginia. In answering that question and Keisha to if you would want, you know, in terms of the point of being intergenerational with this work.

Keisha Ray Thank you so much. And all the comments so far really support why this work is needed. And I’ll just talk from the perspective of bioethics. And you know, we discuss how the intergenerational challenges and harms imposed on black people as well as other minoritized communities haven’t sufficiently been addressed by the field of bioethics. So the purpose of this report is really to think about bioethics as a relatively new field. 50 years we’re hearing initiatives from public health, the NIH conversations around who’s being funded, who’s not being funded based on topic choice, based on where people work. And then in the field of medicine, similar conversations around discrimination, even against black and brown physicians. But this conversation, again, in terms of bioethics, we need to have more of these conversations and it goes back to the anti-black racism. So, again, as a field, we should be positioned to really address these issues, given the interdisciplinary nature, given our field being rooted in justice. But we can’t do that if we don’t really start from within to really address the things institutionally and within our organizations pieces that just things that have been lingering, as Patrick is talking about, the evolution and the morphing of racism, anti-black racism in particular. So, you know, we really reflect back intergenerationally decades ago. I want to really elevate because we elevated this in the report, the Creating the Black Agenda in Bioethics meeting. And Michele, you were also there in 2005.

Michele Goodwin I was there.

Keisha Ray Say, that’s exactly.

Michele Goodwin Where I met you.

Keisha Ray Face was sitting on the right of me. And again, we have this history where again, the field adequately has an address, these issues. But there were many people before us working on these issues, and that was an example of an earlier effort that really needs to be elevated and documented even more, historically speaking, about all of the people that were there that continued to offer mentorship. Vince Bynum, Vanessa Gamble, the late Dr. Carlton Haywood, Dr. Steven Shinseki. So all of these people continue to elevate us, and we’ve heard so much from them. We weren’t positioned to carry out this work, but you all are in the position to carry out this work. But we don’t want to be the faces of this work because we know that we’re anchored by so many other people that were marginalized and excluded and pushed out and called radical. We’re doing bioethics work, race and racism work in particular. So it’s almost like a calling, any of those people so that we can work collectively. Our institutions often make it really challenging for black scholars to work together, and in some ways were even discouraged from doing this work together. But we want to change that paradigm. We want to change that narrative because we can’t do this work individually. It’s a collective story. It’s a collective narrative. There’s history. There is a tradition of us carrying this intergenerational dialog, communication and mentorship along. So this is something that we hope that we elevated in this report. And yeah, I’ll let Virginia.

Michele Goodwin And Virginia and T.J., I’m interested in hearing from you about this. You know, there’s something that strikes me in the answering this question and specifically thinking about the terminology of intergenerational, intergenerational study approach. So on one hand, you’re speaking to say what it means to lift up, pay close attention, to learn from and even honor the legacies of black. Bioethicist And then I’m thinking about Patrick, the issue that you’ve raised in terms of intergenerationally, the pain and suffering of black people as as subjects, right? As living individuals and what they’ve suffered. And so to further set the stage for a genuine question, answering this question, it strikes me that there is a kind of normalcy that has not been interrupted in terms of black pain as being normalized, black suffering as being not normalized. I mean, when you think about how long it took in this nation until very recently. Until very recently. Finally, we have an anti-lynching bill. Right? 2022. Right. And you think about those legacies of pain, you know, people celebrating the lynching of black people with picnics, bringing children to them, taking photographs. And that’s part of the record of how we have this legacy, is that people did celebrate it and that they did take photos and that they gathered their families to celebrate around. Black bodies being tortured, being set aflame after being lynched and hung in trees. And that and this is one of the important aspects of the report is that it looks at issues in an intersectional lens. So blackness isn’t defined just by a male experience, but that that pain also being that which black women experienced as well, which is true even of American lynching. And so Virginia and Keesha, as you answer the question, you know, I wonder your thoughts to what this intergenerational ity of the normalcy of black suffering but doesn’t has to be but is treated as a default.

Virginia Brown Virginia I think I think that’s a it’s a very complicated premise to work with. And and there’s there’s something about it that I want to I want to comment on it. And what comes to mind is what is the critical mass, right? That that. For something to to change. It’s very slow. And then all of a sudden, right. It’s not like what we did hasn’t been happening. Right. Putting this together that that this normative way of of, you know, looking at, you know, blackness and and anti black racism as just being well, you know, that’s how it is. There’s something that happens when there’s just enough of a critical mass to take that extra risk, to come together and to talk about it in community, to figure out how to speak about it and then how to write about it and how to frame it. That’s critically important. And I think that’s in large measure what the special issue is, is that moment where where things changed just enough that there were enough of us to do this. This was laborious and we are still tired now. It’s like a whole nother conversation. But it took it took the four of us as editors, you know, coming together, understanding each other’s strengths, how to do this, how to take care with the words, how to take care with the critiques, how to move this work to delivery. If you’ll allow that as a metaphor, you know, for what we did.

Michele Goodwin And there’s I wonder if you don’t mind, I’m going to interrupt you. But since you mentioned this last point, Virginia, on what it took, because it also seems to me that there’s been over time and we know this through any number across areas of intellectual study, a kind of resistance to centering race in conversation, as intellectual conversation, as a legitimate enterprise. And there takes then a certain kind of energy in explaining why it is a legitimate enterprise, when it should in some ways be very obvious. Right. When does it need you all to do that? Right to this look at the empirical around us in terms of health and to be able to see, well, these are actually critically important conversations to be had. So I just wanted to put that on the table too, because I hear you in terms of what you’re saying, in terms of a kind of energy. And I’m thinking your energy that you’re talking about is not just the traditional energy of you write and you edit, but there’s another kind of added energy to actually having to do this work that centers talking about blackness.

