Tuskegee syphilis study
The
Tuskegee Syphilis Study (
1932-
1972) was a medical experiment, conducted around
Tuskegee, Alabama, where 400 poor, mostly illiterate black American sharecroppers became part of a study on the treatment of
syphilis without their full knowledge.
The study was originally started as a study on the effectiveness of contemporary treatments (including
Salvarsan,
mercurial ointments and
bismuth) which were considered harmful and ineffective, and an attempt to show that non-treatment was less harmful. By
1947,
penicillin had been recognized as a safe and effective treatment for syphilis, yet the remaining members of the Tuskegee group of patients were allowed to sicken and die for another twenty-five years, and some were even actively blocked from effective treatments to allow scientists to study syphilis damage post mortem to better understand how the disease spreads and kills.
The Tuskegee Syphilis Study was terminated in
1972, when it was exposed in the press. The Tuskegee Study is widely regarded as one of the greatest failures of American
medical ethics, and the subject of a presidential apology after the fact to the survivors and their relatives. This study has become an ethical standard against which many other medical studies have been measured.
Statistics
\nThe study started with 400 infected black men and 200 healthy black men as controls. By 1972, only 74 of the test subjects were still alive. Between 28 and 100 had died as a direct result of damage caused by syphilis. Many of the rest had already left the study and treated either within or external to the study.
Study Termination
In 1970, the existence of the study was leaked to the press and became front page headlines. As a result of public outcry, in 1972, an ad hoc advisory panel was appointed which determined the study was medically unjustified, and terminated the study. As part of a settlement of a class action lawsuit subsequently filed by the NAACP, $9 million was given to the study participants and free medical treatment was promised to the survivors and the surviving family members infected as a consequence of the study.
In 1974, the National Research Act became law, which created a commission to study and create regulations governing studies involving human participants.
On May 16, 1997, President Clinton formally apologized to Tuskegee study participants.
Ethical implications
Some believe that the Tuskegee Study has led to a lasting distrust amongst African-Americans of the medical community in general, and medical trials in particular. It has been speculated that this in turn has resulted in under-treatment of African-Americans, and their under-representation in medical trials, in turn leading to poorer medical care for African-Americans for decades to come.
Perspectives on the study are not unified. Some critics of the prevailing view argue that, in 1932, treatments for syphillis were ineffective and had very severe side effects. Furthermore, the men were asymptomatic at the time of beginning the trials, and that a majority of patients would have stayed so, even without treatment. At the time the study was started, it was believed that the serious consequences were real, but not universal. (We now know that "asymptomatic" untreated syphilis causes damage to internal organs including brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.) Finally, prevailing medical ethics at the time did not have the exacting standards for informed consent currently expected; doctors routinely withheld information about patient's condition from them. Therefore, they argue, that the initial stages of the trial were ethically defensible according to the standards of the time. However, with the development of an effective, simple treatment and the changing ethical standards as time went on, such arguments are not made in regards to the continuing practice of the study in its latter years.
The aftershocks of this study led directly to the high standards for human studies we have today.
References
\nJames H. Jones. Bad Blood: The Tuskegee Syphilis Experiment. New York: Free Press, 1981 & 1993.
Susan M. Reverby, ed. Tuskegee's Truths: Rethinking the Tuskegee Syphilis Study. University of North Carolina Press, 2000.
External links
\n* CDC Tuskegee Syphilis Study timeline\n* CDC Tuskegee Syphilis Study Page\n* University of Virginia: The Troubling Legacy Of The Tuskegee Syphilis Study\n* NPR: Remembering Tuskegee: Syphilis Study Still Provokes Disbelief, Sadness\n* Internet Resources on the Tuskeegee Study\n* Tuskegee re-examined spiked-online article defending the initial study (contains many outdated medical assumptions and other inaccuracies)
Category:Medical ethics\nCategory:Alabama history\nCategory:Infectious diseases
