WASHINGTON – American scientists deliberately infected prisoners and patients in a mental hospital in Guatemala with syphilis 60 years ago, a recently unearthed experiment that prompted U.S. officials to apologize Friday and declare outrage over “such reprehensible research.” However, The Tuskegee Syphilis Study is one of the most horrendous examples of research carried out in disregard of basic ethical principles of conduct. The publicity surrounding the study was one of the major influences leading to the codification of protection for human subjects.
In 1928, the director of medical services for the Julius Rosenwald Fund, a Chicago-based charity, approached the U.S. Public Health Service (PHS) to consider ways to improve the health of African Americans in the South. At the time, the PHS had just finished a study of the prevalence of syphilis among black employees of the Delta Pine and Land Company of Mississippi. About 25% of the sample of over 2000 had tested positive for syphilis.
The PHS and the Rosenwald fund collaborated in treating these individuals. Subsequently, the treatment program was expanded to include five additional counties in the southern U.S.: Albemarle County, Virginia; Glynn County, Georgia; Macon County, Alabama; Pitt County, North Carolina; and Tipton County, Tennessee (Jones, 1981).
During the set-up phase of the treatment program, the Great Depression began. The Rosenwald Fund was hit hard and had to withdraw its support. Without the Rosenwald Fund, the PHS did not have the resources to implement treatment.
During this period, there was a debate occurring in health circles about possible racial variation in the effects of syphilis. Dr. Taliaferro Clark of the PHS suggested that the project could be partially “salvaged” by conducting a prospective study on the effects of untreated syphilis on living subjects. Clark’s suggestion was adopted.
In the beginning stages of the project, the PHS enlisted the support of the Tuskegee Institute. Since the Tuskegee Institute had a history of service to local African Americans, its participation increased the likelihood of the “success” of the experiment. In return, Tuskegee Institute received money, training for its interns, and employment for its nurses. In addition, the PHS recruited black church leaders, community leaders, and plantation owners to encourage participation.
At the time of the project, African Americans had almost no access to medical care. For many participants, the examination by the PHS physician was the first health examination they had ever received. Along with free health examinations, food and transportation were supplied to participants. Thus, it was not difficult to recruit African American men as participants in the study. Burial stipends were used to get permission from family members to perform autopsies on study participants (Jones, 1981).
While study participants received medical examinations, none were told that they were infected with syphilis.