Virginia Brown Yeah, there’s a whole a whole other kind of energy. And it just there’s sort of a couple of things. It’s like, personally, I chose not to sit on any of my organizations, you know, racial justice, anything. And I’m like this kind of service work for the way that you value academics work will not be valuable. And you don’t need me. And I can’t tell you this story because I’m going to call my boss and go, she looks unhinged, you know, because I just might be I am sometimes that angry. Right. And I that that’s a very difficult space to navigate. This is a space this kind of writing, this kind of being in community is key discussed this kind of care and labor. Labor that had to be taken when you’re asking someone to carve away their words, okay. That that how how do we how do things hit the carving room floor? Okay. Without the insults and the stabs that are often accompany the kind of we always talk about, you know, reader number two, you know, who who is rejecting your work, you know, how do we not be that okay? How do we come together as a as a as a series of folks and bring something different to this experience to to bring forward a kind of empirical narrative discussion about anti-blackness in health and health care. Um, I, it’s it’s it’s not easy, but the point is it can be done.

Michele Goodwin Mhm. Keisha, did you want to add to that. Yeah.

Keisha Ray You know, I wanted just a slightly different perspective going back to your original question that you posed to us about pain and and sort of offshoots of that. I think for me in this project and it sort of reinforced that a lot of times academics in general, right. We all didn’t get to be these academics because we were lazy or because we didn’t care about scholarship. But I think black academics, we sort of internalize the suffering narrative. The. Just work really hard, get it done, and then you’ll have access to those the spoils of, of the job, the the offices, the director positions, the tenure, the promotion. Right. And so I think too many times we we overwork ourselves and we we don’t value rest, we don’t value calmness, we don’t value vacations, taking time off self-care. And when you’re working on things, when your scholarship is personal, it’s extra important to take that time off because there’s no escape your everyday life. We still function as black people and all of the hardships that go that go with that, and then we go home or to our offices and then we work on the same topic. So there’s no escape. So that means it’s extra important for us to not internalize that the, the, the virtue of being mentally, emotionally, spiritually strong all the time. 24 seven Right. But that also comes with community and knowing that you have colleagues where you’re okay to be vulnerable, you’re okay to say I’m a need your to handle this. And because right now I can and have been so many times that just great to have for people there are times where you know we all have lives outside of this special report we were all dealing with. You know, we have partners, some people have children, some people have other projects that they have to get done for promotion. And, you know, many of us had surgeries and had illnesses as we’re doing this report. And so having to make sure that we have each other’s back so that that way there can be a balance in our lives between our personal lives, this one part of our lives, our work lives, you know, making sure we’re caring for ourselves. And that comes with also making sure that we care for each other, reminding each other that there is a place for rest and that, you know, I always joke with them it’s a maybe it’s a millennial in me, but I’m not going to kill myself for academia. I’m going to make sure that I prioritize myself and I prioritize my my rest. But I think part of that is that we’ve internalized that we have to do well, that we are representing ourselves, but we’re representing a cohort of black bioethicist. So we have to show up and we have to show out. And if we don’t, then we internalize it and say, Well, we messed up, we did something wrong. Right? And so I think there’s lots of ways to internalize struggle. And I think black bioethicists have certainly internalized that a lot. And it manifests itself as being overachievers. It manifests itself as accumulating all that vacation time and not taking it right accumulates and taking a vacation every few years. And I think I just I just want better for for black academics and to to value rest and not internalize distance that we all must struggle. Because we don’t we we all deserve softness and care.

Michele Goodwin There’s so much that is present in what you’ve just mentioned, Keisha. I mean, underlying it are traditions that speak to the uber excellence of black people. You know, the sort of twice as good as three times got. As you know, we’re at a space in which we’re soon to see the first black woman Supreme Court justice in the United States after 200 of after over 233 years. The first and it strikes me that something that. That was had an emotional impact. It should have been for all Americans and I think certainly for many, but especially for I think black people and black women were the ways in which Judge Brown Jackson was treated during the confirmation hearings and even before President Biden announced who the nominee would be. There were people of some repute or at least who think that they have some repute, issuing comments and writing things about this person will be unqualified, nonqualified, all of that. And even in the face of the names of people who were being considered having these incredibly elite careers and of course, the candidate with judge capacity, Brown, Jackson, it didn’t necessarily stop some of the vitriol and pushback. But then if you look at what the empiric saw in terms of what the standards are, you exceeded those of people who sit currently a Supreme Court ruling class at every level of clerkship, district court, appellate court, Supreme Court. Having been a judge and what will be every level, but even as a district court, an appellate court judge exceeding that of half of the members of the U.S. Supreme Court and so much more. And it seems to me that there is something that is a psychological burden that then is further carried. And is it in both directions? Right. It is the need to be overqualified when you’re sitting in the company sometimes of people who have not done the work that you have. And then yet at the same time having to live through the stereotypes actually agree.

Keisha Ray Yeah, that’s, you know, quick anecdote. My very first week of grad school, Cornell West, was the guest speaker for our MLK celebration. And after his lecture, I was the first person in line asked a question and I said, I’m first year philosophy student. What advice do you have for me? And he said, Work twice as hard as everyone else. And I mean, I got it. But again, I just wasn’t going to do that. I just wasn’t going to be the person that internalize feeling inferior in a room and having my CV be who I am. But at the same time, I think a lot of black violences, it’s hard. You have to constantly work against that narrative that you have to be twice as good as the person, as everyone else in the room. And I think many of us don’t. So we work ourselves and we work ourselves. We work ourselves. So we are exhausted and we cannot keep doing this anti-black racist work if we are killing ourselves. Right. We have to we have to take care of ourselves to keep being a part of the community.

Michele Goodwin And that is also so complicated. Yes, you can. But just the fact of origin, because there’s a point that I want you to lift up. I mean, because even just on that point, really, we could have a whole meeting that’s just around what that means, because it seems to me that it’s it takes its own work just simply making sure that people appreciate and logic, you know, the value of doing work in this space. So so, Faith, I want to read just a little bit from the introduction of the report and turn to back to that bioethics meeting that you spoke about from some years ago. So in 2005 and July, I and this we have in the special reports introduction and July 25 and perhaps one of the first organized efforts to strengthen the network of black bioethicists and develop a concrete action plan to advance bioethical issue. Tuskegee University’s National Center for Bioethics and Research and Health Care convened and sponsored a meeting called Creating a Black Agenda in Bioethics on the University’s Historic Campus. And it’s worth noting that it was Dr. Vanessa Gamble who brought folks together in that context. And you alluded to this in your answer before, and I’m going to turn to you right after this, Virginia. And it seems to me and we’ll perhaps be quickly to this, that in part of the report important is, in fact, to center and honor those before. And there’s a part of the report that specific specifically speaks to Dr. Marion Gray. And so I wonder if you might be able to just extrapolate on that a little bit to give us a sense of of why.

