http://www.cdc.gov/tuskegee/timeline.htm
The study originally started out as the Tuskegee Study of
Untreated Syphilis in the Negro Male. The purpose of the study was to bring
enough evidence forward to justify treating African Americans with syphilis
infections. I think that is kind of strange. Why would you not treat people
that have an infection that you know is bad for their health. Unless you are
assuming that people of different races have different outcomes from disease because
the races are so far apart from a genetic level?
The study began in 1932 and originally involved 600
subjects. About 400 with disease and 200 without the disease. The men in this
study never received informed consent and were given promises of free meals, free
medical exams (yeah, I bet) and burial services would be paid for. These people
were also lied to about the status of their disease. They were never told that
they had syphilis. They were only told that they had ‘bad blood’. This is a
phrase used to describe a number of ailments. In 1947, with Penicillin becoming
the drug of choice for syphilis, the subjects were still not offered treatment.
The study was to be conducted for 6 months but ended up lasting for 40 years.
I think that this case illustrates a number of ethical
issues involving medical research. First, is the issue of do no harm. In
clinical studies today it is common to give drug to an untreated or alternative
treated group the drug under study if the data on the new drug is sufficient to
prove that the treatment is significantly better at treating the disease. It is
hard to understand why the participants would not be given the drug of choice
in 1947. What is also bizarre is that the study in general makes absolutely no
sense to me. It was already understood that syphilis was a bad disease so what
was the point of the study? I think it is a great example of something that
happens in science all too often, but certainly not to the degree of this
study, which is basically putting a study together because you can. The lack of
regulation in this study is staggering and makes me wonder what things would be
like know if science was not heavily regulated. With the advancement of science
over the last 50 years there are certainly experiments on certain researcher’s
minds that would most likely put the Tuskegee study to shame.
The final outcome for the Tuskegee study was a settlement
with the victims’ families. Also, study regulations were extremely modified and
set the standards that we currently carry for medical research today. It should
also be noted that the Tuskegee experiment did not become public knowledge
until the media picked up on the issue. Could this study have continued for
another 20 or 30 years without this coverage? Maybe. Overall the Tuskegee study
is a primary example of why bioethics are so important for scientific investigation.
It is important for keeping study participants safe but it is also good for
science itself. What I mean is that it is important for science to be trusted
by the general public. Otherwise you end up with stupid people not wanting to
vaccinate their children.
I also struggle with understanding the point of this study and why only African American men were targeted. Regardless of the point, it's clear now that multiple things were wrong with this study. What I find really disappointing, is that concern was raised in 1968 about this study before news outlets began reporting, and the CDC reaffirmed the need for the study AND got support from the AMA and NMA for continuation. While it was definitely the responsibility of the investigators to have at least informed study participants that they suffered from Syphilis and that there was a treatment out there for them, I think blame should also be placed on agencies like the CDC, AMA, and NMA for not doing something to stop this sooner.
ReplyDeleteThere can be a number of things said about the Tuskegee experiments. It is one of the most appalling examples of scientific research and is often referenced in bioethics classes as an example of the need to regulate science. I think we can learn a great deal from this example. First, is the idea of whether the ends justifies the means as they say. Can you really argue for the loss of couple lives to save the lives of the many? Logically, you could say yes, but it is difficult to use logic in the face of the obvious moral and ethic implications. When you read about what the families went through, it's difficult to rationalize it using pure logic. Second, is the idea of journalists and scientists working together to ensure that research is performed ethically. When scientists disregard ethics to test their hypothesis, it is crucial that these instances are investigated adequately and laws are enacted to prevent anything like this from happening again. Third, this instance reinforces my notion that it is pivotal that some kind of ethical law is used in science. It is often easy to cut corners to generate data faster, however it must never come at the cost of such disregard as the case of the Tuskegee study.
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