Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker
"All in the Name of Science"
from The New York Times (July 30, 1972)
by Jane E. Brody
|It was a scientific experiment. For 30 years Federal health officers
allowed 400 poor black men known to have syphilis to go untreated despite
the discovery that penicillin could cure their devastating disease.
The study, which began in Tuskegee, Ala., in 1932 (ten years before penicillin) to determine the course of untreated syphilis, has raised once again a major dilemma for medical research that concerns the ancient issue of means and ends. Assuming that some experimentation on human beings is necessary to medical progress, how can these studies be performed in a way that does not violate the basic rights of man?
Ironically, the Tuskegee Study, as it is called, was begun in the year Hitler came to power. It was Hitler's atrocious "experiments" done in the name of medical science which led after World War II to the promulgation of the Nuremberg Code, a series of ethical guidelines to be applied to all human experimentation. It was ignored in the Tuskegee research.
None of the men in the study were ever treated for their disease, and at least seven eventually died of the late effects of syphilis. Even before penicillin, none of the patients were given the admittedly toxic therapy of the day -- injections of metals like arsenic, mercury or bismuth -- to see if they fared any better or worse than those untreated. The study's subjects may never have been told in terms they understood what was wrong with them.
One of the study's 74 survivors, Charles Pollard, an intelligent although uneducated farmer in Tuskegee, told a reporter, "they never mention syphilis to me -- not even once."
The ethics of the study would have been questioned regardless of who the subjects were, but the fact that Federal doctors had selected poor, uneducated men -- and not one of them a white man -- further inflamed the issue. As one white Southerner remarked, "The worst segregationist in Alabama would never have done this."
Even with a score of proclamations, codes, declarations, statements and guidelines formulated since the Nuremberg code that are now supposed to be applied to all human experimentation, many questionable studies have been done in recent years and, to loud cries of "human guinea pigs," several have become embroiled in public controversy. Almost without exception, they involve members of minority or disadvantaged groups.
The controversy dissipated after changes were made in the consent procedure and the medical rationale was thoroughly explained. But to this day, many scientists are still objecting to the use of mentally defective children in research, subjects who themselves cannot possibly give informed consent to what is being done to them.
In reading them, one thing becomes clear -- even among the most concerned and conservative, there is no universal agreement on what is and what is not an ethical experiment.