This writing reflects those individuals who were deemed to be unworthy or sacrificial for the “good and progression of science.” In 1932, these men were literally transformed from men to representational “guinea pigs” for the purpose of human experimentation.
So why is this an issue today? Why is the “Visible Man” bringing this up for discussion now? It has been 81 years since the inception of the study and 31 years since the study was terminated. What has happened? What has changed?
To review, the intent of this writing is to provide a safe place and/or voice to those who may be responding to conflicts as they deal with the concept of invisibility in a society or community in which they may not feel valued, validated, appreciated or wanted.
What has happened to the African-American men involved in the infamous United States Public Health Service (PHS) Tuskegee Syphilis Survey? The study lasted 40 years, beginning in 1932 and was terminated due to public outcry and outrage in 1972.
The study focused on 600 men, observing the natural progression of untreated syphilis in rural African-American men who were of the understanding that they were receiving free health care from the United States government.
Why were physicians and other healthcare professionals, many who had taken the Hippocratic oath swearing to practice medicine honestly and uphold professional ethical standards, able to create and maintain a human experimental program lasting 40 years? The Hippocratic oath contains two verses that are germane for this writing:
· I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
· If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.
During the course of the Tuskegee Syphilis Survey human experimental program, the Nuremberg Trials following WWII revealed the horrors of Nazi experimental on Jewish people. The individuals involved in conducting the Tuskegee Syphilis experiment verbalized indignation and were horrified as to what was done by their colleagues in Nazi Germany. However they were unable to reach the same conclusions regarding the experimentation on African-American men.
The question becomes why? Why were these men of medicine and science unable to see the harm they were doing? Did they conceptualize that they were violating the “do no harm” oath that they had sworn to uphold?
We can only theorize why these educated men and women of medicine and science were able to ignore their responsibility regarding providing care for patients and their oath to do no harm.
· First, the men being used for experimental purposes were identified as “research participants” instead of patients. In doing so despite their obvious physical human appearance, the men and women of medicine and science intellectually transformed them into guinea pigs thereby shielding themselves from the responsibilities of patient care as demanded by the Hippocratic oath.
· Second, the overt racism of that era and lack of interactions between educated, upper class white physicians/scientists and the uneducated poor, black rural men, mostly sharecroppers made it appear that the oath was not applicable in this situation.
· Third, unlike the horrifying experimental programs identified in Nazi Germany, the Tuskegee Syphilis Survey focused on the natural progression of untreated syphilis.
So if one considers the third point, one could understand the indignation of physicians and scientists such as Dr. John H. Heller who served as the director of PHS Division of Venereal Diseases for the US Public Health Service (PHS) from 1943-48 who made the following declaration:
“There was nothing in the experiment that was unethical or unscientific.”
Yet there were those outside of medicine and science who observed the issue differently. The national commenter for ABC News, Harry Reasoner expressed bewilderment that that the government:
“ used human beings as laboratory animals in a long and inefficient study of how long it takes syphilis to kill someone.”
So what became of the 600 African-American men of the Tuskegee Syphilis Experiment?
· In 1969, as many as 100 had died as a direct result of complications caused by syphilis.
· Others developed serious syphilis-related heart conditions that may have contributed to their deaths
· In 1974 there were a fewer than 120 known survivors.
Jones (1981) in his publication “Bad Blood” states:
“The Tuskegee Study had nothing to do with treatment. No new drugs were tested; neither was any effort made to establish the efficacy of old forms of treatment. It was a non-therapeutic experiment, aimed at compiling data on the effects of the spontaneous evolution of syphilis on black males.”
Gratitude is due to Peter Buxtun and James H. Jones. It was Peter Buxtun, a Caucasian public health social worker, who originally exposed the study. He openly questioned the ethics and morality of the Tuskegee Syphilis Survey and tirelessly and continuing kept the issue alive until the story broke into the press in 1972, triggering numerous and ongoing congressional investigations.
James H. Jones is the author of the publication “Bad Blood: the Tuskegee Syphilis Experiment- a tragedy of race and medicine (1981). The book is balanced, well written research examining American medicine, race relations and public policy.
And yet the most gratitude is due to the 600 men of the Tuskegee Syphilis Study. The inhumanity they endured and the sacrifices that they and their loved ones made did not go did not go unnoticed. The revelation of the existence of the 40-year study led to congressional investigations and a complete revamping of federal regulations on human experimentation.
The new guidelines created specific criteria for research projects involving human subjects. It was a direct consequence of the Tuskegee Syphilis Study that regulations exist today for the protection of human subjects.
Today, as with the passing of time the 600 African-American men of the Tuskegee Syphilis Study have long since died. However it is for us to remember the occurrence of the study. It is said that those who do not remember history are doomed to repeat it.
Billy Carter, an attorney for the survivors of the study, echoes this. He states referring to the descendants:
“The sad thing is that it could happen all over again. These people could just as easily be conned as their fathers and grandfathers in the syphilis study.”The Visible Man