Historical Scientific Racism and Psychiatric Publications: A Necessary International Anti-racist Code of Ethics

Full text

Perspective
Historical Scientific Racism and Psychiatric
Publications: A Necessary International
Anti-racist Code of Ethics
Imen Ben-Cheikh, MD
1
, Roberto Beneduce, MD, PhD
2
,
Jaswant Guzder, MD
3
, Sushrut Jadhav, MBBS, MD, MRCPsych., PhD
4
,
Azaad Kassam, MD
5
, Myrna Lashley, PhD
3
, Malika Mansouri, PhD, HDR
6
,
Marie Rose Moro, MD, PhD
6,7
, and Don Quang Tran, MD
1
Keywords
antiracism, international code of ethics, historical scientific racism, pseudoscience, psychiatric publications, editorial ethics
Ethical aspects of publishing in scientific journals are an
important issue addressed since the late 1970s by the Interna-
tional Committee of Medical Journal Editors (1978). Today,
medical journals also benefit from other international organi-
zations’ recommendations such as the Committee on Publica-
tion Ethics, World Association of Medical Editors, and World
Health Organization (WHO). These international best prac-
tices guidelines cover various ethical issuesrelated to integrity
in research, authorship, conflicts of interest, and so on.
However, ethical principles of publishing in psychiatry
have received little attention in the literature,
1
and more
specifically, to date, there are no international anti-racist
policies to guide the management of historical psychiatric
publications with pseudoscientific and racist content. The
World Medical Association (WMA) defines the term pseu-
doscience as “a set of statements, assumptions, methods,
beliefs and practices which, without having been tested by
a valid and recognized scientific method, are falsely pre-
sented as scientific.”
2
Embedded in intersectional dimen-
sions, racism is more complex to define. However, despite
different formulations in the literature, there is a consensus
that racism manifests through discriminatory actions or inac-
tions towards a group belonging to a different race, culture,
or ethnicity based on the belief that there is a hierarchy
among human groups, or on unconscious prejudices, in the
absence of any underlying racist ideology. Although race
also has different definitions, its major social repercussions
make it a social concept.
3
Publications with racist content written during historical
and political contexts of colonialism, slavery, or Nazism
currently remain available, sometimes in prestigious psy-
chiatric journals. This racist literature raises an important
contemporary ethical issue as to whether their access
should continue without prior disclosure or warning to the
reader about the presence of racist and pseudoscientific
content.
It is important to be cognizant of how widespread this
literature is. Globalization and online access to several sci-
entific journals make it easy today to access these publica-
tions all around the world. In addition, it suggests the risk for
tragic and not yet analyzed effects of these publications on
scholars and clinicians who “learned” about themselves,
their brain, and their abilities from these books and publica-
tions such as The African Mind, by John C. Dixon Carothers,
first published by WHO in 1953, and again until the seven-
ties, “training” many African psychiatrists about their pre-
sumed inferiority as Africans.
While it is important to be able to access scientific
archives as historical documents, the absence of disclai-
mers about racist content highlights the urgent need to
develop an international code of ethics providing a frame-
work for historical scientific racism to guide editors and
scientific journals. This manuscript addresses from an
1
Department of Psychiatry, Universit´
e de Sherbrooke, Quebec, Canada
2
Department of Cultures, Politics, and Society, University of Turin, Italy
3
Department of Psychiatry, McGill University, Quebec, Canada
4
University College London, United Kingdom
5
Department of Psychiatry, University of Ottawa, Ontario, Canada
6
University of Paris, France
7
Child and Adolescent Psychiatry, Cheffe de service de la Maison des
adolescents, Maison de Solenn, AP-HP, Paris, France
Corresponding Author:
Imen Ben-Cheikh, MD, 108-2924 Blvd. Taschereau, Greenfield Park,
Quebec, Canada J4V 2G8.
Email: imen.ben.cheikh@usherbrooke.ca
The Canadian Journal of Psychiatry /
La Revue Canadienne de Psychiatrie
1-10
ªThe Author(s) 2021
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/07067437211020613
TheCJP.ca | LaRCP.ca
Canadian
Psychiatric Association
A
ssociation des psychiatres
du Canada

ethical, psychological, and social perspective (1) the rele-
vance of an international anti-racist scientific policy fram-
ing historical publications with discriminatory content,
whether it is racist, anti-Semitic, Islamophobic, homopho-
bic, casteist, sexist, and so on and (2) proposes a possible
solution.
Intersections of Historical Colonialism,
Scientific Racism, and Political Abuse
of Psychiatry
Political abuse of psychiatry is the misuse of psychiatry to
violate the fundamental human rights of some groups and
individuals in a society.
4
It has been historically used by
colonial regimes and several totalitarian regimes around
the world. Instances of political abuse in the history of
psychiatry involved psychiatrists who sometimes had great
prestige within the psychiatric community and in their
countries of origin. For example, the American psychiatrist
Donald Ewen Cameron (1901 to 1967), who became an
honorary member of the Canadian Psychiatric Association
in 1965,(
1
) was complicit with the tragic experiences of the
“Duplessis Orphans,” several thousand orphaned children
who were falsely certified as mentally ill by the govern-
ment of Quebec during the 1950s. Austrian psychiatrist
Hans Asperger (1906 to 1980), who gave his name to the
famous autistic syndrome, was complicit with the Nazi
ideology of “racial purification.”
