Bittersweet Fruits

“The penalty may be removed, the crime is eternal!”

~Ovid, Roman Poet

From 1932-1972, the U.S. Public Health Service, working with the Tuskegee Institute, conducted a clinical study in Macon County, Alabama.  The study’s stated mission mandate was to monitor, study, and determine the effects of the natural progression of untreated syphilis in rural African-American men.  All totaled: 600 men enrolled in the study.  Of these 399 had syphilis and 201 were without disease.  In exchange for their participation in the study, the men were given free medical care, meals, and free burial insurance.  Left untreated, syphilis can cause lesions, nerve damage, and in the late stages can lead to damage of the central nervous system.  They were never told they had syphilis, nor were they ever treated for it.  They were told that they were being treated for “Bad Blood.”  In 1947, penicillin had become the standard course of treatment for syphilis.  Despite this fact, the doctors continued the study without treating any participants and withholding penicillin and information about it from the patients. In addition, doctors prevented participants from accessing syphilis treatment programs available to others in the area.  The study was allowed to continue.  In July of 1972, the study was halted then officially terminated after the story broke public.  By the end of it, of the original 399 participants they began with, who had syphilis, only 74 survived.  Another 28 died of syphilis and 100 died from related complications.  Sadly, it doesn’t stop there, 40 of their wives had been infected and 19 of their children were born with congenital syphilis.  No one was ever faulted for the Tuskegee Study.

 In the wake of the fallout from the Tuskegee Study, new ethical standards were imposed preventing the abuse of patients and the system in the name of research.  This change occurred set against the backdrop of what followed in the wake of the cultural fervor and ferment of the 1960’s.  If we examine the actions of the doctors involved, we see that their actions, as heartbreaking and devastating as they are, reflect that they are to some degree the products, indeed victims, of their time and circumstances.  Or if you will allow, the product of their school.  What is interesting to note is that the character of medicine and doctors has changed in the last 40 years.  While we see their actions as paternalistic, that reflects the wisdom and judgments of the era of medicine, and its established conventions, they were operating within.  The impression that one is left with is that these doctors saw these individuals as raw materials through which they could collect data to gather results to verify, with a declared ascent, all of their interested absurdities.  To this day, the legacy of Tuskegee continues to haunt the very nature of medicine.  For this reason, as well as others, people continue to wonder whether doctors care more about their patients or the study of medicine.  This raises many questions about whether the emphasis is on care and concern for people or on scientific study and statistics.  The following video offers some insight into the ethical concerns of this.  If the sacrifice of so many men, however senseless, in the name of scientific inquiry can give society pause to reflect, then maybe there is hope for the future.  At the very least, their sacrifice will not have been in vain.


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