This editorial appears in the August 2025 issue of the American Journal of Bioethics
Bioethics emerged in the shadow of World War II, a response to egregious violations of people’s rights at the hands of Nazi scientists. Subsequently, the field responded to revelations of appalling abuses of orphans, disabled children, poor women, and Black men with syphilis by U.S. Public Health Service scientists. In response to these atrocities, bioethical principles of respect for persons, beneficence, and justice, enshrined in The Belmont Report, ushered in major reforms, including a requirement for informed consent of research participants and review of research protocols by peer committees.
Today, American bioethicists face a deeply troubling ethical climate tainted by some of the same racist hatred. As bioethicists, we must push back. We must ask, as Callahan did at a 1976 Hastings Center conference on “Biomedical Ethics and the Shadow of Nazism,” “when we see new moral or social trends developing in our society, or new moral issues and positions being discussed, what are the dangerous social symptoms we should be aware of?”. In 2020, during the height of the COVID-19 pandemic, Levine cautioned, “some see parallels between what is happening today including the rise of antisemitism; police violence against Black people; anti-immigrant rallies; hate crimes, including murder; and the historic rise of Nazism during the pre-World War II era”.
In this editorial, we highlight the Trump Administration’s broadside attack against diversity, equity, and inclusion (DEI) in higher education, the federal government, and the private sector. DEI has furnished essential resources for dismantling structural injustices that stifle the health and well-being of marginalized groups. Years of research and data gathering have shown that removing barriers facing marginalized groups improves population health and promotes health justice. Considering this, how should bioethics as a field respond to the dismantling of DEI? We underscore the value of DEI, dissect the ongoing assault, and argue for a forceful response by bioethicists.
The importance of DEI
DEI is an effort to address injustice and promote equal access to fundamental opportunities for all to higher education, employment, housing, nutrition, research participation, and healthcare. For example, DEI programs seek to increase the number of women entering science, technology, engineering, and math (STEM); reduce inequities in health and healthcare among Black, Indigenous, and People of Color (BIPOC); or close gaps to higher education for groups historically excluded, such as racial and ethnic minorities, students from low-income backgrounds, people living in rural areas, or people with disabilities. It does this by eliminating barriers facing groups that are socially marginalized and discriminated against in ways that undercut basic opportunities. Such efforts take multiple forms: reducing obstacles based on race or ethnicity, sex, age, disability, gender identity, sexual orientation, religious affiliation, or other aspects of identity that impede access. The overarching aim is to create a fairer, more just society.
So understood, DEI is fundamentally a matter of justice. The dismantling of DEI should therefore be front and center for bioethics. Not only has the work of bioethics been inextricably linked to justice since the field’s inception, justice continues to be a core commitment of bioethicists. A 2025 survey documented that the overwhelming majority (80%) of U.S. and Canadian bioethicists strongly support integrating social justice concerns in bioethics and 75% believe social justice should be a key aim of bioethics scholarship.
The Assault on DEI
DEI efforts gained momentum in response to the 2020 murder of a Black man, George Floyd, by a white Minneapolis police officer, Derek Chauvin, a crime captured by video footage and viewed by millions of people. Floyd’s death and the deaths of other Black individuals at the hands of law enforcement forced a reckoning with systemic racism in law enforcement and the criminal justice system. Many public and private sector organizations embraced DEI initiatives and issued public statements supporting such efforts.
Yet by 2023, a backlash against DEI was evident in social media, the courts, and politics. While critiques of DEI are longstanding, a 2023 U.S. Supreme Court ruling was pivotal, bringing an end to race-based affirmative action in higher education. In 2024, a war on DEI commenced. More than thirty states introduced or passed laws limiting DEI. High-profile companies retreated from DEI commitments. DEI efforts in higher education were downsized or eliminated: between April and December 2024, over 200 American colleges took steps to scrub their websites of any mention of DEI and to eliminate or rebrand their DEI programs and research.
The assault on DEI has been aggressively waged by President Trump through a series of executive orders.1 Trump first signed an executive order “Ending Radical and Wasteful Government DEI Programs And Preferencing”. The order shut down federal DEI programs and mandated all employees whose work is focused on DEI be placed on paid leave immediately and eventually laid off; it annulled policies requiring federal contractors to promote affirmative action and diversity. A second executive order, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” asserted “It is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality…the Executive Branch will enforce all sex-protective laws to promote this reality”. A third executive order, “Ending Illegal Discrimination and Restoring Merit-Based Opportunity,” rescinded fifty years of executive orders addressing discrimination and promoting diversity. It froze new Department of Justice investigations by the Civil Rights division.
To implement these orders, the administration sought to cancel diversity discourse by discouraging the use of the word diversity in all programs receiving federal funding, and by flagging a broad swath of diversity-related terms and strongly discouraging their use: accessible, anti-racism, BIPOC, Black, bias, cultural heritage, disability, disparity, discrimination, equity, gender-based violence, gender affirming care, health disparity, minority, nonbinary, race, racial justice, men who have sex with men, systemic, transgender, unconscious bias, underrepresented, vulnerable populations, and women. An internal memo by the Acting Director of the Office of Personnel Management advised heads of federal departments and agencies to report efforts to disguise DEI efforts by renaming them.
