Sector de actividad

In this section, I introduce the specific thesis questions that guide each stage of the inquiry and briefly preview the rhetorical artifacts to be examined.

Chapter 2 features kategoria, the first component of the two-part speech set of kategoria and apologia as conceptualized by Ryan. Criticism of this genre incorporates several theoretical resources dating from antiquity through the contemporary era, including the frame of Bitzer’s rhetorical situation and the subsequent correctives to this perspective as asserted by Vatz and Consigny. The key text under consideration as a kategoria is the 1996 Tuskegee Syphilis Study

55 See, for example: Katz and others, “Tuskegee Legacy Project.” Additional published findings from the Tuskegee Legacy Project are cited and discussed in Chapter 5.

56 I use the angle brackets to indicate reference to an <ideograph>, following the lead of Lucaites and Condit in their ideographic rhetorical criticism article. See John Louis Lucaites and Celeste Michelle Condit,

“Reconstructing <Equality>: Culturetypal and Counter-Cultural Rhetorics in the Martyred Black Vision,”

Communication Monographs 57, no. 1 (1990): 5-24.

Legacy Committee’s request for a presidential apology, which established expectations for the long-awaited apology. The history of the Legacy Committee sheds light on the motivations and rhetorical situation that contributed to the composition of its appeal to the president, as well as the exigences facing Clinton leading up to his response.

This broader understanding of the rhetorical situation will allow for a more thorough understanding of the exigences that emerged “objectively” due to the Tuskegee Syphilis Study’s termination (Bitzer’s formulation) as well as the exigences and constraints created through creative human effort in the Legacy Committee’s request (Vatz’s formulation).⁵⁷ I argue that the exigences that emerged at the close of the Study lacked sufficient urgency to compel a fitting response at the time. This insufficient condition was rectified through the production of a rhetorical artifact by members of the Legacy Committee that infused urgency into the exigence and set the stage for increased publicity as the 25^th anniversary of the Study’s end drew near.

According to Ryan, “The accuser is the affirmer or the rhetorical prime-mover in the speech set. The accuser perceives an evil or an exigence, he is motivated to expose it, and the rhetorical response to that motivation is a kategoria.”⁵⁸This chapter, then, analyzes kategoria as a bookend of an interactive speech set, by pursuing the following questions:

• What are the generic features of kategoria?

• How did the Tuskegee Syphilis Study Legacy Committee seek to intensify the exigences in the post-Tuskegee rhetorical situation with their demand for an

57 In response to criticism such as Vatz’s, Bitzer amended his stance on exigence in a later work: “Public knowledge will change as new conceptions, values, and principles are added and old ones discarded, and as some of these recede into the background while others become dominant… […C]ertain salient elements will be known to most—if those elements are placed regularly before the public view.” Lloyd F. Bitzer, “Rhetoric and Public Knowledge,” in Rhetoric, Philosophy, and Literature: An Exploration, ed. Don M. Burks (West Lafayette: Purdue University Press, 1978): 69.

58 Ryan, “Kategoria and Apologia,” 256.

apology?

• How was the appeal crafted? What are its prominent features?

• How does the request fit with the generic features of kategoria?

• How did the appeal contribute to further advocacy for a presidential apology?

In Chapter 3, I analyze the so-called apology for the Tuskegee Syphilis Study offered by Clinton, completing my initial analysis of the kategoria/apologia speech set. There are several features of this speech context that require a multi-faceted generic analysis. First, Clinton is a representative of a culpable institution, yet he does not stand personally accused of wrongdoing.

How is he able to respond to the kategoria in light of his innocence? Since he does not necessarily need to speak from a position of defensiveness, does that preclude his remarks from categorization as apologia? In order to make the most of these analytical tools, I use Ryan’s perspective of the speech set to draw productive parallels between the paired analysis of kategoria and apologia and the paired rhetorical artifacts of the Legacy Committee’s request and Clinton’s responsive address.

Although Clinton answered the Legacy Committee’s request, his speech did not close the books on the “Tuskegee legacy” or lay to rest the specific concerns raised by the Legacy Committee. By examining the speech in light of the particular features of the preceding request, I am able to parse the ways in which Clinton’s remarks fulfilled the explicit expectations of the kategoria as well as identify additions to and omissions from the recommendations of the request that may belie the President’s other commitments. Additionally, I discuss how Clinton’s ideological maneuvers in his speech shifted the tone from apology/apologia to a policy-driven epideictic oration. My analysis takes its direction from both Bitzer and Vatz: I consider how Clinton’s rhetoric is a response to the rhetorical situation created by the absence of apology

following the Study and enhanced by the efforts of specific rhetors, and I consider how Clinton’s speech is an important attempt to shape the (re)current rhetorical situation faced by medical researchers seeking to recruit African American subjects. To this end, I engage the following questions:

• What are the generic features of apologia?

• How did Clinton’s remarks fit with the preceding kategoria? What conclusions can be drawn from the degree of fit?

• What is the significance of Clinton’s deviations from the Legacy Committee’s recommendations (both omissions and additions) for a presidential apology?

• How did the request serve to shape the subsequent address? What were the aspects of the exigence that drove Clinton’s speech?

• How did Clinton’s address work as an apologia?

• How did the speech reframe an historical understanding of the Tuskegee Syphilis Study?

