By Conor Brockway, V Form and Damion Nsiah, V Form
Biology Research Paper: Tuskegee Syphilis Study
The first half of the 20th century was plagued by actions that are deemed unethical and frightening in today’s society. These actions included the spreading of the Jim Crow Laws, the rising of the KKK, and the speculation of the stock market, resulting in the Great Depression. Many Americans now know of these actions and condemn them. However, poor medical practices during this time period were often overlooked. Many doctors, without advanced equipment or proper safety guidelines, would perform procedures on living bodies to see what happened to them. These experiments were often completed without informed consent. One of the most unethical studies that came from the 1900’s was the Tuskegee Syphilis Study.
Although there are no exact numbers for syphilis rates in America during 1900-1920, it is estimated that ten to fifteen percent of the general population had syphilis.[i] Syphilis is a bacterial infection that is sexually transmitted. There are four stages to this disease: primary, secondary, latent, and late. The primary stage is the beginning of the syphilis disease. The primary stage is indicated by painless, round sores popping up around the genitals or the mouth. The secondary stage is when reddish-brown rashes spread over the body, often on the hands and feet. Other symptoms include fever, hair loss, swollen glands, and headaches. The latent stage can occur for multiple years, and the body shows no signs of having syphilis, even though the bacteria is still in the body. Finally, the late stage can occur ten to twenty years after one gets syphilis. It often can cause severe damage to organs, such as the brain, heart, and nervous system. Blindness, paralysis, death, and the loss of mental functioning are all possible outcomes of syphilis. In 1947, it was discovered that penicillin could easily cure syphilis.[ii]
However, before penicillin was a known cure, there were many studies that researched syphilis and possible ways to rid the body of it. One study that created a lot of public turmoil during its time period, but is not well-known today, is the Tuskegee Syphilis Study. This study, which started in 1932, took place on the campus of Tuskegee University in Macon County, Alabama. The purpose of this study was to research the effects that untreated syphilis had on the body in Black males, ranging from 25 to 60 years old. There was a prevailing idea that syphilis affected Blacks differently than it affected Whites, due to the extreme amounts of racism that were present in the early 30’s.[iii] The Tuskegee Syphilis Study was one of the most unethical studies that came out of the 20th century, due to doctors withholding medical information from patients, giving patients inaccurate information, and using incentives in an exploitive manner.
The study included 600 Black men. They were mostly poor, illiterate sharecroppers. Out of the 600 men, 399 had latent or late syphilis. The other 201 men were control subjects in the experiment so that the doctors could monitor how a normal body functioned. However, none of the test subjects were informed of the actual experiment. The doctors told the men that they were being treated for “bad blood.” Bad blood was a term used by those in Macon County to describe diagnosable ailments, including syphilis, anemia, and fatigue.[iv] The truth of the matter is that the doctors deliberately lied to the men. The participants of the study believed that the doctors were helping them get treatment for their disease. However, the doctors were actually monitoring how syphilis affected the Black male body. The doctors were not treating the men for anything and were deliberately withholding the truth of the experiment for their own benefits. Again, this is extremely unethical, as the doctors of this study hid the patient’s true illnesses in order to gain scientific knowledge. The doctors not only lied to the men, but they exploited the trust of the men. Trust between patients and doctors is vital, as doctors are often responsible to either save a patient’s life or help a patient become healthier. If there is no trust between doctors and patients, then there would be a huge decline in the amount of people who would get medical procedures done because patients would always be afraid about what the doctor would actually do to them. In addition, withholding medical information from the participants in the study is extremely unethical and illegal in today’s world. Patients deserve to know the effects of procedures or experiments on their bodies, so that they may weigh the risks and benefits that come along with it. Not giving patients all medical information is also illegal today, due to laws that make voluntary informed consent of the patient necessary for all procedures or experiments. In addition to withholding medical information from the men, after penicillin was discovered as a cure to syphilis in 1947, the doctors never gave the participants any penicillin and continued with their study. Not giving the men any penicillin is malpractice. Instead, the doctors concluded that the data that they could get from their study was more important than the lives of 399 Black men.
During the time of the experiment, many of the Black men were willing participants in the study. The doctors offered the participants incentives that the poor Black men could not refuse. These incentives included free medical exams and free rides to and from the clinic. The men were also given free food on exam days and were given free treatment for minor ailments. There was also guaranteed money to help pay for the men’s burials when they died. The doctors lulled the patients into a false sense of security and safety. In order to make the patients believe they were being treated for “bad blood,” the doctors gave the men daily medication to supposedly make them get better. However, the men were given non-effective drugs, such as aspirin, that did not fight syphilis.
