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The Tuskegee Syphilis


Table Of Contents
 Introduction   Human Beings As Laboratory Animals   Bad Science  Doctor's Orders Nurse Rivers Human Guinea Pigs The Snakes Experiments


In 1932 the American Government promised 400 men - all residents of Macon County, Alabama, all poor, all African American - free treatment for Bad Blood, a euphemism for syphilis which was epidemic in the county. Treatment for syphilis was never given to the men and was in fact withheld. The men became unwitting subjects for a government sanctioned medical investigation, The Tuskegee Study of Untreated Syphilis in the Negro Male. The Tuskegee Study, which lasted for 4 decades, until 1972, had nothing to do with treatment. No new drugs were tested; neither was any effort made to establish the efficacy of old forms of treatment. It was a non therapeutic experiment, aimed at compiling data on the effects of the spontaneous evolution of syphilis on black males. What has become clear since the story was broken by Jean Heller in 1972 was that the Public Health Service (PHS) was interested in using Macon County and its black inhabitants as a laboratory for studying the long term effects of untreated syphilis, not in treating this deadly disease.

           The Tuskegee Study symbolizes the medical misconduct and blatant disregard for human rights that takes place in the name of science. The studies principal investigators were not mad scientists, they were government physicians, respected men of science, who published reports on the study in the leading medical journals. The subjects of the study bear witness to the premise that the burden of medical experimentation has historically been borne by those least able to protect themselves. The government doctors who participated in the study failed to obtain informed consent from the subjects in a study of disease with a known risk to human life. Instead, the PHS offered the men incentives to participate: free physical examinations, free rides to and from the clinics, hot meals on examination days, free treatment for minor ailments, and a guarantee that a burial stipend would be paid to their survivors. This modest stipend of $50.00 represented the only form of burial insurance that many of the men had. By failing to obtain informed consent and offering incentives for participation, the PHS doctors were performing unethical and immoral experiments on human subjects. From the moment the experiment begun, the immorality of the experiment was blatantly apparent.
For forty years between 1932 and 1972, the U.S. Public Health Service (PHS) conducted an experiment on 399 black men in the late stages of syphilis. These men, for the most part illiterate sharecroppers from one of the poorest counties in Alabama, were never told what disease they were suffering from or of its seriousness. Informed that they were being treated for “bad blood,” their doctors had no intention of curing them of syphilis at all. The data for the experiment was to be collected from autopsies of the men, and they were thus deliberately left to degenerate under the ravages of tertiary syphilis, which can include tumors, heart disease, paralysis, blindness, insanity, and death. “As I see it,” one of the doctors  involved explained, “we have no further interest in these patients until they die.”

           Using Human Beings as Laboratory Animals

                The true nature of the experiment had to be kept from the subjects to ensure their cooperation. The sharecroppers' grossly disadvantaged lot in life made them easy to manipulate. Pleased at the prospect of free medical care, almost none of them had ever seen a doctor before, these unsophisticated and trusting men became the pawns in what James Jones, author of the excellent history on the subject, Bad Blood, identified as “the longest non therapeutic experiment on human beings in medical history.” The study was meant to discover how syphilis affected blacks as opposed to whites, the theory being that whites experienced more neurological complications from syphilis whereas blacks were more susceptible to cardiovascular damage. How this knowledge would have changed clinical treatment of syphilis is uncertain. Although the PHS touted the study as one of great scientific merit, from the outset its actual benefits were hazy. It took almost forty years before someone involved in the study took a hard and honest look at the end results, reporting that “nothing learned will prevent, find, or cure a single case of infectious syphilis or bring us closer to our basic mission of controlling venereal disease in the United States.” When the experiment was brought to the attention of the media in 1972, news anchor Harry Reasoner described it as an experiment that “used human beings as laboratory animals in a long and inefficient study of how long it takes syphilis to kill someone.”