In Chapter 4 I interrogate the common description of Clinton’s speech as an apology. The Legacy Committee requested an apology from President Clinton and the president’s response is termed an apology in subsequent media reports and academic literature, but critical attention to this characterization is rare in the extant literature. Chapter 4 continues the analysis of Clinton’s speech through the additional frame of genuine apology. I draw on foundational works to develop a basic definition of apology and then discuss Clinton’s address in light of that standard as well as the genre of apologia introduced in Chapter 3. The following questions guide the analyses in Chapter 4:

• What are the constitutive elements and other features of a genuine apology?

• How does Clinton’s address fit with the definition of genuine apology? What conclusions can be drawn from the degree of fit?

• How did Clinton deal with the fact that he was apologizing for an institution that he was not part of at the time of the Study?

• How does the concept of institutional apology help make sense of the “gray area”

of Clinton’s speech?

• How does Clinton’s speech work as apology and apologia? Can either be a potentially “fitting response” to kategoria?

Chapter 5 looks more broadly at the cultural context of the “Tuskegee Legacy” and considers the theoretical traction gained by treating the term ‘Tuskegee’ as an ideograph. The Tuskegee Syphilis Study Legacy Committee described the lingering effects of Tuskegee as “cast[ing] a long shadow on the contemporary relationship between African Americans and the biomedical community”⁵⁹ and the Committee called for a presidential apology that was long overdue. Now that an apology (of sorts) has been made, has the status of the Tuskegee legacy changed in any fundamental way? Is public acknowledgement of the offense an effective remedy for the historical trauma of Tuskegee? If Clinton’s speech did indeed create a shift in the Tuskegee legacy, is the shifting of such a “legacy” appropriate? In Chapter 5, the analysis moves out from the two primary texts in the speech set into a social analysis of the significance of public memory about the Tuskegee Syphilis Study. By treating the Legacy as an ideograph, I develop a framework for a more sophisticated understanding of the uses of ‘Tuskegee’ in the lay public. To do so, I draw on an array of sources, including rhetorical theory, a historian’s analysis of African Americans’ knowledge about the Tuskegee Study, public health researchers’ analyses of

59 Legacy Committee, “Legacy Committee Request,” 559.

Americans’ attitudes about participating in medical research, and examples of journalism that reflect on the significance of Clinton’s speech from the perspective of the lay public.

Public health research led by Ralph V. Katz and colleagues has explored the doxa of medical researchers who assume that the Tuskegee legacy is a significant deterrent for potential minority participants in medical research. As widespread as this particular “understanding” of the Tuskegee legacy seems to be (as evidenced by its reference in scholarly and journalism articles⁶⁰), the authors shed doubt on this particular influence of the Tuskegee legacy by conducting the first long-term, multi-city empirical study to assess minorities’ anxiety about participating in medical research as well as their likelihood to participate. These researchers are also the first to consider the potential influence of Clinton’s 1997 address over attitudes about the Tuskegee Study and its legacy. The frequent citing of the legacy by other researchers, as well as the capacity for Katz and colleagues to design an instrument called the Tuskegee Legacy Questionnaire, indicate that the legacy may circulate ideographically.

By treating the Legacy as an ideograph, I examine how <Tuskegee> is juxtaposed with Clinton’s speech and how that relationship may complicate or shift the mental connotations that accompany references to <Tuskegee>. The assumption underlying this approach is that public memory perpetuates and evolves contemporary understandings of the Tuskegee Syphilis Study.

The often-used term “legacy” is central to this analysis: it is used by those describing long-standing apprehensions of medical and government institutions in the shadow of ethics violations like Tuskegee, but it also describes a recurring rhetorical situation surrounding the ideographically charged <Tuskegee>. In order to parse the ideographic tendencies of the Tuskegee Legacy, this chapter is guided by the following questions:

60 See footnote 16 in this chapter.

• How does ‘Tuskegee’ circulate as an ideograph?

• What do the findings of the Tuskegee Legacy Project reveal about the influence of <Tuskegee> and Clinton’s remarks over Americans’ attitudes and behaviors about participating in medical research?

• How do the rhetorical choices of the Tuskegee Legacy Project Questionnaire designers potentially affect responses from respondents?

• In what ways do Clinton’s remarks fall short of “curing” the Tuskegee legacy?

Chapter 6 concludes the dissertation by summarizing my findings and reflecting on “big-picture” implications of the central theses driving the Study. In this vein, I explore how Clinton’s adherences and deviations from the Legacy Committee’s request transformed an apology into a celebration of modern medicine and therefore disregarded the medical establishment and the modernist priorities on <science> as being key culprits in the Study. For example, when the Legacy Committee asked for bioethics research support by the government, Clinton obliged but also exhorted his African American audience to participate in research as subjects, which was not explicitly requested by Committee. How does this reframing of the apology event complicate the Legacy? To put it another way, was the Committee’s optimism about the “opportunity to challenge this legacy and create a more beneficial one” satisfied?⁶¹ I also revisit claims made in the opening chapter regarding the significance of my research: the benefits of paired rhetorical criticism over strict genre criticism, the opportunities and limits of institutional apologies for government-level wrongdoing, the role of “Tuskegee” as a metaphor, and the capacity and limitations of rhetoric to work within the constraints of historical context while simultaneously shift the framing of the same context. Aaron Lazare speaks to the equalizing effects of apologies

61 Legacy Committee, “Legacy Committee Request,” 563.

as “hurting” the offender to make up for the hurt suffered by the victim.⁶²Since Clinton was an apologizer but not the offender, who benefits from his display of humility?

Chapter 6 takes stock of how the specific findings and overarching themes of the dissertation address the research questions guiding the project, as well as how they suggest future paths of inquiry.