The University and the Center for Bioethics & Health Law—along with all the institutions and inhabitants of Pittsburgh—are situated on the unceded land of the Haudenosaunee Confederacy. A first step toward reconciliation and justice is acknowledgment of injustice.
Historically, in the United States, indigenous peoples have not been adequately, ethically, and respectfully served by healthcare systems and health research. In multiple ways, the health-related interests of indigenous peoples continue to be inadequately addressed both by healthcare systems and within research.
In the research context, issues of tribal sovereignty and respect for culture; community interests, engagement, and consent; and questions of fair benefit are prominent. Regarding health and healthcare, key issues are structural racism and structural inequalities, environmental justice, the trustworthiness and adequacy of public health interventions, and access to healthcare. It is noteworthy that more has been written in bioethics about research involving indigenous peoples than about the ethics of providing them healthcare.