Tuskegee Study of Untreated Syphilis in the Negro Male

Between 1932 and 1972, the United States Government engaged in a scientific study in which approximately 400 African-American men infected with syphilis were diagnosed but left untreated. The Tuskegee Study of Untreated Syphilis was led by the United States Public Health Service (PHS). It took advantage of uneducated, poor African-American farmers from Macon County, Alabama. The movie â€Å"Miss Evers’ Boys† reveals that the Tuskegee Study was conducted by a group of Southern doctors, and tells the story of the 400 African-American men who were the uninformed subjects of this study, which sought to determine whether untreated syphilis affects African-American men in the same way that it does white men. Further data for the study were to be collected from autopsies. Although originally projected for completion within six months, the study actually remained in progress for 40 years. At first, these African-Americans were treated for the disease, but once funding for the study was cut, treatment ceased. The study proceeded without informing its subjects that they were no longer being medicated. Miss Evers was told that once the Government realizes that the study has remained in progress, new funds will be made available within a year. But the study went on for forty years, without the researchers resuming the men’s treatment at any point. The men were simply given placebos, then observed. They were even given spinal taps (â€Å"back shots†) to give them the impression that they are receiving treatment. Penicillin became available, but it was not administered to them, partly because of a rumor that it could kill them, but mostly because the researching doctors did not want the study’s outcomes jeopardized by this unforeseen variable. Most of the men died, and some went crazy; very few were alive at the end of the forty-year research period. The eventual finding was that untreated syphilis affects African-Americans and whites alike. The study began with good intentions. In 1929, prior to its inception, the blood-testing of African-Americans was funded by The Rosenwald Foundation for Black Community Development in the South. These blood tests were intended to locate the presence of syphilis, after which treatment could begin. When it transpired that treating all the infected men would be monetarily unfeasible, Dr. Taliaferro Clark, director of the PHS, proposed the study of the effects of untreated syphilis (in its late stages) in the black male. This study was to be an initiative of the Tuskegee Institute in Macon County, Alabama. After Dr. Clark retired in June of 1933, Dr. Raymond Vonderlehr succeeded him as Director of the Division of Venereal Diseases. The true nature of the study had to be kept from the subjects, to ensure their cooperation. Its goal was to discover how syphilis affects blacks as distinct from whites—the theory being that whites experience more neurological complications from syphilis, whereas blacks are more susceptible to cardiovascular damage. How this knowledge was to be useful in the clinical treatment of syphilis is uncertain. Regulations for using human beings in medical experiments are strict, and require that patients have a full knowledge and clear understanding of the experiment’s health risks and benefits. Yet the government doctors associated with the study refused even to use the term â€Å"syphilis. Instead, they misled their subjects by simply informing them that they had â€Å"bad blood. † Even when penicillin became available in 1947, these men were denied access to it, because its administration would interfere with the findings of the study. Local physicians, draft boards and PHS venereal disease programs were given as information nothing more than a list of â₠¬Å"subjects. † The only treatment the men received was aspirin and iron supplements. Since none of them had ever had more than a little healthcare, they believed that what they were getting as treatment was very effective cure for bad blood. In exchange for taking part in the study, the men received free medical examinations, free hot meals, a certificate signed by the Surgeon General, and a $50 burial stipend. Syphilis is a highly contagious disease caused by the spirochete Treponema Pallidum. Acquired T. Pallidum enters the body through skin mucous membranes, usually during sexual contact. Congenital Syphilis (CS) is transmitted to the fetus from the infected mother when the spirochete penetrates the placenta. Syphilis is a systemic disease, attacking tissues throughout the body. After initial penetration, the spirochetes multiply rapidly. First they enter the lymph capillaries, where they are transported to the nearest lymph gland. There they multiply, and are released into the blood stream. Within days the spirochetes invade every part of the body. A multi-organ infection, CS may result in a the neurologic or musculoskeletal handicap, or death, of the fetus when not properly treated. Trends in the CS rates of women of childbearing age follow by approximately one year the rates of primary and secondary syphilis. Racial/ethnic minorities continue to be affected disproportionately by CS. No biologic association exists