This chapter elaborates the connections between colors and bioethics. Colors have often been associated with normative judgments. In Medieval moral theology colors represent the seven deadly sins. Color historians argue that the Protestant Reformation introduced a moralistic approach to colors in public life, distinguishing worthy from unworthy colors. That colors have a moral value is clear in the hierarchy which many societies apply to colors. Cultures often oppose colors with white, regarded as colorless. White is associated with innocence and purity, cleanliness and hygiene. The moral value of colors is furthermore evident in their use to articulate social divisions and distinctions. In the past, numerous societies had color codes and stringent regulations for the application of color in public life. Social classes are indicated by the colors that they are allowed to use for their clothing. But this moral value of colors has become problematic when it is applied to people themselves. Johann Blumenbach in the 1770s distinguished five varieties of the human species (‘races’) according to skin color: Ethiopean (black), Caucasian (white), Mongolian (yellow), Malaysian (brown) and Amerindian (red). Colors are different because of geographical factors such as climate. Blumenbach opposed any hierarchy among the varieties, rejecting the idea that some are superior and others inferior. Nonetheless, this is exactly how his ideas were interpreted and elaborated in theories of scientific racism. In classifications of people, skin color was associated with character and moral worth. Particularly black was connected to evil and negativity, while white people were believed to be superior.
The pervasiveness of moral associations of white and black has now become a major topic of concern in ethical debate. Since it is an imperative in health care ethics to prevent harm to patients, racism and the concept of race should be the focus of bioethics. That requires an analysis of the contextual and structural dimensions of health and diseases, and also an awareness that all subjects of bioethical inquiry are racialized. It is suggested that bioethics itself, as it has emerged as a new discipline since the 1970s, is based on an underlying principle of white supremacy, i.e. the idea that White lives are of greater value than colored lives. The theoretical framework of bioethics with respect of autonomy, consent, transparency and risk assessment presupposes individual citizens who are independent and free to make decisions ignoring mostly non-white people who are disadvantaged and vulnerable because of social, economic, and environmental conditions. In these analyses, white is usually not considered as a color itself so that White people become invisible as a racial group. The result is that the concept of race is only applied to non-white people, while Whites are regarded as a social group which is neutral in race relations, and which is also the norm from which deviations are assessed. White is then equated with being human, and the embodiment of universality. This is reflected in the practice of ‘race norming’, i.e. the adjustment of test scores to account for the race of people who were tested. The assumption is that the physiology of White bodies is the norm and that outcomes for colored bodies need to be corrected because their physiological capacities are less.
