T is for the Tuskegee Study of Untreated Syphilis

Image: Participants in Tuskegee Study

Attribution: By Department of Health, Education, and Welfare. Public Health Service. Health Services and Mental Health Administration. Center for Disease Control. Venereal Disease Branch (1970 - 1973). [Public domain], via Wikimedia Commons

The Tuskegee Study of Untreated Syphilis in the Negro Male started with good intentions. In the 1920s, estimates of syphilis in the population at reproductive age were high--35%. The treatment at the time involved heavy metals mercury and bismuth, but the cure rate with such medicine was less than 30%. Side effects of these toxic materials were bad and sometimes fatal.

In 1929, the stock market crashed and the Great Depression started. Funding for the original program was cut, so in 1932, the decision was made to simply study the progression of the disease with about 400 negro men with syphilis and 200 without syphilis (the control group).

Image: Doctor draws blood from participant

Attribution: Wikipedia Commons

Despite urban myths to the contrary, no one was injected with syphilis, but the subjects were promised free treatment, meals, and burial insurance without knowing their diagnosis, what treatments they would receive, or what other treatments might be available. This lead to several abuses.

Spinal taps were performed without anesthesia to study the neurological effects of the disease. When penicillin became available in the 1940s as a safe and effective treatment to replace the dangerous heavy metals, the study participants were not informed. In fact, the decision was made to deliberately keep these men from receiving penicillin in order to continue the study in 1936, 1940, and again in 1947.

Even when the ethics of the study were questioned in 1968, the CDC "reaffirmed (the) need for study and gained local medical societies' support." Which societies, you ask? Both the AMA (American Medical Association) and the NMA (the largest and oldest national organization representing African American physicians and their patients)!

Image: Depression Era poster 

Attribution: Wikipedia Commons

And that's not all. Since the men with syphilis were not aware of their diagnosis, they did not know they could pass the disease to their wives through sexual contact. They did not know that their children could be born with the disease.

The study lasted 40 years.

Finally, a press leak in 1972 ended the study for good, but it was too late for the victims. Besides the men who died from untreated syphilis, 40 wives contracted the disease and 19 children were born with congenital syphilis.

After the study was made public, laws were put into place to protect participants in medical studies so that they would have informed consent, knowledge about the treatments received, and knowledge about alternative treatments. A settlement of ten million dollars was awarded to the victims for lifetime medical benefits and burial services. President Bill Clinton issued an apology. The Tuskegee University National Center for Bioethics in Research and Health Care was established.

Have you ever heard of this study? What bit surprised you the most? That the men didn't even know they had syphilis? That penicillin was denied to them? Or that the CDC supported the study even as late as 1969?

Sources:

Wikipedia, Tuskegee Syphilis Experiment

The New Social Worker: The Tuskegee Syphilis Study and Its Implications for the 21st Century

CDC: The Tuskegee Timeline