Trump’s invective against DEI is defended as a necessary step to restore a merit-based system, promote national pride and unity, and end what it describes as a wasteful and ineffective use of taxpayer dollars.
Trump’s First Argument: Restoring Meritocracy
The first argument holds that ending DEI is the best way of “restoring the values of individual dignity, hard work, and excellence fundamental to American greatness”. Eliminating DEI “faithfully advances the Constitution’s promise of colorblind equality before the law. It ensures that Americans will be rewarded based on merit for their talent and hard work.
In reply, the notion of ‘colorblindness’ embeds false ideas about how people in fact view themselves and others. It assumes that abolishing DEI will return us to a ‘well-ordered society,’ where everyone acts justly and social rewards and punishments are doled out based on merit alone. Yet, where is the empirical evidence showing that all people can transcend racial labeling, shed implicit and explicit biases, and enter a utopian, “post-racial stance in which the individual no longer sees race but only sees the person for the other attributes and qualities of their existence”?
In further reply, the appeal to meritocracy assumes that people have a fair opportunity to develop their talents and therefore ought to be judged solely on the basis of their achievements. Yet this reasoning ignores the many ways the deck is stacked. People’s starting points in life are not equal, and high performers often enjoy privileges that those who perform less well lack, such as access to safe neighborhoods, food security, quality education, and basic healthcare. A robust body of evidence shows that social determinants impact people’s health and ability to access opportunities across the lifespan. A just society takes reasonable steps to level the playing field. The Trump Administration’s cuts to federal programs, such as the National Institutes of Health (NIH), have had the opposite effect, undermining efforts to eliminate health inequities by groups like the National Institute of Minority Health and Diseases .
Trump’s Second Argument: Establishing National Unity
A second argument the White House advances in support of dismantling DEI holds that focusing on diversity divides people and will “undermine our national unity”. The concern is that DEI initiatives stigmatize and demean majority groups, such as white people and men, causing them to feel excluded.
In reply, appeals to ‘national unity’ must foreground the experiences of all groups in society, ensuring that all experience a sense of belonging to and being part of the nation. Studies suggest that underrepresented people generally experience a lower sense of belonging than majority identity groups do, both with respect to having a sense of “involvement in everyday practices” and having a sense of “being included in the general environment”. DEI initiatives attempt to address this by enhancing the sense of belonging felt by historically excluded groups. Terminating DEI funding sends the opposite message; it disproportionately impacts historically underrepresented groups, signaling “there is not a place for them at the table”.
To avoid excluding minority or majority groups, DEI initiatives should double down on efforts to welcome all groups, use clear and inclusive language, and ensure that all voices are heard and all are included. Efforts to assess and track effects of DEI programs should be sustained and strengthened.
Trump’s Third Argument: Eliminating Waste
A third argument against DEI is that it is ineffective and generates “immense public waste”.
In reply, DEI takes many forms; its broad scope of application makes sweeping claims about its ‘effectiveness’ or ‘ineffectiveness’ suspect. True, some DEI efforts are ineffective. But others show benefits. DEI strategies should not be idealized as “the ultimate solution to issues of inequality;” nor should they be demonized as simply “divisive or unnecessary”. A large body of evidence suggests that DEI efforts aiming to “de-bias” individuals are less effective than efforts aimed at de-biasing organization processes, environments and policies. For example, in medicine, racial concordance between clinician and patient is associated with greater likelihood that patients will adhere to prescribed treatment and seek preventive care. In STEM fields, diverse teams are more apt than homogenous ones to make better decisions; innovate; be creative; and produce higher quality, more impactful science. Notably, these benefits accrue to everyone, not just to socially marginalized groups.
Absent evidence showing that systemic bias corrects itself, the task ahead is identifying evidence-backed methods to create a fairer society.
Other Trumpist Arguments
In addition to the above arguments, opponents of DEI in medicine assert that DEI replaces a neutral “scientific approach to treatment” with a “politicized medical education” focused on “progressive causes”. In reply, rather than striving for an elusive neutrality, epistemically just communities acknowledge social biases and act to counter them. They take steps to rectify wrongs baked into systems like healthcare.
Critics of DEI also charge that “DEI zealots” violate free speech by acting “like a tribe that intends to exclude anyone from higher education who isn’t in their group”. In reply, when restrictions on academic freedom are generally made, “the ethical quandary is not whether to restrict, but who, what, when, where, and why”. While line-drawing is contentious and challenging, the fix is not to ignore racism, sexism, ableism, and anti-LGBTQ+ prejudices.
What bioethicists must do to defend DEI
Our analysis gives compelling reasons for opposing the Trump administration’s wholesale assault on DEI. Yet, many bioethicists feel understandably fearful and muzzled. As DEI grant funding is cut and positions eliminated, people engaged in DEI-related research, teaching, and public speaking are worried about job security and what their future holds. Early career researchers are unsure they can have a career if they endorse DEI. Those who have not been directly impacted by DEI hostility are often ducking for cover, trying to stay out of the line of fire in the hopes that they will not be hit. Universities and academic leaders now frequently restrict or discourage public-facing protests or dissent.