5
The German psychiatrist
Emil Kraepelin (1856 to 1926), after conducting a com-
parative psychiatry research in Java, proposed a racial
developmental hierarchy to explain the observed clinical
differences while ignoring the social context.
6
The Italian
physician and anthropologist Cesare Lombroso (1835 to
1909), considered as the leader of the scientific school of
criminology, developed a theory of “innate criminality,”
stating that criminality is recognizable by craniological
and physical characteristics. In his book The Criminal Man
(1867), Lombroso writes
(2)
(... ) Criminals resemble savages and the colored races. These
three groups have many characteristics in common, including
thinness of body hair, low degrees of strength and below-
average weight, small cranial capacities, sloping foreheads, and
swollen sinuses ( ....), upwardly arching temporal bones,
sutural simplicity, thick skulls, overdeveloped jaws and cheek-
bones, oblique eyes, dark skin, thick and curly hair, and jug ears.
Scientific racism that marked the history of medicine
and psychiatry during the 19th and 20th centuries was at
the origin of several publications in scientific journals in
the United States and Europe despite their pseudoscientific
or racist content. The American psychiatrist George Alder
Blumer published in 1899 an editorial correspondence in
the American Journal of Psychiatry
(3)
in which he
describes patients during a trip in the Antilles. Blumer
writes (p. 716)
(...) many of the patients—the majority impress one as degen-
erates, are not much higher in the scale of existence than the
anthropoid ape. ( ...). Nowhere did I see patients working, as
we understand the word work. The native negro is naturally an
indolent fellow, and the very liberal poor laws of Barbados are
calculated to enervate him.
Racist assertions of Black people’s inferiority in brain
size, intelligence, and morality have persisted in psycholo-
gical literature over the last 100 years despite repeated cri-
tiques.
7
The Canadian psychologist John Philippe Rushtel
was still claiming an intellectual inferiority of Blacks in a
text published in 2012 in the prestigious journal American
Psychologist(
4
). In 1908, the French psychiatric journal
Annales M ´
edico-psychologiques published a text written
by Boigey describing what he considers “the psychological
profile of the Muslim”(
5
). Boigey writes, for example (p. 8,
translation):
The manifestations of this state are the following: 1—The exis-
tence in the intellectual territory of any Muslim, of real “dead
spots” where certain impressions are never registered ( ... )2—
The obsession or, if we prefer, the madness of words. These
words are: Allah, Illah! and others contained in prayers and
invocations to the Godhead. You must have seen the Muslims
in the mosque say like hallucinators, for hours and a hundred
times a minute, these two words Allah, Illah! swinging their
heads like floating buoys undulating on an invisible sea, to get
an idea of this kind of madness. After an hour of this exercise,
the wisest became ecstatic delirious.
According to Berthelier
8
(p. 131–132), this was the first
psychiatric publication “properly and entirely racist” of a
rare violence.
The Annales M ´
edico-Psychologiques published other
racist papers written by the French psychiatrist Antoine
Porot in his “Notes de psychiatrie musulmane” in 1918(
6
)
and “L’impulsivit ´
e criminelle chez l’indige
`ne alg ´
erien” with
his student Arrii in 1932(
7
). Author of theories of primiti-
vism and “criminal impulsiveness” among North Africans,
Antoine Porot describes them by stating
The true indigenous mass, a shapeless block of profoundly
ignorant and credulous primitives, far removed from our men-
tality and our reactions. (Notes de psychiatrie musulmane,
p. 377, translated)
The native, a large mental deficiency, whose higher and
cortical activities are little evolved, is above all a primitive
being whose life, essentially vegetative and instinctive, is
mainly regulated by his diencephalon.(
8
)
The history of psychiatry is marked by several other pseu-
doscientific publications conveying hateful theories.
9
Renneville
10
underlines that a false or erroneous theory can
still have a wide following: “Whatever status one grants to
these discourses, ‘false science’, ‘error’, ‘ideology’, we
would probably have a lot to lose by underestimating their
2The Canadian Journal of Psychiatry

effects in our societies” (p. 1723–1724, translated).
Although racism in psychiatric literature is reported by sev-
eral authors in North America and Europe,
11,12
the effects of
pseudoscientific racist texts remain little recognized by the
international psychiatric and scientific community. The
American Psychiatric Association’s recent apology
13
was
an important step in recognizing that past inaction has con-
tributed to perpetuating structural racism. Decolonization of
psychiatry, initially embodied by Frantz Fanon’s anti-racist
psychiatry during the French colonial period, has become a
postcolonial contemporary issue
14,15
that could take differ-
ent forms involving both the fields of psychiatry and ethics.
Scholarly Publishing and Anti-racist
Policies: Ethics’ Role in Dismantling
Structural Racism
Despite the efforts to dismantle scientific racism since the
end of World War II, it is not yet completely eradicated.
16
According to Potter
17
and Ibrahim and Morrow,
18
intersec-
tions of scientific racism, colonialism, and political abuse of
psychiatry are historical roots of current persisting systemic
oppression in psychiatry and structural racism in our societ-
ies. As highlighted by Memmi,
19
historical relations between
colonizers and colonized inevitably influence contemporary
social relations between ex-colonizers and ex-colonized.