Keisha Ray Thank you so much for elevating that. And we worked with an anti-racism task force to develop and carry out this special report. And we will elevate their names, hopefully at the end of this forum. But in our conversations, everything seemed to come back to Dr. Marion Grace, the Kennedy. I learned through conversations that some of my mentors were actually trained by her, so it was just the natural selection to really dedicate and create a tribute in her name. Again, it goes back to certain people not being acknowledged appropriately for their contributions to the field of bioethics. And I think what makes this really special for me and Virginia also has a long standing relationship. I knew her as the director of Tuskegee Bioethics Center. I knew her as someone that was very motivated. And I’ll never forget her raspy voice, but also as someone who gets the conferences and hey, let’s go shopping. I learned about conference shopping from Dr. Marion Grace, the kind of, you know, just a very lively individual. But through these tributes, I’m an editor reading number seven authors that contributed tributes. I really learned of her her impact in a more profound way. That distance that I had from her as a student, I learned that there were other people that really just began to construct their scholarship around Dr. Marion Grace, the causes of it. And I’ll just, you know, leave it there. I just hope that other people really read that tribute and are impacted in the same way and learn about her activism and her scholarship on race and racism. There’s so much to say about her, and I think this was just really the beginning of telling her story and a story of other black bioethicists who have been involved and were involved in this work early on.

Michele Goodwin You know, when I think about the work of Dr. Marion Grace, the country, and in some ways sometimes our sheroes are rendered invisible and, you know, as a connection, I think about Dr. Pauli Murray, who from the position of of law, both in civil rights as related to sex equality and civil rights as related to race, played such a pivotal role was the forerunner of Justice Ruth Bader Ginsburg, a forerunner in terms of her writing, an impact of Justice Thurgood Marshall. In fact, Justice Thurgood Marshall says that it was Dr. Pauli Murray who wrote the Bible of the civil rights movement and yet surveyed so many people with no clearly of of Justice Ruth Bader Ginsburg and her work and, of course, of Justice Thurgood Marshall and wouldn’t know about Dr. Pauli Murray, even though she wrote both in terms of sex and race, the materials that were used by Justice Thurgood Marshall and then also by Justice Ruth Bader Ginsburg when they were lawyers, before they ever served on the court of Virginia. I wonder if you might want to pick up on that. And you also had something to add from before.

Virginia Brown Yeah, so so sort of two things. I wanted to go back to that. That got to be twice as good discussion. And at this, it, it, it did enter into our space as editor’s, right? I mean no doubt. And it was more borne out of. Is this good enough to go out yet? Is there more like what will you know? Like it’s going to go through another round of editing and just a whole sort of historical burden of Is it good enough? We even had to navigate ourselves to knowing better, right? Like we know better. But we were still confronted with. That that negative legacy. So I just I just wanted to say that we you know, we’re not. You know, it impacts us in many different ways. We know we’re good. We know we we have something good. But is it yet good enough? Well, you know, it’s it’s it’s that. Representing the race kind of thing still shows up. And that’s really you know what I wanted to comment from the earlier comment.

Michele Goodwin I hear something, general about when to draw to the to the full panel that connects with what you’re saying, Virginia, which is the question of is it worth studying the conditions that uniquely fall upon black people? Right. It seems to me that that is also part of what the struggle is. Right. That black pain, a black suffering has not been treated as a legitimate enterprise worthy of study, and that to elevate it in and of itself has been a for that has been something that has attracted resistance. And I think it’s worth with people who are listening, knowing that not only did you edit in this process, but also the editing that you did also went before a peer review process. Does anybody want to speak to that?

Virginia Brown Yeah. And and I think I think there’s a question that comes before that to get at where we are today, which is through a like a really quick story. My my grandfather’s dad was enslaved. So Grandpop lived with my mother and her sister as a child. And when I learned this, I said to my mom, oh, my God, you know, did you talk about Grandpop and his mother being enslaved? What was the discussion about my mother’s like? We never talked about that stuff, you know, not how, like, you’ve got to be kidding me. So we had this long dialog, you know, for years. Clearly they did not talk about it. But I think that’s the that’s we got to start with that. We, we, we got shaped as a people to not acknowledge that pain and suffering. We carried it with us. It shows up in ways that epigenetically, as we’ve discussed, you know, is showing up, that emotionally and socially is showing up that we have to deal with so that we can take a look at what we’re doing ourselves right to to stop it, right to to as Kiesha was saying, you know, I can’t, you know, Keesha, I don’t think is being a millennial. I’m just like, you’re just trying to keep us real, you know, you’re trying to ask us to shed shed that and to say, you know, you cannot. But what do they say? You put your your mask on first, you know, before you tend to someone else on the plane. If it loses oxygen, you’ve got to take care of yourself and not acknowledging it collectively. And so let me bring it to the intergenerational thing and I’ll stop in a moment. I think it’s really important when we add to this conversation about the intergenerational nature of this work that that I want to call the people’s attention. This in particular, what made Marian, S.D., so different is that in her intergenerational sharing of her knowledge, she put you at the table next to her and said, Get busy, okay? She didn’t tell us to wait your turn. She didn’t tell us that we hadn’t we weren’t old enough or, you know, didn’t have enough letters behind our names. Okay. She asked us to get busy. So the sharing and being able to be coached, you know, in that sharing is critically important to the intergenerational work that we try to do as a team of editors and scholars in particular, we have a range of early career to to preeminent scholars who are part of this thing. And it wasn’t like, Oh, you know, you don’t have enough letters. Be how you name, you can’t be a part of this. It was like, No, you’ve got something to say. Get it on some paper. Well, we’ll work. We’ll work with you and we’ll workshop it to make it representative of what you want to say. And I think that’s really important when we talk about what are the aspects of intergenerational work that is is one that’s really important.