between race and the risk of delivering an infant with CS; race serves as a marker of other factors, such as poverty and access to health care, in communities with high syphilis rates (5-7). Individual factors, such as illicit drug use and the â€Å"wanted† status of a pregnancy, also influence the chances of a mother delivering an infant with CS. In acquired syphilis, the organism rapidly penetrates intact mucous membranes or microscopic dermal abrasions, and, within a few hours, enters the lymphatics and blood to produce systemic infection. The central nervous system is invaded early in the infection. Examinations demonstrate that there are abnormal findings in the cerebrospinal fluid (CSF) of more than 30% of patients in the secondary stage of the infection. In the first 5-10 years of contracting the infection, its principal involvement is with the meninges and blood vessels, resulting in meningovascular neurosyphilis. Later, the parenchyma of the brain and spinal cord are damaged, resulting in parenchymatous neurosyphilis. Three stages mark the progression of the disease: primary, secondary and tertiary. The primary stage commences 10-60 days after infection. Lesions usually appear at the point of contact, which is typically the genitals. After that, a painless, somewhat raised round ulcer appears. This chancre may be so small that it goes undetected. Leading into the secondary stage, the chancre will heal within 30-60 days without any treatment, leaving a scar that can remain for months. The secondary stage lasts from approximately 6 weeks to 6 months. During this time, a rash similar to measles or chicken pox appears on the skin. Fever, indigestion and headaches may accompany the rash. Bones and joints may be painful, and cardiac palpitations may also develop. In some cases, highly infectious, spirochete-laden ulcers may appear in the mouth. Scalp hair may drop out in patches, creating a moth-eaten appearance. Syphilis in the tertiary stage manifests as gummy or rubbery tumors on the skin, which is the result of spirochete concentration in body tissue. These sores band together into large, encrusted ulcers that consist s of several layers of dry matter. â€Å"Tumors may also attack and weaken the walls of heart or blood vessels. Heart valves may no longer open and close properly, resulting in leakage. The stretching vessel walls may produce an aortic aneurysm, a balloon-like bulge. If the bulge bursts, as often is the case, the result is sudden death† (Pyle). Many factors declare the destructive Tuskegee experiment wrong, regardless of whether it contributed to the fight against syphilis. There were 28 deaths directly attributable to the syphilis experiments, 100 deaths due to the complications of the disease, 40 wives of experiment subjects were infected by the disease, and 19 children were born with congenital syphilis. Risks have to be taken in science for the sake of advancement, and risks always have some negative consequences. But scientific experimentation on people selected on the basis of their skin color and social class, then kept ignorant of their condition and its danger to themselves and to others, and misled to believe that they are receiving curative treatment, is nothing short of a conspiratorial act of pure evil. The Tuskeegee experiment went on until 1972, close to thirty years after penicillin was discovered during the ’forties. Syphilis, the deadly bacterium Treponema pallidum, had reached epidemic proportions in the past. Science should strive to make the world a better environment to live in. It is to be applauded when its research efforts make great strikes to this end. But in the case of the Tuskegee Study, the wrong done in the name of scientific research far outweighs the right. This study made victims of its subjects, and of people connected with them, knowingly and unnecessarily. It wantonly lied to the subjects who had volunteered in good faith, first by refusing to disclose the exact nature of the medical condition, then by pretending to them that they were receiving curative treatment, then again y withholding the apt curative treatment that became available. This study sought out African-American men who had been infected by syphilis, then proceeded to treat them like purpose-serving injected lab rats. Even after the whistle was blown in 1972, in a Washington Star article by Jean Heller, the public health service remained unrepentant, insisting that the men had freely volunteered to become the subjects of the study. An Alabama state health official even tried to make light of Heller’s revelation of gross abuse and deception: â€Å"People are making a mountain out of a molehill. Science is a necessary part of life. But for its great achievements, mankind would still be in the Dark Ages. However, pursuit of the advancement of scientific knowledge must never cross the well-marked line between that which is necessary, and that which is cruel and unnecessary. The Tuskegee syphilis experiment did cross that line, and that besmirched scientific research and the integrity even of its ethical practitioners. Work cited Pyle, Kevin C. â€Å"Tuskegee Syphilis Experiment. † Available at: http://www. dreamscape. com/morgana/adrastea. htm.