According to Johnstone and Kanitsaki,
20
racism has been
neglected as an ethical issue, and, if this problem remains
unaddressed in the field of scientific and scholarly publica-
tions, the potential harmful consequences will remain diffi-
cult to prevent and manage. Racism is a social determinant
of health that has an impact on the health status of children,
adolescents, adults, and their families.
21
Experiences of
racism, discrimination, and micro-aggressions are documen-
tedtobeassociatedwithrace-basedstress,physicaland
mental health impacts, and potential racial trauma.
22
The
concept of historical trauma refers to trauma symptoms
related to a collective trauma with generational implications
such as colonialism, genocides, and slavery. While a diag-
nostic category of post-traumatic stress disorder can validate
the traumatic event, it could simultaneously cover the polit-
ical, racial, and historical roots of suffering.
23
Thus, histor-
ical trauma requires complex analysis to avoid simplistic
interpretations.
Bioethics could play an increasingly important role in the
development of institutional policies to address racism and
social injustice.
24
According to Mayes,
25
bioethics has not
been able to respond to institutional racism as it is itself
shaped to favour majority groups over minority groups.
Mayes emphasizes that institutional racism in health care is
compounded by the fact that both medicine and ethics are
implicated. Fernando
12
highlights that one of the reasons
institutional racism persists is the collective denial and the
failure of our societies to face the horrors of racism in the past
with a full appreciation of their consequences. Ben-Cheikh
26
proposes psychoeducation to help dismantle structural and
institutional racism, including education on explicit contex-
tualization of racist historical publications. Knowledge of the
historical and political context of the past does not change the
racist character of a text today. An implicit contextualization
is thus insufficient and should not justify the absence of an
explicit disclosure about a racist content.
In Europe and in North America, sensitive contents in
media (e.g., violence, profanity, obscenities) are routinely
preceded by disclaimers. The aim of these warning signs or
messages is not to censure but rather to allow the reader to
have a critical thinking, to know what to expect, and to
make a clear choice whether or not to view the content.
While it is important to keep historical documents of sci-
entific publications, we suggest an anti-racist strategy
implicating an international publishing code of ethics that
should define how editors present pseudoscientific and
racist articles to the readership. Science and bioethics
should no longer collude with the invisible violence pur-
ported by historical racist publications. Only when our pro-
fessions, in partnership with publishers, recognize and
correct the “epistemological ignorance” generated by what
Charles Mills defined as a “racial contract,” we will be
actively countering an ignorance that continues to invisibly
permeate our knowledge: “a cognitive and moral economy
psychically required for conquest, colonization, and
enslavement”
27
(p. 19).
Conclusion and Recommendation
The American and Canadian psychiatric associations have
recently recognized the existence of structural racism in
psychiatry and are committed to developing anti-racist pol-
icies that promote equity in mental health for all.
13,28
Several
editorials around the world have also called for action
against racism and social injustice.
26,28,29,30
Historical psy-
chiatric publications with racist content should not be for-
gotten or ignored. The role of colonial pseudoscience in the
roots of contemporary structural racism should be recog-
nized and analyzed. Today, it is a matter of scientific, social,
and editorial responsibility to develop an international anti-
racist code of ethics that fights scientific racism and provides
a framework for historical publications.
Editors have the challenge and responsibility to both pre-
serve access to historical archives and treat the entire read-
ership with respect and dignity, regardless of their ethnicity,
colour of skin, religion, gender, and Otherness. We recom-
mend that all scientific journals identify any historical pub-
lications that have a racist content and add at the beginning
of these publications a disclosure statement such as The
reader is warned about racist content in this paper, written
at a time of political oppression against groups of human
beings based on their racial, ethnic or religious identity.
While this potential solution is simple, it represents none-
theless an unprecedented action in terms of anti-racist poli-
cies in the scientific publishing field. Furthermore, the
process to achieve such a change is complex. While some
La Revue Canadienne de Psychiatrie 3

racist content would be obvious to all readers, others may be
subject to interpretation and debate. To achieve an effective
sorting of historical publications, especially for more subtle
or ambiguous cases, we suggest that editors get the support
of relevant national and international professional organiza-
tions such as the Society for the Study of Psychiatry and
Culture in North America and the Centre Ressource Euro-
p´
een en clinique transculturelle (Centre Babel) in Europe
and that a competent and diverse committee of experts gets
implicated. Finally, as historical racist publications concern
many disciplines in medicine and in psychology, an interna-
tional anti-racist publishing code of ethics should target
scientific publications broadly and would need the support
of important organizations like the World Psychiatric Asso-
ciation and the WMA.
Psychiatry has been used politically and socially, in a
malicious way, at different periods of history. As scientists,
physicians, ethicists, psychiatrists, psychologists, we should
take a critical look at this past, which is not gone as much as
we would like, to both recognize the embedded impact of our
history on our contemporary societies and embrace our col-
lective responsibilities in the face of these drifts.
