The necessity to follow an established set of moral principles and values is an essential requirement for any medical research. The contemporary ethical standards are informed by the errors in judgment allowed in previous experiments. These mistakes permitted modern studies to be safer both for those conducting them and their subjects. This essay will discuss the Tuskegee Study of Untreated Syphilis in the Negro Male and how it informed ethical guidelines for medical research involving human subjects.
The Tuskegee study is considered one of the most unethical examinations of the twentieth century. The experiment was conducted in Alabama between 1932 and 1972 and focused on observing the progression of untreated syphilis in African American men (Alsan et al., 2019). It was initially designed as an interventional program that would provide treatment, but the funding for it was reduced, forcing the researchers to change the objective (Alsan et al., 2019). In 1932 the Tuskegee Institute recruited 600 African American men for the study, 399 of whom were suffering from syphilis while 201 were not and became the control group (Steinreich & DeBauche, 2017). The subjects were not informed of the nature of the investigation, with the scientists promising they would receive free treatments for syphilis and other illnesses and free transportation and meals (Steinreich & DeBauche, 2017). In 1947, after penicillin was discovered as an effective cure for syphilis, it was not utilized in the trial, with the men participating in the experiment not being informed about it (Steinreich & DeBauche, 2017). Overall, the researchers of the Tuskegee study purposefully endangered the lives of the partakers.
There were two main demographic characteristics of the participants that placed them at risk: gender and race. Only African American men were recruited, with men and women of other races and ethnicities not considered for the experiment. Additionally, it can be argued that the income of the involved participants also endangered them, as the advertisement for the study was aimed at men who were not able to afford medical care for their condition (Yearby, 2017). During the experiment, 28 men died of the disease, and approximately 100 recruits died of syphilis-related complications (Steinreich & DeBauche, 2017). Furthermore, 40 wives of the subjects were infected, with at least 19 children born with syphilis (Steinreich & DeBauche, 2017). The researchers showed an obvious disregard for the health and well-being of the recruited African American men and their families to study the progression of the disease that was already well-documented.
The experiment raised several ethical and legal issues for the involved stakeholders. The trial was investigated by an Advisory Panel supervised by the Assistant Secretary of Health that concluded that it was unethical (Barrett, 2019). In 1973, one of the participants filed a civil lawsuit for the violation of federal and state laws that was later expanded to include the surviving partakers and family members of the deceased (Barrett, 2019). The study also led to the National Research Act of 1974 aimed at develop of guidelines for medical research being passed (Barrett, 2019). Specifically, it led to the creation of three crucial tenets: informed consent, beneficence, and justice (Yearby, 2017). Thus, any person participating in an experiment must be informed about its purpose, and it should benefit the subjects and not intentionally harm their health and well-being (Yearby, 2017). These tenets align with the American Psychological Association’s principles of beneficence, nonmaleficence, and justice (American Psychological Association, 2017). Therefore, the errors committed during the trial were carefully considered to establish safer and more ethical research procedures.
In summary, the Tuskegee syphilis study is an example of unethical medical research that intentionally placed its subjects at risk. The participants were selected based on their race and gender, although the third characteristic of low income was common among the initial recruits. The review of the study led to the development and recognition of several ethical guidelines, including the necessity to obtain informed consent, beneficence to the participants, and justice.
Alsan, M., Wanamaker, M., & Hardeman, R. R. (2019). The Tuskegee study of untreated syphilis: A case study in peripheral trauma with implications for health professionals. Journal of General Internal Medicine, 35(1), 322–325. Web.
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Web.
Barrett, L. A. (2019). Tuskegee Syphilis Study of 1932–1973 and the Rise of Bioethics as Shown Through Government Documents and Actions. DttP: Documents to the People, 47(4), 11–16.
Steinreich, D., & DeBauche, G. (2017). Tuskegee at forty-five and US medicine’s 107 years of artificial scarcity and economic exclusion. Quarterly Review of Business Disciplines, 4(1), 55–74.
Yearby, R. (2017). Exploitation in medical research: The enduring legacy of the Tuskegee Syphilis Study. Case Western Reserve Law Review, 67(4), 1171–1226.