In 1972, Jen Heller wrote an article in the Associated Press that ended the Tuskegee Syphilis Study. In Heller’s article, she wrote about a “nontherapeutic experiment” that was named as a study that was conducted on Black men in the South and had been going on for 40 years.[v] The exposure of what had really been going on sparked public outrage because doctors had betrayed their patients. Instead of treating their patient’s diseases, the Tuskegee doctors were withholding proper treatment. Between 30-100 Black men in the study died directly from their syphilis that was not treated. Also, many of these men went on to infect their wives with syphilis, and a few of the wives gave birth to children infected with syphilis.[vi]
This chain reaction led to the intervention of the national government and U.S. federal agencies. The Assistant Secretary for Health and Scientific Affairs took action by appointing the Ad Hoc Advisory Panel to review the study. The Ad Hoc Advisory Panel quickly came to a conclusion. They found that the Black men agreed on their own will to participate in the study. However, the Panel did find out that there was no informed consent during the study. Informed consent is when the doctor tells the patient all of the risks and benefits that go along with medical procedures. In the Tuskegee Syphilis Study, the participants of the study were never truly told what the doctors were researching. In addition, the participants were never told about the potential and dangerous consequences of syphilis on themselves or their loved ones. The Panel also concluded that the men had no choice to leave the study after penicillin was found to be a cure. The Tuskegee Syphilis Trial was labeled as ethically unjustified and officially ended in November 1972.
The men of the study received their compensations in 1973. Attorney Fred Grey filed a class action lawsuit on behalf of the men and families that were part of the study. The lawsuit ended in an out of court settlement of approximately $10 million. The lasting impact of the Tuskegee Syphilis Study was that a new act, the National Research Act, was created. This act said that any study that used humans and was federally supported had to be reviewed by Institutional Review Boards. As a side note, even St. Markers who are in the STEM Fellowship program have to complete Institutional Review Boards for their projects. In addition, any person partaking in a study has to give voluntary informed consent.[vii] Although not well-known in the general public, the Tuskegee Syphilis Study helped shape the medical practices of today by creating laws that made studies safer for participants and created an ethical guideline that all doctors must follow.
Conor Brockway is a V Form day student from Sudbury, Massachusetts. He plays baseball and squash, and enjoys history and science.
Damion Nsiah is a V Former from Dallas, GA. He is a Prefect in Marr/Coolidge, wrestles, and plays football and tennis.
[i] Nicholas Jabbour, “Syphilis from 1880-1920: A Public Health Nightmare and the First Challenge to Medical Ethics,” University of Rhode Island, accessed March 1, 2015, http://www.uri.edu/artsci/com/swift/HPR319UDD/Syphilis.html.
[ii] “About the USPHS Syphilis Study,” Tuskegee University, accessed March 1, 2015, http://www.tuskegee.edu/about_us/centers_of_excellence/bioethics_center/about_the_usphs_syphilis_study.aspx.
[iii] Allan M. Brandt, “Racism and Research: The Case of the Tuskegee Syphilis Study,” n.d., PDF. http://www.med.navy.mil/bumed/Documents/Healthcare%20Ethics/Racism-And-Research.pdf
[iv] “About the USPHS Syphilis.”
[v] “About the USPHS Syphilis.”
[vi] Brandt, “Racism and Research: The Case.”
“About the USPHS Syphilis Study.” Tuskegee University. Accessed March 1, 2015. http://www.tuskegee.edu/about_us/centers_of_excellence/bioethics_center/about_the_usphs_syphilis_study.aspx.
Brandt, Allan M. “Racism and Research: The Case of the Tuskegee Syphilis Study.” N.d. PDF.
“Frequently Asked Questions.” Centers for Disease Control and Prevention. Last modified December 30, 2013. Accessed March 2, 2015. http://www.cdc.gov/tuskegee/faq.htm.
Jabbour, Nicholas. “Syphilis from 1880-1920: A Public Health Nightmare and the First Challenge to Medical Ethics.” University of Rhode Island. Accessed March 1, 2015. http://www.uri.edu/artsci/com/swift/HPR319UDD/Syphilis.html.