           A Heavy Price in the Name of Bad Science

                By the end of the experiment, 28 of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis. How had these men been induced to endure a fatal disease in the name of science? To persuade the community to support the experiment, one of the original doctors admitted it “was necessary to carry on this study under the guise of a demonstration and provide treatment.” At first, the men were prescribed the syphilis remedies of the day, bismuth, neoarsphenamine, and mercury, but in such small amounts that only 3 percent showed any improvement. These token doses of medicine were good public relations and did not interfere with the true aims of the study. Eventually, all syphilis treatment was replaced with “pink medicine” aspirin. To ensure that the men would show up for a painful and potentially dangerous spinal tap, the PHS doctors misled them with a letter full of promotional hype: “Last Chance for Special Free Treatment.” The fact that autopsies would eventually be required was also concealed. As a doctor explained, “If the colored population becomes aware that accepting free hospital care means a post-mortem, every darky will leave Macon County . . .” Even the Surgeon General of the United States participated in enticing the men to remain in the experiment, sending them certificates of appreciation after 25 years in the study.

   Following Doctors' Orders

                It takes little imagination to ascribe racist attitudes to the white government officials who ran the experiment, but what can one make of the numerous African Americans who collaborated with them? The experiment's name comes from the Tuskegee Institute, the black university founded by Booker T. Washington. Its affiliated  hospital lent the PHS its medical facilities for the study, and other predominantly black institutions as well as local black doctors also participated. A black nurse, Eunice Rivers, was a central figure in the experiment for most of its forty years. The promise of recognition by a prestigious government agency may have obscured the troubling aspects of the study for some. A Tuskegee doctor, for example, praised “the educational advantages offered our interns and nurses as well as the added standing it will give the hospital.” Nurse Rivers explained her role as one of passive obedience: “we were taught that we never diagnosed, we never prescribed; we followed the doctor's instructions!” It is clear that the men in the experiment trusted her and that she sincerely cared about their well being, but her unquestioning submission to authority eclipsed her moral judgment. Even after the experiment was exposed to public scrutiny, she genuinely felt nothing ethical had been amiss. *SEE HER LINK BELOW*

Many critics of The Tuskegee Study draw comparisons to the similar degradation of human indignity in inhumane medical experiments on humans living under the Third Reich. How could such callousness happen outside Nazi Germany? To deny that race played a role in The Tuskegee Study is naive. All 600 subjects (399 experimental and 201 controls) were black the PHS directors and most of the doctors who studied them were white. Was The Tuskegee Study government sanctioned, premeditated genocide? In July 1972, Jean Heller broke the story. Under examination by the press, the PHS was not able to provide a formal protocol for the experiment, in fact, one never existed. While it was obvious to the American public as a whole, PHS officials maintained that they did nothing wrong. By the time the story broke, over 100 of the infected men had died, others suffered from serious syphilis related conditions that may have contributed to their later deaths even though penicillin, an effective treatment against syphilis, was in widespread use by 1946.

On July 23, 1973, Fred Gray, a prominent civil rights lawyer, brought a $1.8 billion class action civil suit against many of those institutions and individuals involved in the study. Gray demanded $ 3 million in damages for each living participant and the heirs of the deceased. The case never came to trial. In December, 1974, the government agreed to a $10 million out of court settlement. The living participants each received $ 37,500 in damages, the heirs of the deceased, $15,000. Gray received nearly $ 1 million in legal fees. Had the subjects of The Tuskegee Study been taken advantage of ? Although the survivors and the families of the deceased received compensation, no PHS officer who had been directly involved in the study felt contrition. No apologies were ever tendered; no one ever admitted any wrong doing. On the contrary, the PHS officers made it clear that they felt they were acting in good conscience. They felt betrayed by the government's failure to defend the study they commissioned. But as one survivor said "...I don't know what they used us for. I ain't never understood the study."  In 1990, a survey found that 10 percent of African Americans believed that the U.S. government created AIDS as a plot to exterminate blacks, and another 20 percent could not rule out the possibility that this might be true. As preposterous and paranoid as this may sound, at one time the Tuskegee experiment must have seemed equally farfetched. Who could imagine the government, all the way up to the Surgeon General of the United States, deliberately allowing a group of its citizens to die from a terrible disease for the sake of an ill conceived experiment? In light of this and many other shameful episodes in our history, African Americans widespread mistrust of the government and white society in general should not be a surprise to anyone.
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