Tuskegee: could it happen again?

The Tuskegee Syphilis Study is often paired with the horrific Nazi experiments as the prime examples of what happens when powerless subjects, the state's coercive power, racism, and medical research are unmoored from ethical concerns. In the Tuskegee study, over 400 African-American men with late stage syphilis were never told they were in a 40 year long (1932–72) experiment sponsored by the United States Public Health Service to study “untreated syphilis in the male Negro”. The men were not directly offered treatment, even though they were told that the aspirins, tonics, and rubs were to help cure their “bad blood”. With the support of community based physicians and nurses, the local standard of “no care” in Alabama's “black belt” became an orchestrated reality, even after penicillin became widely available in the late l940s. The medical uncertainty over how to treat late stage syphilis and the desire to hold on to the subjects became the cover for the deceit that was perpetuated at Tuskegee. The government supported physician/scientists who ran the study went on to greater fame in their careers; although there was a lawsuit, no one was ever legally punished for what was done.

The ethical systems put in place after World War II and after the outcry over Tuskegee did change the regulations that supposedly now govern human subject research. Governmental regulating bodies, institutional review boards, data and ethics monitoring committees, and ethics courses were established or strengthened to obviate the possibility of a reoccurrence of abuses of this magnitude. Informed consent and an emphasis on the rights of the subject, not just the duties of the doctor, have become central to our ethical beliefs and to internationally promulgated …