Acknowledgement
The authors thank Dr Cecile Rousseau for reviewing an earlier draft
of the manuscript and for her valuable suggestions.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Imen Ben-Cheikh, MD https://orcid.org/0000-0003-2119-1312
Malika Mansouri https://orcid.org/0000-0001-6243-6043
Notes
1. Cameron DE. Can J Psychiatry. 1965;10(6):459.
2. Lombroso C. Atavism and punishment. In: Criminal man. Lon-
don: Duke University Press;2006. p. 91–94. On presumed pre-
valence of left-handedness in women and “savage races,” see
also Lombroso C. Left-handedness and left-sidedness, North Am
Rev. 1904;177:440–444, 562.
3. Blumer GA. The insane in the antilles. Am J Psychiatry.
1899;55(4):713-723.
4. Rushton JP. No narrowing in mean Black-White IQ differ-
ences—predicted by heritable g. Am Psychol. 2012;67(6):500–
501.
5. Boigey. ´
Etude psychologique sur l’islam, Annales M´edico-Psy-
chologiques, 9e s´erie, t. VIII. 1908 octobre.
6. Porot A. Notes de psychiatrie musulmane. Annales m ´edico-psy-
chologiques. 1918;(9):377–384.
7. Porot A. et Arrii D.C. L’impulsivit´e criminelle chez l’indig`ene
alg´erien; ses facteurs—Annales m´edico-psychologiques.
1932;(2):588-611.
8. Porot A. 35th congress of alienists and French-speaking neurol-
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110817x1935_djvu.txt
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La Revue Canadienne de Psychiatrie 5

Racisme scientifique historique et publications
psychiatriques: n´
ecessit´
e d’un code d’ ´
ethique
international antiraciste
Ben-Cheikh Imen, MD
1
, Beneduce Roberto, MD, PhD
2
,
Guzder Jaswant, MD
3
, Jadhav Sushrut, MBBS, MD, MRCPsych., PhD
4
,
Kassam Azaad, MD
5
, Lashley Myrna, PhD
6
, Mansouri Malika, PhD, HDR
7
,
Moro Marie Rose, MD, PhD
8
, and Tran Don Quang, MD
1
Mots-cl´
es
antiracisme, code d’´
ethique international, racisme scientifique historique, pseudoscience, publications psychiatriques, ´
ethique
´
editoriale
L’´ethique dans le domaine de la publication scientifique est
abord´ee depuis la fin des ann´ees 1970 par l’International
Committee of Medical Journal Editors (ICMJE, 1978).
Aujourd’hui, les revues m´edicales b´en´eficient ´egalement des
recommandations d’autres organisations internationales,
telles que le Committee on Publication Ethics (COPE),
l’Association mondiale des ´editeurs m´edicaux (World Asso-
ciation of Medical Editors) et celles de l’organisation mon-
diale de la sant´e (OMS). Ces guides de bonnes pratiques
couvrent plusieurs questions ´ethiques comme l’int´egrit ´ede
la recherche, les droits d’auteurs, les conflits d’int´erˆets, etc.
Cependant, les principes ´ethiques de la publication en
psychiatrie ont rec¸u peu d’attention dans la litt´erature
1
et,
plus sp´ecifiquement, `a ce jour, il n’existe pas de politique
antiraciste internationale pour guider la gestion des publica-
tions psychiatriques historiques `a contenu pseudoscientifi-
que et raciste. L’Association m´edicale mondiale (AMM)
d´efinit le terme pseudoscience comme « un ensemble d’affir-
mations, de suppositions, de m´
ethodes, de croyances et de
pratiques qui, sans avoir ´
et ´
e´
eprouv ´
ees par une m ´
ethode
scientifique valide et reconnue, sont faussement pr ´
esent ´
ees
comme scientifiques »
2
.Int´egr´e dans une intersection de
plusieurs dimensions, le racisme est plus complexe `ad´efinir.
Cependant, malgr´e diff´erentes formulations dans la litt ´era-
ture, il existe un consensus selon lequel le racisme se man-
ifeste par des actions ou inactions discriminatoires envers un
groupe appartenant `a une race, une culture ou une ethnie
diff´erente. Ces discriminations peuvent ˆetre bas´ees sur une
id´eologie raciste sous-jacente ou sur des pr ´ejug ´es incons-
cients en l’absence de toute id´eologie raciste. Bien que la
notion de race ait ´egalement diff´erentes d ´efinitions dans la
litt´erature, ses r´epercussions sociales majeures en font un
concept social
3
.
Des publications `a contenu raciste ´ecrites dans un con-
texte historique et politique de colonialisme, d’esclavage ou
de nazisme demeurent aujourd’hui disponibles, parfois dans
des revues psychiatriques prestigieuses. Cette litt´erature
raciste soul`eve une question ´ethique contemporaine impor-
tante, `a savoir si son acc`es devrait continuer sans divulgation
ou avertissement pr´ealable du lecteur de la pr´esence d’un
contenu raciste et pseudoscientifique.
