The Tuskegee Syphilis
Experiment
ONE OF AMERICA'S DIRTY LITTLE SECRETS
THE TUSKEGEE SYPHILIS
EXPERIMENT
Table Of Contents
Introduction Human
Beings As Laboratory Animals Bad Science
Doctor's
Orders Nurse Rivers Human
Guinea Pigs The
Snakes Experiments
Introduction
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.