Also RacismA majority of the medical community, including

Also known as the Tuskegee Syphilis Experiment, the Tuskegee Syphilis Study was initiated in 1932 by the U.S. Public Health Service (USPHS) with the purpose of determining the natural course of untreated syphilis. Centralized in Macon County, Alabama, the study was conducted in black males: 400 black males were identified as syphilitic and 200 males were identified as uninfected men but were still observed as control human models. In the early 1950s, penicillin was identified and widely accepted as the superior form of treatment for syphilis. Regardless of this groundbreaking discovery, the syphilitic men involved in the study did not receive the treatment. The U.S. Public Health Service deliberately obscured the men from a cure. After about fifteen years, a major board committee at the Center for Disease Control, CDC, (a federally-operated firm) ruled for the continuation in the study regardless of its health implications for the men involved. In 1972, the United States Department of Health, Education, and Welfare stopped the experiment when personal accounts of the study caused immense national upheaval. At the time the study was published over national press, only seventy-four of the total 400 test subjects were alive and twenty-eight others were directly suffering from advanced syphilitic contusions. Although the forty-year Tuskegee Syphilis Experiment is not generally known to the public today, the study was shaped around racial prejudice, supported by the public health systems, and resulted in many devastating consequences that still and will continue to persist. Medical Opinion and RacismA majority of the medical community, including racially-biased physicians, strongly suggested that blacks were specifically prone to contracting venereal diseases solely due to their ethnicity. Quite the extreme, one doctor of the twentieth century estimated that over fifty percent of all African American individuals over the age of twenty-five, regardless of their location of residency, were syphilitic. Meanwhile, other doctors believed treating blacks for venereal disease to be impossible. Their reasoning behind this was that symptoms for latent syphilis cases are usually inactive, but this is the case for any individual regardless of race. This represents the amount of weight racial judgement had in the medical community’s mindset as a whole. Additionally, increased crime within in an area was attributed to to the high incidence rate of syphilis. In the early twentieth century, the vital core of medical leadership revolved around the discrimination of blacks regarding sex and disease. All of these improper and illogical assumptions during the time of the study provide the driving force behind the origin of the Tuskegee Syphilis Study. Origins of Tuskegee The Tuskegee Syphilis Study was conducted with a grant from the Julius Rosenwald Fund. The USPHS conducted the experiment with a goal of determining the prevalence of syphilis among the African American community and to discover medicines and drugs for implementation is a mass treatment of everyone affected with syphilis. By surveying several counties within Alabama, the USPHS decided on the town Tuskegee in Macon County for its highest syphilis rate in the state. During its first instigation, the potential behind the study plummeted and eventually died out. However, Dr. Taliaferro Clark, Chief of the USPHS Venereal Disease Division, believed the situation of Macon County deserved renewed attention in 1932, nearly three years after the primary failure. Clark believed the high prevalence of syphilis in such a confined area offered an “unusual rare opportunity for observation.” With this study, Clark aimed to investigate pathways toward a complete cure; if that was not attained, he hoped to understand the most devastating effects of the disease and devise plans to avoid these consequences. Clark was observing subjects in the study similar to how researchers observe mice in today’s laboratories. The standard therapies prior to the discovery of syphilis posed certain dangers because of their harmful toxicity; however, the alternatives to the treatment were much worse. Prior evidence suggested that untreated syphilis could lead to cardiovascular disease, insanity, and premature death. This made the potential results from the experiment seem omnipotent for a multitude of health issues including the prominent syphilis. The premise that blacks, immoral and lustful, would not seek or continue treatment was mainstream in the medical community and eventually shaped the entire study. Some considered the test of untreated syphilis seemed “natural” because the USPHS assumed the syphilitic men would never considered to be treated anyway. However, this fails to prove morally and ethically correct. Test Subject Selection The preliminary step of the syphilis study was a thorough physical examination, full body x-rays, and a spinal tap to identify the presence of neurosyphilis. All participants were African American males between the ages of twenty-five and sixty. From the start of the study, the USPHS had no intention of relaying any treatment for the already infected men. And, in order to keep the expenditures and complexity of the study low, the Public Health Service only scheduled the study for six months. This forced Chief Clark to test a large number of participants who did not fit the requirements, often including woman, but this method did achieve the big goal of keeping the expense of the study as small as possible. The overall infection rates from these tests were contradictory to the prediction of USPHS on the incidence within Macon County. While it was predicted that thirty-five percent of the entire population of the Macon County would be infected with syphilis, only twenty percent of those tested were diseased. In order to overcome this setback, official from the Public Health Service told the black subjects that they were ill and offered them free medical care. This persuaded the black men to be willing to whatever the official informed them about. Throughout this entire interaction between the subjects and the official, it was never made clear to the African Americans that they were actually chosen as participants in an experiment. Ironically, the subjects “believed they were being treated for ‘bad blood,'” which was the South’s colloquialism for syphilis. But, their condition was only worsened due to the decisions of the Public Health Service, and they only become more eager for the “medical treatment” offered to them for free. Since the Health Service promised the participants free treatment, they were given ineffective drugs throughout their participation period, utilizing the placebo effect and ultimately preventing a failure in the study. The readiness of the test subjects to accept the “treatment” contradicted the existing notion that blacks would not seek therapy. One step of the selection proved to be especially difficult. However, the Public Health Service devised further deceptions to convince its subjects. When the test subjects complained about spinal taps, they told the subjects that it was a standard check up. After the USPHS’s approval for the continuation of the experiment in 1933, the head of the experiment decided that it would be necessary to select and maintain a group of healthy, uninfected men to serve as controls. Clark devised a proper experimental project in that he distributed non effective drugs to the men in the control group, making them believe they were undergoing treatment. However, control subjects who became syphilitic were simply transferred to the test group – an inept violation of standard research procedure. Finally, because it proved difficult to persuade the men to come to the hospital when they became severely ill, the USPHS even promised to cover their burial expenses. Results of the StudyMany detrimental consequences were the result of the study. According to the doctors, life expectancy was reduced by about twenty percent in the participants. An article published in 1955 found through autopsies that more than thirty percent of the test group had died directly from advanced syphilitic lesions in the cardiovascular or the central nervous system. During the forty years of the experiment, the USPHS had sought, on several occasions, to ensure that the subjects did not receive treatment from other sources. To close up this end, the Public Health service bribed a group of black doctors into not telling or treating the men. Lists of subjects were distributed to the physicians of Macon County, and the physicians were notified to refer the men on the lists back to the Tuskegee Study if they sought care at other hospitals. When the USPHS evaluated the status of the study in the 1960s, they continued to “rationalize the racial aspects of the experiment.” A group of physicians met again at the CDC in 1969 to decide whether or not to terminate the study. Although one doctor argued that the study should be stopped and the men treated, the overall consensus was to continue. When the first accounts of the experiment appeared in the national press in July 1972, data were still being collected from the infected men, and autopsies of the dead participants were still being performed.Conclusion In retrospect, the Tuskegee Syphilis Study revealed more about the impact of racial disease on the community than about the impact of syphilis on the human body. Additionally, in unveiled more about the “nature of scientific research than the nature of the syphilis disease.” The degree of deception and damages caused by the United States Public Health Service have been seriously misconceived. Greater weight on social, ethical, and moral values need to be instigated on any science research. A valid assessment on the various aspect of a study needs to be conducted, as shown by multiple examples throughout the history of the United States.


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