Il est important d’ˆetre conscient `a quel point une telle
litt´erature est r´epandue. La mondialisation et l’acc`es en ligne
`a plusieurs revues scientifiques permettent aujourd’hui
d’acc´eder facilement `a ces publications partout dans le
monde. De plus, cela sugg`ere un risque d’effets tragiques et
non encore analys´es de ces publications sur les chercheurs et
cliniciens qui ont « appris » sur eux-mˆemes, leur cerveau et
leurs capacit´es grˆace `a ces livres et publications: tel que The
1
Professeure d’enseignement clinique, D´
epartement de psychiatrie,
Universit´
e de Sherbrooke, Qu´
ebec, Canada
2
Professeur titulaire d’anthropologie m´
edicale et psychologique,
D´
epartement de cultures, politique et soci´
et´
e, Universit ´
edeTurin,
Turin, Italie
3
Professeure, D´
epartement de psychiatrie, Universit ´
e McGill, Qu´
ebec,
Canada
4
Professeur de psychiatrie transculturelle, Universit´
e College London,
Londres, Royaume-Uni
5
Professeur adjoint, D´
epartement de psychiatrie, Universit´
e d’Ottawa,
Ontario, Canada
6
Professeure, D´
epartement de psychiatrie, Universit ´
e McGill, Qu´
ebec,
Canada
7
Maˆ
ıtre de Conf´
erences-HDR, Psychologue clinicienne en protection de
l’enfance, Universit´
e de Paris, France
8
Professeure de psychiatrie de l’enfant et de l’adolescent, Universit´
ede
Paris, France, Cheffe de service de la Maison des adolescents, Maison de
Solenn, AP-HP, Universit´
e de Paris, France
Corresponding Author:
Imen Ben-Cheikh, MD, 108-2924 Blvd. Taschereau, Greenfield Park,
Quebec, Canada J4V 2G8.
Email: imen.ben.cheikh@usherbrooke.ca
6The Canadian Journal of Psychiatry

African Mind, de John C. Dixon Carothers, publi´e pour la
premi`ere fois par l’OMS en 1953, et de nouveau jusque dans
les ann´ees 70, qui « forme » de nombreux psychiatres afri-
cains sur leur pr´esomption d’inf´eriorit´eentantqu’Africains.
S’il est important de pouvoir acc´eder aux archives scienti-
fiques en tant que documents historiques, l’absence de divulga-
tion des contenus racistes souligne un besoin urgent de
d´evelopper un code d’´ethique international fournissant un
cadre au racisme scientifique historique, pour guider les
´editeurs et les revues scientifiques. Ce manuscrit aborde d’un
point de vue ´ethique, psychologique et social 1) la pertinence
d’une politique scientifique antiraciste internationale enca-
drant les publications historiques `a contenu discriminatoire,
qu’elles soient racistes, antis´emites, islamophobes, homo-
phobes, cast´eistes, sexistes, etc., et 2) propose une solution
possible.
Intersections du colonialisme, du racisme
scientifique historique et des abus
politiques de la psychiatrie
L’abus politique de la psychiatrie est le d´etournement de la
psychiatrie pour violer les droits humains fondamentaux de
certains groupes et individus dans une soci´et´e
4
.Ila ´et´ehistor-
iquement utilis´eparlesr´egimes coloniaux et plusieurs
r´egimes totalitaires `a travers le monde. Les cas d’abus poli-
tiques dans l’histoire de la psychiatrie ont impliqu´e des psy-
chiatres qui b´en´eficiaient parfois d’un grand prestige au sein
de la communaut´e psychiatrique et dans leur pays d’origine.
Par exemple, le psychiatre am´ericain Donald Ewen Cameron
(1901-1967), devenu membre honoraire de l’Association des
psychiatres du Canada en 1965(
1
), ´etait complice des
exp´eriences tragiques des « Orphelins de Duplessis » ; des
milliers d’enfants orphelins faussement certifi´es malades
mentaux par le gouvernement du Qu´ebec dans les ann´ees
1950. Le psychiatre autrichien Hans Asperger (1906-1980),
qui a donn´esonnomauc´el`ebresyndromeautistique,´etait
complice de l’id´eologie nazie de « purification raciale »
5
.Le
psychiatre allemand Emil Kraepelin (1856-1926), apr `es avoir
men´e une recherche comparative `a Java, a propos´e une
hi´erarchie raciale pour expliquer les diff ´erences cliniques
observ´ees, tout en ignorant le contexte social
6
.Lem´edecin
et anthropologue italien Cesare Lombroso (1835-1909), con-
sid´er´e comme le leader de l’´ecole scientifique de criminologie,
ad´evelopp´e une th´eorie de « criminalit ´einn´ee », affirmant que
la criminalit´e est reconnaissable `a des caract´eristiques cranio-
logiques et physiques. Dans son livre L’homme criminel
(1867), Lombroso ´ecrit (
2
):
«(...) Les criminels ressemblent aux sauvages et aux races
color´ees. Ces trois groupes ont de nombreuses caract´eristiques
en commun, y compris la minceur des poils, de faibles degr´es de
force et un poids inf´erieur `a la moyenne, de petites capacit´es
crˆaniennes, des fronts inclin´es et des sinus enfl´es ( ...), des os
temporaux se cambrant vers le haut, une simplicit´e suturale, des
crˆanes ´epais, des mˆachoires et pommettes surd´evelopp´ees, des
yeux obliques, une peau fonc´ee, des cheveux ´epais et boucl´es et
des oreilles d´ecoll´ees ».
