The Tuskegee Syphilis Study: Another Look at Unethical Medicine

Tuskegee is a small city in Alabama, which has played a pivotal role in the civil rights movement. It still houses Tuskegee University, which began as the Tuskegee Normal School for Colored Teachers founded in 1881 by Booker T. Washington; it is also where Rosa Parks was born. Sadly, it is also the location of the Tuskegee Syphilis Study.

According to Tuskegee University, it all began in the 1920s when a Chicago-based charity approached the government via the Public Health Service (PHS) with some ideas for improving the health of African Americans. The PHS had a special interest in addressing Syphilis as they’d recently completed a study that showed that upwards of 25% of a 2,000 person sample were afflicted with it.

Although the study may have began with good intentions, it shifted from being about helping those afflicted with the disease to becoming a study about the effects of untreated Syphilis on live patients.

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. (source)

You can imagine where they went with this. With a captive audience of living subjects at their disposal, the PHS made the horrifying decision that in order to study the disease in living patients they would not disclose the illness and instead would watch as patients slowly deteriorated and eventually died from it. In some cases, they even prevented subjects from receiving treatment from other sources: “During World War II, about 50 of the study subjects were ordered by their draft boards to undergo treatment for syphilis. The PHS requested that the draft boards exclude study subjects from the requirement for treatment. The draft boards agreed.” (source)

Unbelievably, this study continued until the late 1970s. When the director of the PHS department responsible for the study between 1943 and 1948 was interviewed in 1981 he admitted, “The men’s status

did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.” (source)

Further reading: Henrietta Lacks and the Tragic Story of Medical Ethics, Racial Politics and Health Care Reform in America.

Image: Disease by Erik Starck