The (intractable) medical ethics of Dr. J. Marion Sims: The historical record set against his ethics

J Healthc Sci Humanit. 2025 Spring;15(1):90-104.

ABSTRACT

Dr. J. Marion Sims’ experimental surgeries on enslaved women in the 1840s-celebrated in medical memory as foundational to modern gynecology-remain a focal point of moral protest because the “progress” attributed to him was secured through racialized coercion and profound asymmetries of power. This essay argues that many defenses of Sims invoke ethics without sustaining ethical analysis and shows that the dominant nineteenth-century frameworks most often appealed to in these debates-utilitarianism, deontology, and, to a lesser extent, virtue ethics-do not vindicate his practices when applied with conceptual discipline. It then introduces three constraints that should govern responsible judgment: the limits of speaking for the enslaved subjects whose voices are largely absent from the archive, the role of epistemic trust in moral evaluation, and the ambivalence of care in relationships structured by domination. Moving beyond theory that struggles to render systemic violence fully visible, the essay pursues normative objectivity through Black bioethics and care ethics, centering lived experience, historical exploitation, relational obligation, and empathic responsiveness. On this account, the core wrong is not merely questionable intent or contested benefit, but the denial of personhood and the transformation of coerced suffering into sanctioned scientific achievement.

PMID:42027226 | PMC:PMC13101421