Le racisme scientifique qui a marqu´e l’histoire de la
m´edecine et de la psychiatrie aux XIXe et XXe si`ecle a ´et ´e
`a l’origine de plusieurs publications dans des revues scien-
tifiques aux ´
Etats-Unis et en Europe, malgr´e leur contenu
pseudoscientifique ou raciste. Le psychiatre am´ericain
George A. Blumer ´ecrit en 1899 une correspondance
´editoriale dans la revue American Journal of Psychiatry (
3
)
dans laquelle il d´ecrit des patients lors d’un voyage aux
Antilles. Blumer ´ecrit (p.716 et p. 722):
«( ...) Beaucoup de patients - la majorit´e impressionne comme
des d´eg´en´er´es, ne sont pas beaucoup plus ´elev´es dans l’´echelle
d’existence que le singe anthropoı
¨de. ( ...). Nulle part je n’ai vu
des patients travailler, comme nous entendons le mot travail. Le
n`egre indig`ene est naturellement indolent, et les lois tr`es
lib´erales pauvres de la Barbade sont calcul´ees pour l’ ´enerver. ».
Des affirmations racistes d’inf´eriorit´edesNoirsenmati`ere de
taille du cerveau, d’intelligence et de moralit´e ont persist´e
dans la litt´erature psychologique au cours du dernier si`ecle
malgr´edescritiquesr´ep´et´ees
7
. Le psychologue canadien John
Philippe Rushtel revendiquait encore une inf´eriorit´e intellec-
tuelle des Noirs dans un texte publi´een2012danslapresti-
gieuse revue American Psychologist (
4
). En 1908, la revue
psychiatrique franc¸aise des Annales M ´
edico-psychologiques
publie un texte r´edig´e par le docteur Boigey d´ecrivant « le
profil psychologique du musulman »(
5
). Boigey ´ecrit (p.8) :
« Les manifestations de cet ´etat sont les suivantes : 1-L’exis-
tencedansleterritoireintellectuel de tout Musulman, de
v´eritables « points morts » o `
u certaines impressions ne s’enre-
gistrent jamais ( ...) 2-L’obsession ou, si l’on pr´ef `ere, la folie
des mots. Ces mots sont : Allah, Illah! et d’autres encore con-
tenus dans les pri`eres et les invocations `a la Divinit´e. Il faut
avoir vu `a la mosqu´ee les Musulmans prononcer comme des
hallucin´es, pendant des heures et cent fois par minute, ces deux
mots Allah, Illah! en balanc¸ant leurs tˆetes comme des bou ´ees
flottantes ondulant sur une mer invisible, pour se faire une id´ee
de ce genre de folie. Au bout d’une heure de cet exercice, les
plus sages sont devenus des d´elirants extatiques".
Selon Berthelier
8
(p.131-132), il s’agissait de la premi`ere
publication psychiatrique « proprement et enti`erement
raciste », d’une rare violence.
Les Annales M ´
edico-Psychologiques ont publi´e d’autres
textes `a contenu raciste du psychiatre Antoine Porot en 1918,
les Notes de psychiatrie musulmane (
6
), et en 1932
L’impulsivit ´
e criminelle chez l’indige
`ne alg ´
erien ´ecrit avec
son ´el`eve Arrii (
7
). Auteur de th´eories de primitivisme et «
d’impulsivit´e criminelle » chez les Nord-Africains, Antoine
Porot d´ecrit ces derniers en d´eclarant:
«Lavraiemasseindig`ene, un bloc sans forme de primitifs
profond´ement ignorants et cr´edules, tr`es ´eloign´es de notre
La Revue Canadienne de Psychiatrie 7

mentalit´e et de nos r ´eactions » (Notes de psychiatrie musul-
mane, 1918, p. 377).
« L’indig`ene, gros d´ebile mental, dont les activit´es
sup´erieures et corticales sont peu ´evolu´ees, est surtout un ˆetre
primitif dont la vie, essentiellement v´eg´etative et instinctive, est
surtout r´egl´ee par son dienc´ephale ». (
8
)
L’histoire de la psychiatrie est marqu ´ee par plusieurs
autres publications pseudoscientifiques v´ehiculant des
th´eories haineuses
9
. Renneville
10
(p.1723-1724) souligne
qu’une th´eorie fausse ou erron´ee peut tout de mˆeme gagner
un large public : « Quel que soit le statut que l’on accorde a
`
ces discours, « fausse science », « erreur », « id´
eologie », nous
aurions probablement beaucoup a
`perdre a
`sous-estimer leurs
effets dans nos soci´
et ´
es ». Aujourd’hui, bien que le racisme
historique dans la litt´erature psychiatrique soit rapport´epar
plusieurs auteurs en Am´erique du Nord et en Europe
11, 12
,les
effets des textes pseudo-savants historiques racistes restent
peu reconnus par la communaut´e psychiatrique et scientifique
internationale. Les r´ecentes excuses de l’association
am´ericaine de psychiatrie (APA)
13
constituent un pas impor-
tant dans la reconnaissance de la contribution de l’inaction
pass´ee dans la perp´etuation du racisme structurel. La
d´ecolonisation de la psychiatrie, amorc´ee par la psychiatrie
antiraciste de Frantz Fanon durant la p´eriode coloniale fran-
c¸aise, est devenue un enjeu contemporain postcolonial
14, 15
qui peut prendre diff ´erentes formes, impliquant `alafoisles
champs de la psychiatrie et de l’´ethique.
