Tuskegee Study

The Tuskegee Syphilis Study

Enerolisa Paredes
Nursing 302
Professor Cypress
October 14, 2016

Tuskegee Study

The Tuskegee Syphilis Study

From the 1930s until 1972, the United States Pubic Health Service led a study on the
history of untreated syphilis in Tuskegee, Alabama. Around 600 African-American men from
which 400 had syphilis and 200 were enrolled in the study. From these non of them were
informed or gave consent and were deceived believing they were receiving exceptional free
treatment for their disease. Portions of the testing system included unnecessary spinal taps and
mercury rubs that were actually painful or harmful towards their health. By1936 it was clear that
issues were more frequent in the contaminated men. During the following ten years the death
rate was twice as high in men with syphilis. Even thought in the 1940s penicillin appeared to be
a compelling treatment for the disease, the subjects were not given or even educated about its
accessibility. The story circulated in 1972 inciting public outrage, requiring measures from the
country to prevent it from happening again. From this, many rules, codes and laws were created
and passed in order to prevent a violation to test subjects in studies.
The Tuskegee syphilis study became en epitome of the representation of the violation of
human rights. As a consequence, an assessment for human research subjects created a document
The Belmont Report. This ethical document was adopted by the National Commission for the
protection of Human Subjects of Biomedical and Behavioral Research proposing three criteria,
respect for others, beneficence and justice. Respect for human dignity demonstrates that every
individual, particularly those with subordinate opportunity, including prisoners and inmates, has

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the proper protection they are qualified for. In the Tuskegee Syphilis Study, the subjects were not
watched over in the most ideal way that is available. They were submitted to painful treatments
that had no effect nor helped as a remedy for their disease. The second criteria, beneficence,
concluded that no intended harm should be done to the subjects, and the benefits should out
weight any damage. Even after penicillin exhibited a cure, the African Americans were withheld
treatment. Specialists violated the ethical principles by not benefiting their test subjects all for
selfish reasons. Thirdly, justice in choosing those to be studied. In this case, the individuals
chosen for the study specifically lived underneath poverty level, and never had access to health
benefits and treatment for any type of disease. Due to this criteria, the people enrolled in the
study were less likely to withdraw or even complain about the therapy they were receiving.
In addition to the Belmont Report, the Nuremberg code was created. It instills a
fundamental rule for human subject research indicating the prerequisite of informed consent. The
informed consent is a requirement on any biomedical research that implicate human beings. The
Tuskegee victims were not informed; in actuality they were intentionally misled about the study.
One of the pretexts is that it would have been hard to get informed consent from the subjects in
the study, on the grounds that a considerable lot of them may have been unskilled. They might
not have completely comprehended the study due to lack of education; or perhaps been mislead
by being provided with medical care in a place where insurance was rare. These reasons may

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have forced them into "consenting" to the study. Informed consent would need to have
been recorded and saved.
Many ethical issues and rights violations arose from the Tuskegee study. Raging from
misinforming test subject to lack of consent to do an autopsy on the deceased patients. As
mentioned, the USPHS rehearsed trickery in selecting subjects for the study. Also, they were
never informed that the study was meant to follow syphilis through out their life. Meaning that
the course of the disease would not be interrupted and the symptoms were merely going to be
recorded. When the spinal taps were preformed, the information that was given to the test
subjects was that it was a mean for a cure. In reality, these procedures were done to see the
amount of neurological damage that was been done to their bodies. This treatment would leave
some of them paralyzed, or with extreme neuronal damages. It was never disclosed to the
subjects that the overview was intended to recognize syphilis. The expression "bad blood,"
which was a neighborhood saying for everything from pallor to leukemia, was utilized by the
specialists and never characterized for the subjects. In addition, subjects were never told they had
syphilis, the course of the illness, or treatment. Participants were lure with the idea of free
medical exams, meals, and burial insurance. For those who actually had syphilis, they were
never informed of their diagnosis nor given any treatment for it.
The gravest charge against the study on ethical grounds is the withholding of treatment
for researches purposes. Many of the children born from parents that were not treated for syphilis