While recognizing these challenges, we urge bioethicists, especially senior bioethicists, to push back. We must ask ourselves, ‘When the storm clears, will we be on the right side of history?’ To ensure that we are, we must speak up, stand together, and ask for support from allies and leaders.
First, the Field Must be Sure Its Own House in Order
Part of getting our own house in order is embedding DEI in our research, teaching, and service. In 2022, the Association of Bioethics Program Directors offered our field an important roadmap. They commissioned a two-year Presidential Task Force on Racial Equity, Diversity, and Inclusion (REDI), and proposed important guidelines for addressing REDI. While the Task Force focused specifically on anti-racism, its guidelines are helpful for addressing other forms of discrimination, such as discrimination based on having a gender identity falling outside the traditional male/female binary; having disabilities; being female; being an immigrant; or belonging to a non-majority religious group. The Task Force recommended the field reckon with its failure to promote anti-discrimination by ensuring that future bioethics leaders recognize the field’s role in perpetuating systemic injustice and create fundamental change in all aspects of bioethics. The Task Force minced no words: “all those doing the work of bioethics should be competent in discussing racism [and other forms of discrimination], its expressions (interpersonal, cultural, institutional, structural), and adaptations over time, as well as arguments for its moral wrongness and effective responses to it”.
Another important aspect of getting our house in order is working to realize greater diversity within our own ranks. A 2024 survey of American bioethicists showed that bioethicists tend to come from more educated families and are generally whiter, more liberal, and less religious than the overall American population. Notable efforts to create more inclusive pathways to bioethics are underway. Bioethics centers and programs should learn from and build on these efforts.
Second, Bioethics Must Speak Truth to Power
Bioethicists must push back against the brazen assault on human dignity we are witnessing, rather than keeping our heads low. Models to follow include the American Society for Bioethics and Humanities’ (ASBH’s) 2020 statement opposing injustice and its institutional and structural manifestation: “we are called upon as professionals in the fields of bioethics and health humanities to recognize the harm and detriment of injustice and to understand the assumptions that have long upheld individual, institutional, and structural racism in our professional settings, violated our professional responsibilities, and undermined our ability to fulfill our professional obligations”.
When politicians deny the relevance of DEI to sound science and public health, bioethicists must emphasize its appropriate relevance. This includes calling attention to how diversity of research participants ensures the accuracy and relevance of science for all, highlighting advantages of diverse workforces for innovation and impact, and discrediting pseudoscientific claims about racial differences and immutable gender roles. Bioethicists must probe the categories used to define diversity and the power structures they embed, asking, “How are the categories formed? Why are they formed? Who decides?… Bioethicists can use their skills in identifying where values are embedded in the classification process to show how these values can support inequity and discrimination, even unintentionally”. For example, decades of research has generated broad scientific consensus that social constructs of descent-based identity, such as race and ethnicity, not only vary wildly but “do not align with genetic groupings”.
Third, Bioethics Must Commit to Justice
While much of the debate over DEI focuses on whether it produces benefits or harms, a more fundamental question is whether DEI is equitable and fair, treating all people with the respect and dignity they deserve.
What is fundamentally at stake in the controversy surrounding DEI is what justice in the real-world demands. The Trump administration champions meritocracy. They align with the Heritage Foundation’s Mandate for Leadership (also known as ‘Project 2025’) that claims DEI programs should be ended because they unfairly discriminate against majority groups by advantaging racial minorities.
Our view of justice is restorative: it “begins from and defines itself in terms of the reality of violation, alienation, and disregard among human beings. Its central concept of ‘restoring relationships’ supposes that it is disregard or violation of acceptable human relationship that stands at the core of its agenda, practically and philosophically”. Everyone benefits from addressing inequity, and these benefits carry over from one generation to the next. As the U.S. National Academies rightly stress, “addressing inequities and improving the health of individuals in the most disadvantaged communities improves the quality of care for everyone and advances population health. This goes beyond the individual and extends to their children, whole communities, and society at large”.
As bioethicists, we must reject poorly justified assaults on DEI. We must stand for justice and with groups that continue to be marginalized, discredited, and discriminated against. We must enact a commitment to justice in bioethics research, ethics consultation, teaching, public speaking, and service.
Conclusion
Bioethicists are uniquely positioned to expose shoddy arguments and push back against the wholesale dismantling of DEI initiatives. Establishing a more just society has been core to the values and mission of our field since its start. As bioethicists, we must continue to promote justice, even in an environment where doing so may exact a price. We urge all bioethicists to push back against the Trump Administration’s reckless and unjust assault on DEI.
Acknowledgements
The authors are grateful to Ruth Faden for generous assistance and helpful feedback on the paper. All views expressed are solely the authors’ own. They do not represent the views of any institutions, associations, or organizations the authors may be affiliated with.