Michele Goodwin State if you wanted to add in to that. Yeah.

Keisha Ray Thank you for raising that. I think when we talk about labor, we really need to think about labor as emotional, mental, intellectual. And this is what I felt throughout. This project, it’s hard to describe. I think you’ve been having this conversation right now. We’re still not at the point where we really even been able to unpack the process and what’s happened. We think maybe down the line we can write more about even the process of engaging in partnership, working with in collaboration with this task force to develop this work. So that’s one part that’s really important. But when we think about and I’m glad you raised the peer review process because we don’t want people to think we just developed these articles and we didn’t go through the general rigorous process. That’s important to note. So thank you so much for raising that, Michele. But part of that is when we were really thinking about a list of reviewers, my student was working on it and it took a long time to really identify people who suited to really review this work. And when we got, you know, reviewer comments back at the editors, we actually had to sit with the comments. We know how it feels individually to get reviews that can be negative, but we’re also protective of the work. We’re protective of the authors. We had to sit with the comments and think about, is this something that we even want to pass on, know like we don’t want to break people’s spirits? One negative comment can really about someone’s writing or what someone should be writing about. And you know, there were comments about an insider’s perspective and just hearing that language really calls to the need for guidelines and recommendations for editorial practices and processes. If someone doesn’t understand the work as a reviewer, you shouldn’t review the article. You are not an expert in this area. People need to make that clear. Those questions should be asked. Negative comments really demand highlighting and maybe not asking that person to review an article again. So I think, you know, just thinking more about what are the practices and processes that we can do to make reviews more equitable is a piece in a conversation that we need to continue having.

Michele Goodwin I want to unpack that a bit more. And Patrick asked you if you have comment on this and really to share it with the panel, to really help people understand such that this insider conversations that could be taking place right now is really understood. So if we unpack this a bit further, you know, when these works are going out for peer review, there are people, people in the field who can give green light or not. But we also know that in this field, it’s been very hard for people of color to break through in the academy. And hard for black people in the academy and people of color in the academy to do the work of focusing on people of color, because it’s perceived that I mean, some people are discouraged from writing about people of color across disciplines that they happen to be because it’s perceived as too insider lazy, etc.. And so and what is interesting then and again may be hard for people to digest is that there’s a lot of scholarship that’s written about people of color that’s written by non people of color. And in both context is treated as legitimate and brilliant and what a sacrifice for them to write about these matters. Addressing people of color. And at the same time, something that we’ve not talked about, but that is being lifted up in the wake of the horrific deaths of Breonna Taylor and George Floyd, etc., has been the effort to explore more equity, diversity, inclusion and belonging across scholarship. And people who have historically been able to get very high in grants have now turned to people like you and others say, you know, consult with me so that now I can go and get a grant. So basically what I’m waiting to do is try to help people to understand how these processes work so that even now you have folks who can basically plug and play, consult you and say, tell me about some of this stuff. That people have never worked on before. And plug and play your knowledge into some grants. And then it’s a cohort of people that may have very limited background and experience within the space who become defined as the people who are experts, who then get the sign off on the work that you will do or that other people who contribute to this work do. And that makes all of this complicated, I think, in these spaces. Anybody want to draw upon that or just speak to it at all?

Patrick Smith Well, I’ll let my colleagues speak to those research questions, as we’ve had many conversations on that in the past. And we talked about this idea, Michele, just a few moments ago about resistance and the resistance of some of these type questions. And, well, one thing first to the to the last part of the of your comments during your question there. I mean, there has always been, unfortunately, this commodification of black suffering. Right. And, you know, where too often people capitalize on black suffering. Now, this is not to say that any research program or project or grant that people are undertaking to study these issues is at every turn. Right. An instance of commodification, of black suffering, right? No, not saying that at all. But we also know the complexity of these kinds of issues and how oftentimes we want to take shortcuts to get to certain ends without doing the hard work that is needed. And this goes back to this notion of the resistance, right? So often when I think about this, the resistance of centering black folks, black suffering in these questions of health justice, which I think is a very important part of the conversation, a couple of things come to mind. The first is, I think that notions of racism and how it works, how it is understood as an ideology, is deep connections to questions of economic exploitation is really under theorized right? So in a lot of ways, the way we don’t even have a frame of reference to make the data that people are identifying in terms of health care disparities and some of these other questions. Intelligible, Right. There’s no frame of reference that makes it intelligible. And it does come across to some as simply being much ado about nothing. Right. Because it’s under theorized in the literature, the work of good theorists, ethicists, philosophers of race, you know, who who have been doing this work has not been incorporated and integrated in ways that I think that can help provide a frame of reference. So I do think it maybe it’s a little in the self-interest of people like Keesha Ray and myself, right. That that philosophers are still needed in this in this work and this role. And the other thing is the notion of kind of complicity. Right? One of the things that are what Duke University through the Trans Center, the work of Jeff Baker, Damon Tweedy, many others are really just interrogating what is the history of the medical center with, let’s say, the city of Durham or whatever local context you find yourself in, and really began to take make accountable organizations in institutions at that localized level. I think that many institutions and every institution can really do that kind of work to see what that relationship is about, to interrogate those various practices. The challenge with those kinds of things, obviously, would be notions of complicity. Right. And so then people are thinking about what does this mean? What does this look like? Because I think at the end of the day, one of the questions that we do have to wrestle with in terms of health justice is what about notions of principles of redress? Right. And all of this is bound up together. But I don’t think we’ll have movements to help justice without doing that hard work of going through there, through that. And there are no shortcuts for that. But yeah. T-shirt faith. Yeah.

