In Search of Medical Truth: How the History of Biological Determinism Threatens the Future of an Equitable AI-Integrated Healthcare System in the U.S.

Abstract

This thesis investigates the historical, political, and social factors that pose risks to Black Americans, as the prospect of AI-integrated healthcare becomes more imminent. This work is important in disrupting the perception that science and technology operate independently from and devoid of human biases. The following paper is propelled by the question: Does the current regulatory context in the U.S. acknowledge the history of medical racism and adequately protect the Black American community against the threat of biased AI technologies in healthcare? The analysis that shapes this investigation contributes to existing literature that examines the use of race as a biological category in medicine. These findings are then contextualized within the broader use of science in policymaking to understand how science is operationalized in political spheres. By examining instances where decision-making healthcare AI has harmed Black Americans, the thesis identifies factors of racialized medicine that exacerbate existing healthcare inequalities. The paper also demonstrates how the structure of national institutions dedicated to the advancement of medicine and technology are exclusionary to those most at risk of discrimination in healthcare settings. Building on principles of critical race theory, calls for an understanding of race as a social construct are identified in current discussions of healthcare AI. Following an inventory of the influence of biological determinism in the United States healthcare system, roadblocks to systemic change, and the plausible applications of AI in healthcare, a set of policy solutions are proposed. These proposals engage critical race theory and create avenues for Black voices to be heard throughout the healthcare AI development process, from national research forums to intimate clinical settings.