Bowman also described the rampant discrimination in the United States in the early days of sickle hemoglobin testing because of many misconceptions. Firstly, it was believed that sickle hemoglobin was only common in Africans, however, it is also found in Southern Italians, Arabs, Southern Iranians, and Asian Indians. Secondly, there was confusion between being a carrier of the sickle cell trait and having sickle cell anemia. This caused insurance premiums for African Americans to increase even if they were simply a carrier of the trait and had no evidence of lower life expectancies. Many athletes who were carriers were restricted from performing in the Olympics.
Black communities believed in this misinformation and demanded mandatory sickle hemoglobin screening laws in at least 12 states. The laws were selective for African Americans and incorrectly stated that over 2 million African Americans in the United States had sickle cell anemia when they were carriers of the trait. Federally supported screening and education programs had unrealistic testing goals due to a lack of personnel. Over $200 million had been spent on federally sponsored sickle hemoglobin programs; however, the funds were only granted by Congress because they believed the screening programs would lead to a reduction in the number of children with the disease. Counseling was available for African Americans, but because of the lack of prenatal diagnosis, many were encouraged not to get pregnant through abstinence or by abortion in case of accidental pregnancy even though it was illegal in most states (Bowman 2000).
Bowman addressed many discriminatory practices in healthcare, one of which being prenatal diagnosis. On the first visit, African-American mothers were to be tested to determine whether they were carriers of the sickle cell gene. If the mother is a carrier, then the father should be tested to determine if he is also a carrier. Further testing can be performed to determine whether the fetus has sickle cell anemia. If the parents want to continue the pregnancy, then the decision must be supported, and if not, then abortion and counselling would be offered. Most women were not informed of this test as obstetricians in only 1 in 19 centers informed their patients. In addition, women who tested positive were offered counselling but required a test from the father for prenatal diagnosis which was a problem since 50 percent of the women were not living with the father and the proportion of out-of-wedlock births increased significantly.
The question raised was will prenatal programs for African-American women increase abortions. African-American women often chose to keep the child, however, Southeast Asians frequently aborted the child. In 1988, federal funds were banned for clinics that offered abortion counselling. Over 4 million women who depended on federally supported family planning clinics suffered as they were denied access to abortion and important medical information that would keep them from becoming pregnant. This created a type of family planning counselling for the affluent, including many services, particularly prenatal screening, and one for the poor that was severely lacking in valuable patient information (Bowman 2000).
Dr. Bowman has been know to openly discuss and criticize the government’s stance on ethical guidelines surrounding research and genetic testing done on minority groups. Through referencing his own firsthand experience, he criticizes the government for the violation and disregard of their own ethical principles.
In 1997, Dr. Bowman was asked to submit an amicus curiae brief for plaintiff employees against the University of California Lawrence Berkeley Laboratory. This appeal revolved around the question of whether clerical or administrative workers who underwent general employee health examinations may, without their knowledge or consent, be screened and tested for highly private and sensitive medical and genetical information. Black employees were tested for the sickle cell trait and only Black and Hispanic employees were repeatedly subjected to syphilis without prior consent or knowledge, implying racial overtones. The complaint against the University asserted that this testing violated Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA), and their right to privacy as guaranteed by both the United States and State of California Constitutions (Bowman 1998). However, the court ruled against the employees. Though the district court dismissing the ADA claims was deemed proper, none of the arguments made by the Secretary held merit in respects to the claims brought against him in his official capacity (Bowman 1998).