Keisha Ray I mean, I think I’ll just briefly add in terms of sort of this conversation around picking scholars, black scholar range, we’ve been hearing a lot about this and it’s something we’ve talked a lot about in terms of who’s actually getting credit. And it’s nice to be in a consultancy capacity, but we have to actually lead the projects and lead the work, which means that people have to invite us to lead the projects and lead the work. So, you know, what we’re calling for really in this report is just the change in leadership and expansion of leadership to really include black bioethicists in these positions. And it goes beyond just center directorships. It’s also editorial boards. Take a look at your boards. Who’s there, who’s not there? Think about your leadership within bioethics journals, who needs to be there. So I think, you know, we’re at the stage where we’re sort of, you know, again, just editing. But in order to really have sustainable change, we have to really embed our work, our perspectives throughout the field of bioethics in different ways. So that’s, you know, I think that’s one area that we really need to continue. And this report really calls out some of those things. So I encourage you to go and take a look at some papers that talk about centering Black Scholars by Alicia Best. She really highlights the phenomenon of black people not being acknowledged for their work in health equity work and not getting the funding, the identity work perspective that we really have to continue to push back, push against that narrative. So I’ll stop there and I hope you have something to say. Yeah, I’ll just briefly add to this is something that other projects face and I have worked on with other people we go to is to think about who’s getting funded and we mentioned that briefly. So, you know, again, this is a good point to to show our appreciation for Greenwald and for Hastings, because these projects like this don’t get done without someone putting their money where their mouth is. Right. Someone has to fund these kinds of projects because if they don’t, then they just don’t get done right. Our time is valuable, but then also just administrative costs and then to think about cost in different ways. There are lots of people behind the scene that are not here who put in who put in the time to create call to action, to put in time to do press releases. Right. And also thinking about our own time, we didn’t just put this together and then shoot it off. We’re doing webinars. We are also doing other sort of documents that are related to make sure that people see this. So there’s lots of things that go into it. But one is really is it really requires money, requires funding, plainly speaking. And someone someone has to to fund these kinds of projects. And then also thinking, too, just about making sure that university starts to start to think about the kinds of projects that count towards tenure, the things that count towards promotion, the things that matter. We have to sort of change that too. And a part of that is taking into account narratives. I saw someone in the Q&A talk about narratives, and that’s something that I’m very passionate about, is making sure that narratives are seen as legitimate scholarship. They’re not seen as just anecdotal with that. So to say that narratives don’t matter really is anti-black behavior. It really should be, because there’s a lot to be known from narratives about the black experience that is academic, that is scholarship. And one way to do that is to make sure that you are putting it forth into classrooms, that we’re putting it in our work. And so I think that it’s super important to think about how you change what matters, and you can do that through narrative. You can do that through changing promotion structures, and you can do that through funding.

Michele Goodwin Well, you know, on that that notion of not that notion, but in terms of thinking about what is standardized, it seems to me that the the experience that you’re talking about as narrative, we understand it’s legitimate when often when it’s not black. Right. Narrative is a crucial function, let’s say, of the law. What do witnesses do? Witnesses provide a narrative. Its its foundational narrative is understood and appreciated when we call it a qualitative aspect of sociology that we are interviewing people and whatnot within the anthropology when we call it ethnographic, that it seems to me that this is just another way in which you’re highlighting the kind of delegitimizing of of black storytelling that is, that is real life excavation of experiences. I can’t help but think about in this conversation that which is also the psychological and emotional, which is very important, which informs the physical. And it reminds me of post. Abolition of slavery. The revered practice of apprenticeship became became harmonized as a tool of the South for the kind of revisiting of American slavery. And here’s what I mean by that. In the South, there were platforms that were put in place whereby random white people could accost the black family and literally take their child away and go before a magistrate. And appeal that the parents had somehow been negligent. Which reminds me of Professor Dorothy Roberts current work as she’s been doing and torn apart. But they could appeal to a magistrate and say that this child needed what they could give and that what they would give would be an apprenticeship for this child. Magistrates would sign off and these were kind of secondary forms of slavery where these children could be taken away for five, ten years or more from their parents. And here’s the point about narrative, which is that in the best. Articulation that these black parents could have. They wrote to the Freedmen’s Bureau, speaking urgently to give me my child back. How do I get my child back? Is a form of narrative, but it’s a real life experience and also something that is psychologically part of the legacy, an intergenerational legacy. I want to turn to the Q and A before we wrap up and also ask those who are participating that if they have questions to put them in our Q and A. I don’t want to turn to a comment that is in the Q and A about the importance of excavating a foundation. And that is the house is unstable. How does one rebuild it or do you need to just knock the whole thing down and then to your right from the beginning, start all over. Anybody who would like to address that.

Keisha Ray Yeah. I mean, I’ll answer briefly so we can get to your question. But I mean, yes, the answer is yes. Right. And I think that’s part of what what part of the the not compromising part that that even is in some of the articles in this special issue is that part of it is how how brave can we be, how brave can we be to say some of our systems just don’t work and have to be dismantled and start over? Right. And I think a lot of times people don’t want to hear that. And I think part of, you know, even in my own work, I’ve gotten pushback from editors or peer reviews that say, well, what’s the middle ground like? What’s the tell us another solution? Right? When I say this macro solution is to burn it all down and start over and they want, well, give me something nice. Right. And I think that’s a part of this scholarship, is that people want to want the nice answer that’s in the nice gift boxes. Sometimes it’s not. Sometimes it’s interrogate the foundations and start over if need be.

Michele Goodwin Anybody else want to address that before I go to the next question?

Virginia Brown Yeah. Yeah, I agree. Heterogeneous. I just want to say something about transformational scholarship. Okay. That that it is a kind of inquiry into the work that we do. And I want to read this thought to you. True transformation for a transformative world, you know, where we’re actually not mandating things, as Kiesha, you know, spoke to that. We’re actually, you know, sometimes you’ve got to do destroy it and build something a new it. That worldview, that transformative worldview holds that inquiry needs to be intertwined with politics. Those politics, as we’ve discussed them, are those sort of structural inequalities and the kind of political change that that a political change agenda to confront social oppression at whatever levels it occurs. That is the kind of work that we get to do. It asks the repeated question of what is it that ethics, bioethics owes justice, it owes it everything. It owes it a focus on social justice to transform and fundamentally change the way that we’ve engaged in health and health care.