Publications savantes et politiques
antiracistes: r ˆ
ole de l’´
ethique dans le
d´
emant`
element du racisme structurel
Malgr´e les efforts d´eploy´es pour d´emanteler le racisme scien-
tifique depuis la fin de la Seconde Guerre mondiale, ce dernier
n’est toujours pas compl`etement ´eradiqu´e
16
. Selon Potter
17
et
Ibrahim et Morrow
18
, les intersections du racisme scientifi-
que, du colonialisme et des abus politiques de la psychiatrie
sont les racines historiques de l’oppression syst´
emique persis-
tante en psychiatrie et du racisme structurel dans nos soci´et´es.
De plus, les rapports historiques entre colonisateurs et
colonis´es influencent in´evitablement les rapports sociaux con-
temporains entre ex-colonisateurs et ex-colonis´es
19
.
Selon Johnstone et Kanitsaki
20
, le racisme a ´et´en´eglig´e
en tant que probl`eme ´ethique et, si ce probl`eme reste non
trait´e dans le domaine des publications scientifiques, les
cons´equences potentiellement n´efastes resteront difficiles `a
pr´evenir et `ag´erer. Le racisme est un d´eterminant social de la
sant´e ayant un impact sur la sant´e des enfants, des adoles-
cents, des adultes et de leurs familles
21
. Les exp´eriences de
racisme, de discrimination et de micro-agressions sont doc-
ument´es comme ´etant associ ´ees `a un « stress racial », des
impacts sur la sant´e physique et mentale et potentiellement
un traumatisme racial
22
. Le concept de traumatisme histor-
ique fait r´ef´erence aux sympt ˆomes de traumatisme li´es `aun
trauma collectif ayant des implications g´en ´erationnelles,
comme le colonialisme, les g´enocides et l’esclavage. Alors
qu’une cat´egorie diagnostique de trouble de stress post-
traumatique peut valider l’´ev´enement traumatique, elle pour-
rait simultan´ement camoufler les racines politiques, raciales
et historiques de la souffrance
23
. Ainsi, le traumatisme his-
torique n´ecessite une analyse complexe pour ´eviter des inter-
pr´etations simplistes.
La bio´ethique pourrait jouer un r ˆole de plus en plus
important dans l’´elaboration de politiques institutionnelles
pour lutter contre le racisme et l’injustice sociale
24
. Selon
Mayes
25
, la bio´ethique n’a pas ´et ´e en mesure de r´epondre au
racisme institutionnel, car elle est elle-mˆeme fac¸onn´ee de
fac¸on `a favoriser les groupes majoritaires par rapport aux
groupes minoritaires. Mayes souligne que le racisme insti-
tutionnel dans les soins de sant´e est aggrav´e par le fait qu’`ala
fois la m´edecine et l’´ethique sont impliqu´ees. Fernando
12
souligne que l’une des raisons pour lesquelles le racisme
institutionnel persiste est un d´eni collectif et l’incapacit´e
de nos soci´et´es `a faire face aux horreurs du racisme dans
le pass´e avec une pleine appr´eciation de leurs cons´equences.
Ben-Cheikh
26
propose la psycho´education pour aider `a
d´emanteler le racisme structurel et institutionnel, incluant
une ´education sur la contextualisation explicite des publica-
tions historiques racistes. La connaissance d’un contexte
historique et politique du pass´e ne change pas le caract`ere
raciste d’un texte lu aujourd’hui. Une contextualisation
implicite est insuffisante et ne doit pas justifier l’absence
d’une divulgation explicite d’un contenu raciste.
En Europe et en Am´erique du Nord, les contenus sensi-
bles dans les m´edias (violence, blasph`eme, obsc ´enit´es, etc.)
sont syst´ematiquement pr´ec ´ed´es d’un avertissement du pub-
lic. Le but de ces signes ou messages d’avertissement n’est
pas de censurer, mais plutˆot de permettre au lecteur une
pens´ee critique, savoir `a quoi s’attendre et faire un choix
´eclair´e de voir, ou non, le contenu.
Alors qu’il est important de conserver les documents des
publications historiques, nous sugg´erons une strat´egie anti-
raciste impliquant un code d’´ethique international pour
d´efinir la fac¸on dont les articles pseudoscientifiques et
racistes devraient ˆetre pr´esent´es au lectorat. La science et
la bio´ethique ne devraient plus rester complices de la vio-
lence invisible des publications historiques racistes. Ce n’est
que lorsque nos professions, en partenariat avec les ´editeurs,
avanceront pour reconnaˆıtre et corriger « l’ignorance
´epist ´emologique » engendr´ee par ce que Charles Mills a
d´efini comme un «contrat racial», que nous lutterons active-
ment contre une ignorance qui continue `a impr´egner invisi-
blement nos connaissances: « une ´
economie cognitive et
morale psychiquement requise pour la conque
ˆte, la coloni-
sation et l’asservissement. »
27
(p.19, traduction).
