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The Tuskegee Syphilis

study
By
Angela Long, RN and Myriam Diatta, RN

What is Syphilis?
Highly contagious sexually transmitted
disease that first appeared in Europe in late
15th century
Transmitted by the bacterium Treponema
Pallidum
Syphilis infection has 3 stages (primary,
secondary and late stage)

Treatment of Syphilis
In 1947, Penicillin became the main treatment for
syphilis
A single dose of Penicillin G is given intramuscular to
treat the infection if infected for less than a year.
If infected for more than a year or for an unknown
period of time, Penicillin is given weekly for 3 weeks
Doxycycline or Tetracycline is administered to those
allergic to Penicillin
If left untreated, syphilis can cause permanent
health problems such as blindness, dementia or even
death.

The Tuskegee Syphilis


experiment
Clinical study conducted from 1932 to 1972
by the US Public health Service and the
Tuskegee institute
Goal: to study the natural progression of
untreated syphilis in rural African Americans
Subjects were 600 impoverished
sharecroppers
399 were previously infected and 201 never
had syphilis

Unethical Principles

Subjects were coerced/manipulated into the study


Subjects were never told they had syphilis
Subjects were never treated
Subjects were told they were being treated for bad
blood (CDC, 2013)
Subjects were never given informed consent
Subjects were never given the option to quit even
after the introduction of Penicillin as a treatment/cure
Victims included the participants, their wives and
many children born with congenital defects

Unethical Principles cont


Violation of the principle of Autonomy
Violation of the principle of Beneficence
Violation of the principle of Non Maleficence

Termination of the study


In 1972, the study became news in the
Washington Star and the New York Times.
CDC and PHS appointed a investigatory
panel who deemed the study medically
unjustified
In 1973, a class action lawsuit was filed.
US government paid 10 million to survivors
of the study and their families, lifetime
medical benefits and burial services

U.S. law and Regulation


changes
1974 National Research Act
1979 Belmont Report
1979 Establishment of the Office for Human
Research (OHRP)
Led to federal law and regulations requiring
Institutional Review Boards for the protection
of human subjects.

Conclusion
The Tuskegee experiment was known for one
of the most non-therapeutic study in the
United States
Resulted in a decrease in trust of researchers
from African Americans
Caused hundreds of death, infected wives
and children born with congenital syphilis.

References
Beauchamp, T., & Childress, J. (2013). Principles of Biomedical Ethics (7th ed.). New York:
Oxford University Press.
Center for disease control and Prevention (2013) U.S. Public Health Service Study at
Tuskegee. Retrieved from http://www.cdc.gov/tuskegee/timeline.htm
Karamanou, M., Kyriakis, K., Tsoucalas, G., & Androutsos, G. (2013). Hallmarks in history of
syphilis therapeutics. Le Infezioni in Medicina, 4(1), 317-319. Retrieved from
www.pubmed.com
Mays, V. M. (2012, November 1). The legacy of the us public health service study of untreated
syphilis in african american men at Tuskegee on affordable care act and health care reform
years after president Clintons apology. Ethics Behavior, 22(6), 411-418.
http://dx.doi.org/10.1080/10508422.2012.730808
Protection of human subjects and informed consent. (2014). Retrieved from
http://www.fda.gov/science research
Rancher, W., & Wolf, L. (2013, December). Redressing past wrongs: changing the common
rule to increase minority voices in research. American Journal of Public Health, 2136-2140.
http://dx.doi.org/10.2105%fajph.2013.301356
Syphilis CDC fact sheet. (2014). Retrieved from http://www.cdc.gov/std
Tampa, M., Sarbu, I., Matei, C., Benea, V., & Georgescu, S. (2014, March 15). Brief history of
syphilis. Journal of Medicine and Life, 7(1), 4-10. Retrieved from www.ncbi.nlm.nih.gov
The Tuskegge timeline. (2014). Retrieved from www.cdc.gov/tuskegee/timeline.htm
Varmus, H., & Snatcher, D. (2014, October 2). Ethical complexities of conducting research in
developing countries. The New England Journal of Medicine, 337-348.
http://dx.doi.org/10.1056/NELM201410023371411