Michele Goodwin I want to turn to another question that we’ve had in the Q&A. And this relates to what can journals, some of the most elite journals, seem to center the experiences and important questions with regard to health matters that people of color face. They tend to be centered in the editorial space. Can you address what that’s meant by by the person who puts that in? Right. I want to hear from you. I have my own perspective on it. But but this is about you all. And, you know, what do you think about that and what can be done to move the questions and the concerns and considerations with regard to health, bioethics and people of color out of editorial and into the mainstream of our top journals. I’d like to answer that.

Keisha Ray Yeah, I mean, this is something I’ve been thinking about along with some of along with the other editors and some of the things that we’ve talked about, even some of the things that I’ve written about. I think it’s really up to journals to. Two to follow. They make a lot of declarations and then say, you know, we are committed to diversity. We are committed to dismantling racist practices. Right. And I think that it is up to them to make sure that they are actually following through. And I’ve seen this happen at different journals that I’m on the editorial board for. They will create sort of mentorship programs to make sure that that that diverse scholars know what it takes to to publish. And I think sometimes it’s just a matter of education. But then also sometimes I really think that we have to sort of which again, takes on a burden, but we have to keep really pressing them to do better. And again, I acknowledge that this is a burden on those scholars that are already being pressed to make sure that the oppressor does a better job. But I do think that sometimes it can help. And I also think that sometimes it’s really about creating a standard and then saying that we are going to make sure that this standard is upheld. But it’s a standard like there’s a lot of the science journals are now creating guides for their peer reviewers and saying that if you are reviewing a paper that is about race and racism, this is one way that you can a guide that you can use to make sure that you are properly doing it. And they on top of that, make sure that these articles go out to the proper reviewers, like Dr. Fletcher mentioned. You have to have the right reviewers for these articles, but then they also create these guys to sort of help. And then they have editors that that make sure the guys to follow the not like in certain sort of consult positions where I will be brought in to sort of look to see is is has this been done well is this review to the proper standards? Does this guide even help reviewers to to review papers that are about race and racism? So I think there are journals are doing a better job, but there’s also more to be done. And I think, too, it matters who’s on editorial board, right? Because in my own positions and editorial boards, there have been times where I’ve called out and said, please do not send that email to the thousands of people on the listserv because this is racist. This isn’t going to go over well. And you all don’t see those emails. You see the email that got curated, you know, by my myself or some of my colleagues. But we’re but if I wasn’t there, you know, there could have been scandals. If people like Virginia and Padgett weren’t there, there could be these these things. So also acknowledging the invisible labor that that we are doing, because we are we are doing a lot for the journals. And I think, you know, just it’s a process. But that doesn’t mean that you can’t demand change and you can’t demand that a journal editors and editorial boards take on the responsibility and do the work themselves.

Michele Goodwin Okay. So I wondered if you wanted to add to that.

Keisha Ray Yeah, thank you for that. Thank you. Dr. Ray and I just we have models of people that are actually journals are doing it well. And I think we should really look to those models. And I want to highlight the Journal of Health Equity, the new editor in chief, Doctor Monica Macklemore. And if you take a look at the editorial board, the deputy editor, the associate editor, you see racial, ethnic diversity. You see diversity in terms of sexual identification. Even so, again, there are people that are transforming and really dismantling. And, you know, the question is, do we just get rid of everyone and just change the, you know, completely will that this is what we’re seeing. So I think it’s just important as we think about addressing health and health care disparities that again, we go back to who’s doing it right and who’s doing it well and what can we learn from them.

Michele Goodwin I want to put a last couple questions to you before we begin to wrap up. And and I hope we do this again, because this has been such an important conversation. Your work is not meant to simply sit on the shelf. This is a work that seems to me that very purposefully was thought of as something that is prescient, important, meant to influence, meant to carry on and be part of a legacy going forward. And so in lifting up something that’s on my mind and also one of the questions from one of our attendees is the question about the importance of policymaking in all of this, you know, such that academia can be its own silo, right? Where, where people sit in their academic silos and are quite distance from the live real world lives of people. So what is the role of this work in influencing public policy or stated differently? What would you want the impact to be? In terms of public policy related to this work. And why don’t I start with you, Patrick, and then just open it up in case anybody else would like to comment.

Patrick Smith Yeah. I would just say quickly here that I would want this report to be part of a larger body of research and discourse that says we have to attend very carefully and critically and in concrete way is to how anti-black racism is impacting notions of health and health justice, and then begin to formulate policies around that in ways that can be enforceable. And I am drawn towards those legal scholars work, right? Those who are doing work in health justice and people like, you know, danah boyd matthew over against other of as well as others right. Who are trying to find ways to make sure that our civil rights legislation has teeth to it, that we have to go beyond just the intentions of people and organizations and institutions to actually looking at the real consequences that matter and being able to recognize when we have these disparate outcomes, right, that we need to have policies in place that are trying to one, mitigate that to one, but then to also find ways to hold organizations and those of us accountable in ways that we can just be more attentive to or attend to these issues with a little bit more care and intentionality that’s expressed beyond just the verbal commitment that we give to it.

Michele Goodwin Anybody want to add on to that before I go down with some very quick couple last wrap up questions?

Keisha Ray Yeah, I mean, I think this report really demonstrates that black officers should be leading conversations around health and health care and equity. So when we think about conversations with media or just generally contributing to scholarship, you have a list, a body of people who will also refer you to other people. So when the question comes up in terms of us not being present or not existing, we really thought to just challenge that narrative. And I think we did that here. So I’ll just say that in the other piece. And when we talk about policy, we can’t do this work unless we have a change in institutional policy. We can’t influence public discourse or health policy unless we’re supported by our institutions. And we know that many institutions have started to make those changes, like we can think about changes in community based participatory research and how in other institutions there’s a different pathway for that or our public health practice or even DEI work. Now we’re seeing that. We’re seeing this work being credited in promotion and tenure decision. So we just have to keep that top of mind when we’re thinking about having us doing this type of work that for some might view it as service related. This is your national service again, but we want to challenge that discourse. This is scholarship and this is creating scholarship and this is doing it at one of the highest levels. And I’m just I’m thankful for the opportunity to work with all of these amazing and brilliant people. I’ve learned so much from them. This has been a restorative place, and I hope we continue to do this work together.