Conclusion et recommandation
Les associations am´ericaine et canadienne de psychiatrie
ont r´ecemment reconnu l’existence du racisme structurel
en psychiatrie, et s’engagent `ad´evelopper des politiques
8The Canadian Journal of Psychiatry

antiracistes qui promeuvent l’´equit´eensant´e mentale pour
tous
13, 28
.Plusieurs´editoriaux `a travers le monde ont
´egalement appel´e`a agir contre le racisme et l’injustice
sociale
26,28,29,30
. Les publications psychiatriques histori-
ques `a contenu raciste ne devraient pas tomber dans l’oubli
ou l’ignorance. Le rˆole de la pseudoscience coloniale dans
les racines du racisme structurel contemporain devrait ˆetre
reconnu et analys´e. C’est aujourd’hui une question de
responsabilit´e scientifique, sociale et ´editoriale de
d´evelopper un code d’´ethique international antiraciste qui
lutte contre le racisme scientifique et encadre les publica-
tions historiques.
Les ´editeurs et r´edacteurs en chef ont le d´efietla
responsabilit´e`alafoisdepr´eserver l’acc`es aux archives
historiques et de traiter l’ensemble du lectorat avec respect
et dignit´e, quels que soient son appartenance ethnique, sa
couleur de peau, sa religion, son genre, et sa diversit´e. Nous
recommandons aux revues scientifiques d’identifier les pub-
lications historiques racistes et d’ajouter au d´ebut de ces
publications une d´eclaration mentionnant, par exemple: Le
lecteur est averti du contenu raciste de cet article, r´
edig ´
e
lors d’une p ´
eriode d’oppression politique contre des
groupes d’e
ˆtres humains en raison de leur identit ´
e raciale,
ethnique ou religieuse. Si cette solution potentielle est sim-
ple, elle constitue toutefois une action sans pr´ec ´edent en
termes de politiques antiracistes dans le champ ´editorial
scientifique. De plus, le processus pour aboutir `a ce chan-
gement est complexe. Si certains contenus racistes sont
´evidents pour tous les lecteurs, d’autres peuvent faire
l’objet d’interpr´etations et de d ´ebats. Pour un tri efficace
des publications psychiatriques historiques, en particulier
pour les cas plus subtils ou ambigus, nous sugg´erons aux
´editeurs et r´edacteurs en chef d’ˆetre soutenus par des orga-
nisations professionnelles nationales et internationales
comp´etentes comme, par exemples, la Society for the Study
of Psychiatry and Culture (SSPC) en Am´erique du Nord, et
le Centre Ressource Europ´een en clinique transculturelle
(Centre Babel) en Europe, et qu’un comit´ed’experts
comp´etent et diversifi´e soit impliqu´e. Enfin, comme les
publications historiques racistes concernent de nombreuses
disciplines m´edicales et de psychologie, un code d’ ´ethique
´editoriale antiraciste international devrait cibler les publi-
cations scientifiques historiques globalement, et
n´ecessiterait le soutien d’organisations importantes comme
l’Association Mondiale de Psychiatrie et l’Association
M´edicale Mondiale.
La psychiatrie a ´et ´e utilis ´ee politiquement et sociale-
ment de mani`ere malveillante `adiff´erentes p ´eriodes de
l’histoire. En tant que scientifiques, m´edecins, ´ethiciens,
psychiatres, psychologues, nous devons jeter un regard
critique sur ce pass´e, qui n’est pas aussi r´evolu que nous
le souhaiterions, pour `a la fois reconnaitre l’impact
intrins`eque de l’Histoire sur nos soci´et´es contemporaines,
et assumer nos responsabilit´es collectives face `a ces
d´erives.
Notes
1. Donald Ewen Cameron. Canadian Psychiatric Association Jour-
nal. 1965;10(6):459.
2. Lombroso, C., Gibsonand, M., Rafter, N., & Seymour, M. (2006).
Atavism and Punishment. In Criminal Man (pp. 91-94). Durham;
London: Duke University Press. doi:10.2307/j.ctv11vc7kd.19.
Sur la pr´evalence pr´esum´ee d’ˆetre gaucher chez les femmes et
les «races sauvages», voir aussi Lombroso C., (1904). Left-
Handedness and Left-Sidedness, The North American Review,
177 :562, 440-444.
3. Blumer GA (1899). The insane in the Antilles ». American
journal of Psychiatry,55(4):713-723.
4. Rushton JP. No narrowing in mean Black-White IQ differences–
predicted by heritable g. Am Psychol. 2012 Sep;67(6):500-501
5. Boigey. 1908. « ´
Etude psychologique sur l’islam », Annales
M´edico-Psychologiques, 9e s´erie, t. VIII, octobre.
6. Porot A. Notes de psychiatrie musulmane. Annales m ´edico-
psychologiques, 1918 (9)
7. Porot A. et Arrii D.C. L’impulsivit´e criminelle chez l’indig`ene
alg´erien. Annales m´edico-psychologiques, 1932, (2) : 588-611.
8. Porot A., 1935, 35e congr`es des ali´enistes et neurologues fran-
cophones `a Bruxelles . [acc´ed´e 2021 April 19]. https://archive.
org/stream/BIUSante_110817x1935/BIUSante_110817x1935_
djvu.txt
Remerciements :
Les auteurs remercient Dr C´ecile Rousseau pour la r´evision d’une
version ant´erieure du manuscrit et pour ses pr´ecieuses suggestions.
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