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were born with congenital syphilis. Most of them would die after been born, and the surviving
few would become blind, deaf and fail to thrive. Understanding welfare was reliably disregarded,
despite the fact that there have been various endeavors to legitimize why penicillin treatment was
withheld. A few doctors felt that repair of existing harm would be insignificant, and others felt
that the harm that could come about because of responses to the penicillin treatment, including
fever, angina, and burst veins, would exceed its advantages. At the season of the Tuskegee Study,
no information was accessible on the proficiency of penicillin treatment in late syphilis, and
short-and long adverse effects of medications had not been very much archived. To put it plainly,
when the study was assessed intermittently, researchers judged that the advantages of no
treatment exceeded the advantages of treatment. In addition, the subjects were never given a
decision about proceeding in the treatment once penicillin had gotten to be accessible; truth be
told, they were kept from getting treatment.
The specialists exploited the financial circumstance in which the members had
encountered low levels of medical care. The contacts were with specialists and nurses who were
seen as power figures. One of the important figures in the study is Nurse Eunice Rivers. She was
instrumental to the study for both procuring its members and then keeping them involved in it.
Nurse Rivers was one of the first African-American nurse to be employed by the Public Health
Service. She gained the respect of her supervisors and published her history while been part of
the study. Throughout the years, history specialists who have examined Rivers have observed her
to be an unpredictable character: a dark lady who sold out her race even as she looked to

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enhance the dark subjects' prosperity; a medical caretaker who deceived her calling by damning
those she was accused of administering to. But through present day eyes, she turn more a
casualty, someone that was pressure into doing what she was told. The time in which the study
was conducted is characterized by being patriarchal, a world run by whites. There was also an
economic depression, in which those with jobs felt blessed. Nurse rives accepted the position,
resulting in a bitter sweet position. Given these facts, nurse Rivers could be seen as a victim
being judged by her sexual orientation, and her race. Non the less, she believed she was doing
important work and would work on public health assignments that benefited patients.
The Tuskegee Syphilis Study was a disputable study that kept running for more than forty
years, watching untreated syphilis in African-American men. It was reported in medical journals
but no protest was done by the medical community. The morality of the study, the criteria nor the
values of the subjects were addressed. One of the key requirements to create a study that does
not violate the ethics of the individual is to insure that the consequences are comprehended. The
participation in the study must be voluntary and not take advantage of the social-economic status
of the subject. Presently, there are guidelines that must be followed by researchers, but some
times there is a lack of adherence to it. In order to more strictly prevent a violation to the
autonomous rights of the test subject strong punitive measures must take place.
Currently there are many regulations that need to be passed before using humans as
participants in a research study. The first step is the preclinical phase, the second is testing in

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animals, usually rodents. It then has to be pass to the Food and Drug Administration, and if
approved it needs to go to phase I of clinical trial until the study is completed. These are one of
the many regulations that scientist need to pass through before conducting any type of research.
In the present time there are many ethical research principles that did not exist in the past, such
as the informed consent and the Nuremberg Code. The Tuskegee Syphilis Study subjects never
knew why they died, nor their purpose. A tragedy as it is, set an example to illustrate what would
happen when those ethical principles are not taken in consideration.

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References
Belmont Report. Ethical Principles and Guidelines for the Protection of Human Subjects of
Research. U.S. Government Printing Office, Washington, DC, (DHEW Publication OS
78-0012), 1978; pp 1-120.
Berthlof, R. (2001). Protecting Human Research Subjects. Retrieved October 06, 2016, from
http://www.annclinlabsci.org/content/31/1/119.full
Kang, N. (2011). Examining Tuskegee: The Infamous Syphilis Study and Its Legacy. African
American Review, 44(1-2), 301-304. doi:10.1353/afa.2011.0020