Michele Goodwin So before I get to this, the next question that was on my mind, I actually want to turn to something that you just mentioned, safe water. It relates to structure and two points with regard to structure in which you raised for me as one who gets cited. And the second is who gets to be interviewed? In this work such that it’s not all on you or those who’ve come before you. But really, when we think about interrupting what was, it’s also a matter of responsibility in journalism and media to actually do the work and to actually find the people who are actually doing this work. And not just simply the shift to the same old folks and people who’ve always been cited, but to actually do that effort of contacting scholars who work in this field and scholars of color who do this work and who have been doing this work. And faith, I think, who wanted to comment back on that?

Keisha Ray Yeah. I mean, we’ve had this conversation among us and I think we do a lot of recommendations. Someone will reach out and we’ll refer to someone else. And yes, it is the responsibility of the media. But I also think it starts with us as black scholars not to accept every media request, because we know that there are other people that may be more appropriate to respond, more centered expertize, and I’ve experienced that with the person. So it’s like, yeah, I’m not the person to talk about abortion related issues. I do reproductive health work. And I think, again, that’s a way of amplifying, elevating and just passing a recommendation on to someone else. And we have to do more of that. And Patrick talks about this a lot with white supremacy and how it tends to just allow one person to center, one black person, one person of color. And I think in our work, I mean, what we’re trying to do is to show that we are a part of a collective. You can’t just pick one of us out of the crowd and say, hey, you’re our person. We’re all of your people, we’re all doing similar work and we approach our work in different ways. So that’s just one thought in terms of making sure that everyone is credited in their work and everyone’s amplified and, you know, making sure that one person is just not walking away as a lead and just yeah. So that’s that’s important to us and this was important in our work.

Michele Goodwin Anybody else want to add to that before just a couple of quick wrap up questions.

Keisha Ray Yeah. I’ll just add to that. It’s also a matter. Everything they said was spot on. And it’s also a matter of protection because we’ve all seen it too easily with, you know, using like celebrity culture. Whenever there’s the person, the harder that they raise you, the harder that you fall. Right. They sort of wait for you to mess up. And so I think that if we have a community behind ourselves and you have the people speaking to the media who are the best representative of a topic, that is also a matter of self-preservation. You know, just just to put it crudely. But I think that it has to if I saw someone in the Q&A as, say, you know, it also has to do we have to do a little bit internal work, because I think sometimes we internalize that if someone else is getting the spoils of the job, then it makes me feel lesser then or it makes me feel like I am not getting what I need. And so we have to do a little bit of internal work to say just because someone else is succeeding doesn’t mean that I am not also a success. And I think and again, that’s a part of this white supremacist thinking that there can only be one. And if someone else is shining, that I must be dull. And that’s just really not the case. But if you can have that community support behind you, it can help you to sort of let go of those things. But again, it’s about finding out, finding your people.

Michele Goodwin Faith. I think I saw that. You’re okay. All right, though. All right. So I let it get to this point where I ask about what’s going to be coming next in terms of a silver lining. But I want to mention a couple of things. First, because we would be remiss if we didn’t. So first, Patrick, is that there was care and concern with the special report about the cover itself. What role does imagery play and why is that important within the larger context of talking about how we visualize thinking about race and bioethics? anti-Blackness and bioethics.

Patrick Smith Yeah. No, I’m so glad you asked that question, Michel. I mean, we actually had a cover art committee that was chaired by Vince Bonhomme. Faith was on that Joanne Suarez, and they looked at hundreds of pieces of art from past generations, current generations, and they settled on a piece that was here by a young artist, brilliant artist out of the DC area, Wesley Clark. And the title of the cover art is We Need. And it’s a fascinating piece just to sit and kind of reflect on and just thinking about this American project, right in the metaphors we use about the American project and why do we still need all these generations later and wrestling with this? And so that committee settled on that particular piece. And one of the things about, you know, artists, whether it be in the Harlem Renaissance, the civil rights movements, the Black Lives Matter movements, artists have always leveraged the power of the arts to illuminate injustice and to stimulate some dialog, to drive collection, collective action, to engage in the process, and more motivation to help create the social conditions such that trust can be restored. All of this is the role that the arts can play in artist in particular, and I do think that part of the continuing legacy of doing this work well is making sure that we’re taking seriously the intersections of arts in medicine. Toni Morrison Thinking as a literary artist writer from The Nation. Oh gosh, couple of decades ago, right when she was, you know, concerned about the political climate. And the idea was that in times of moral, spiritual and political upheaval, right, she was encouraged by colleagues of hers and friends of hers not to despair, not to be discouraged, because it is at that time that artists go to work, that they do language, that they do what they are uniquely gifted and tasked to do. And I think the same thing can be said with the visual artist musical artists as well. And I just think that this is just a medium that well we need to incorporate because it does so much. And I could go on and on about that. So I think I better stop now and consider myself well.

Michele Goodwin I’m glad that you did mention that. I did say that I’m here in Zurich and for a series of medical meetings that have started with the cellist playing right. Again, this importance of understanding that how we come to our work and how we understand it can be informed and influenced by the arts and. FE The question that I wanted to ask you before I ask you all about a silver lining coming forward and and then close with reading another passage that I want you from the introduction so faced. There was a task force that was associated with this. And I think that that’s also important because a point that you have emphasized over and over again has been collectivity around, not centering, just one voice, understanding that there is a field, understanding that this has been intergenerational work, understanding that many voices come together and that they should be acknowledged. And so I know that that would be something important to you. So could you just speak to the task force that was a part of this?

Keisha Ray Yeah, we had a brilliant task force that really, again, helped to anchor this work. And at some point we’ll have to have a conversation with them so that they can share their reflections. But, you know, there’s one thing about doing this work. We have to do it collectively. And there were things that we just didn’t know. There were things that we didn’t have access to. For instance, the Creating Black Agenda conference list. Doctor Stephen Shinseki had that stories that we were not aware of. So again, it really warrants it having this diverse group of people. And in the future, we hope that we can start to influence the way and change editorial practices. So when you’re developing a report we do this with in our research community based work in Virginia has done a lot of this as well from the beginning, from the conceptualization, all the way through dissemination. It requires a little more time. It requires more consensus. I know there are times where I’m sure Hastings was like, Do you have to go back to everyone and ask the question? And we understand it. But we also recognize in this process, in this work, it requires interdisciplinary perspectives and diverse perspectives to really carry it out. So I think this is just one way, one model of doing it, and we hope to really document this in our process in the future.

Michele Goodwin And a conversation that’s gone much too quickly today. All right. So final question for you all. Is this. It’s a quick one. But what do you see as a vision of hope or a silver lining going forward, given that what we started off with and what we’ve talked about are articulations of a black suffering intergenerationally, the hardship with bringing this work to fruition and forward. And yet at the same time, I see this as a very hopeful endeavor and project. And so if we could just go through a quick piece about just what you see going forward. And we’ll start with you, Virginia. What do you see as a silver lining or space going forward that offer some lens of hope?

Virginia Brown Well, I think that before I can get there is rest to get to is needed to get to that silver lining. I think what’s possible is that there’s you there’s this concrete thing that got done, you know, when to be able to look back and say, we did this. Okay. Is is a reminder that we can do we can do more. That the possibility is there for more. So there’s a silver lining. There is a community. We are there. We are name. Patrick is going to name everyone for us as at the end. I know you know this, but it’s so important. It’s the possibility is possible. That’s the silver lining for me.

Michele Goodwin Thank you so much for that. Keisha, what do you see as a silver lining message of hope going forward?

Patrick Smith I’m.

Keisha Ray I think the report itself is hope. It shows that there is good work being done, that people, black scholars, are working together to create this this this awesome scholarship and that people are listening to participants. Being here is is hope that people are wanting to listen to people, that people care. And people want to take these these ideas to their institutions and maybe do their own special reports or maybe write their own articles or maybe plan their own teaching or their own community development. The fact that we’re here, I think, is is hope. So I think there is change happening. And I think we have to we have to acknowledge that there’s a lot more to go and we can get so bogged down in the what’s next, what’s next. But I think we need to look at what’s happening right here in the moment.

Michele Goodwin Patrick, I’d like to turn to you.

Patrick Smith And Dr. Ray hit my words. One of the things that gives me hope is the fact that we’re still here, right? I come from a tradition where people tell the story, right? They give the roll call of those who’ve come before and then they can end up with through it. All right. You know, we’re still here, despite the hardships, despite the challenges, despite the fact we still have to write a report dealing with these issues. We are still here. And so for me, this notion of hope, it is not a kind of optimism. So I reject that notion of optimism. Being related to hope is not a kind of blind historical determinism that things are just going to work out. There has to be a deep sense of intentionality. There has to be a deep sense of rolling up our sleeves, wanting to get the work done. And hope comes in, in the fact that we can imagine a world that is different than it currently is now. That’s what sustains us in doing the work of justice in health. If we could not envision the world being different than it is right now, then what is it that sustains us in doing the work with all the burdens that come with it? So for me, where the hope is in the fact that we are still here and that we still have a moral imagination that can envision the world being different than it is right now.

Michele Goodwin All right. And I’m going to conclude my questions with you, Faith. Silver lining, message of hope.

Keisha Ray Yes. That we can work together despite institutional and disciplinary barriers that keep us working in silos and that we can actually produce the work. I know early on Patrick’s like, Hey, let’s not announce this until we actually start to get some things on paper because we don’t want to be the people known not to carry something out. I mean, we have that burden that we carry. And I think just showing the versatility of black scholars of our work, the interdisciplinary nature, that’s important, we’re not a monolith. And I think that’s something that this report really shows, that we were all doing equity justice related work, but we approach our work differently. So happy that we were able to work together. And again, it’s restorative and we hope to continue to carry this work out.

Michele Goodwin And doctors. Keesha Ray. Sorry, Dr.. Doctors Keisha Rae, Patrick Smith, Faith Fletcher and Virginia Brown. I want to thank you for participating today. It’s been my honor and my pleasure. And before I see the stage, let me just close with a passage taken from the special report introduction. In the 1962 essay As Much Truth as One Can Bear a manifesto written to literary artists about their role during times of social and political upheaval. The novelist, playwright and social critic James Baldwin declared, and I quote, We are the generation that must throw everything into the endeavor to remake America into what we say we want it to be. Without this endeavor, we will perish. Not everything that is based can be changed, but nothing can be changed until it is faced. Baldwin’s plea still speaks to us. He wrote, For those of us in the field of bioethics who recognize that racism continues to affect every aspect of our collective life, including our work in the field, it is every bit as relevant now as it was six decades ago, before bioethics had begun. If we bioethicists seek to transform the field of bioethics, we must do the inner work needed to cultivate an anti-racism ethos and to generate the collective social and political will. You wrote within the field to address the systemic issues surrounding racism and health, and I applaud you for your indefatigable, courageous and important work with this special report. It has been my honor and privilege to be with you today. And now I will turn it over.

Keisha Ray Thank you all for that conversation. And before we end the webinar, we want to turn to Misty Anderson from the Greenwald Foundation to hear about the importance of this work again.

Virginia Brown I thank you. And I’ll be very quick. I’m processing this tremendous conversation from the past 2 hours. What an experience. I’d just like to say that the Greenwald Foundation is incredibly proud to have sponsored this special report and the robust collection of scholarship that it features, which feels even more salient after listening to this deeply personal conversation today with everything the panelists brought to the fore to share with all of us who are viewing. And I really look forward to the continuation of this conversation over the coming weeks, months, years, as as it must continue. And then finally, I’d just like to thank the Hastings Center for hosting this webinar for Dr. Goodwin, for moderating for all of the panelists for this deep, informative and meaningful conversation. Thank you so much.

Michele Goodwin Thank you.

Keisha Ray Thank you, everyone. Great. Thank you all for joining this event today and thank you to everyone who spoke today. The link to the special report can be found in the Q&A and a video recording will be available shortly at www.thehastingscenter.org. So we hope that you all have a great rest of your day and thank you again for coming.

Virginia Brown Thank you.