The Tuskegee Syphilis
Study
When looking for information concerning the Tuskegee Syphilis Study, there is a
small assortment of books to choose from. I chose The Tuskegee Syphilis
Study by Fred Gray because he was the lawyer in the lawsuits against the
government, and I thought that he would be able to provide the most in-depth
analysis of the event because he was actually involved in it. It was also
written fairly recently, so that enables the book to analyze the long term
effects that it has had on African-Americans, the South, and history in
general. Gray's book provides a very informative study, but if you're looking
for more information, check out James Jones' Bad Blood. Gray takes a lot
of information from this book which was written about 20 years before his. When
searching the web for information on the Tuskegee Syphilis Study, the results
were quite slim. Most of the results involved syllabi for college classes or
websites much like our own that were prepared for a class. The website that I
reviewed is from the Tuskegee University National Center for Bioethics, which
was actually created from President Clinton's apology and ideas for improvement
of racial relations and medical testing. The webpage's main purpose is to
educate the public about the atrocities that were performed on African-Americans
in the Tuskegee Syphilis Study, and to help prevent an event like this from ever
happening again
The Tuskegee
Syphilis Study by Fred D. Gray examines a medical study that occurred in
Tuskegee, Alabama which dealt with monitoring African-American subjects discover
the effects of untreated syphilis. The main goal of the study was to seek
out African-American males in the second stage of syphilis, and then to
sporadically perform exams on these men to determine the effects that syphilis
had on their bodies. The test subjects were told that they were receiving
medical treatment for "bad blood," but in reality, they never received
penicillin, which was the most effective treatment for syphilis. After 40
years of this race-based experiment, the story broke nationwide, and for the
first time the test subjects realized that they had been involved in this
experiment and that they had not received treatment. By this time, many of
the participants had died, but a group of survivors led by Charlie Pollard began
to gather information to put together a law suit against the doctors who
performed the medical experiment and the federal government who had financially
supported the project. The author of this book, Fred D. Gray, was the
lawyer who represented the participants. In 1973, the lawsuit ended in
victory for the participants and they were collectively awarded $10 million to
split between the living syphilitics and families of the deceased. In
1997, President Bill Clinton formally apologized for the terrible injustice done
to these African-American men, but only seven of them were alive to witness
it.
Fred D. Gray's
book offers a personal insight into these shocking experiments because of his
direct involvement with them. He describes his past work on civil rights
cases in Alabama, but he considers the Tuskegee Syphilis trial to be the most
important in his entire career. Gray's main reason for writing the book
was to explain the events of the injustices performed on the individual test
subjects, and how this incident should be an example of immorality that should
never be repeated. He begins with the origins of the study. He
describes that in 1932, "word spread throughout Macon County that 'government
doctors' were to provide free exams to start a new health program" (49).
Out of the 3,684 African Americans tested, 1,468 cases of syphilis were found,
and that number was narrowed down to 408 subjects for the test. These men
were told they had "bad blood," and they were offered free medical care and
treatments. Although the main purpose of the study was to discover the
effects of untreated syphilis, the doctors continued to lead the
participants to believe that they were receiving treatment for "bad
blood."
In the second
phase of the experiments, a control group of 200 men was added as a comparison
to the syphilitics. These men were also not informed about the basis of
the study, but instead were told that they would be receiving "free treatment
from government doctors." Both the syphilitic group and the control group
were not to receive any medication or treatment of any kind from local hospitals
or doctors. Their names were put onto lists given to local hospitals, and
they were told not to treat the patients. Instead, the participants had to
schedule appointments with the government doctors, and while they were told they
were receiving penicillin, in actuality they were just receiving aspirin or
other ineffective means of treatment. During this period, many of the
participants began to die because of the effects of untreated syphilis, and
autopsies were performed by white doctors without permission from the
deceased.
The final phase
of the study occurred from 1965 to 1972, and the end of the experiment was in
sight. Over two-thirds of the original participants were deceased, and the
other 200 were very difficult to locate. The climate of race relations had
also changed, and many of the people involved in the study were beginning to
reexamine the morality of the study. Even with these differenced and
difficulties, the study continued on until the summer of 1972, when the story
was revealed nationwide and abruptly stopped.
This is the point
in which Fred Gray joined the surviving participants in the struggle for
justice. In the first lawsuit, Pollard vs. United States of
America, Gray's prosecution entailed the following
accusations:
"1) The U.S. government
violated the constitutional rights of the participants.
2) The
government knew the participants had syphilis and failed to treat
them.
3) The
Public Health Service failed to fully disclose to the participants that they had
syphilis, that they were participating in the study, and that treatment was
available for syphilis.
4) The
Public Health Service led the participants to believe that they were being
properly treated for whatever diseases they had, when in fact, they were not
being meaningfully treated.
5) The
Public Health Service failed to obtain the participants' written consents to be
a part of the study.
6) The
Study was racially motivated and discriminated against African Americans in that
no whites were selected to participate in the Study.
7) There
were no rules and regulations governing the Study."
The final settlement went in favor of the prosecution, and they
were awarded $10 million to split amongst the living syphilitics and controls,
and the relatives of the deceased.
Even with the end of the study and the settlement, the survivors
and Gray were not satisfied. It was not until May 16, 1997 when President
Clinton publicly apologized for the harmful and prejudice injustices that the
government had committed against the participants of the study. Only seven
survivors were alive to hear the apology, but it still represented closure for
them and for Gray.
This American example of racially based medical experimenting began in 1932
before the Germans began their experiments on Jews, homosexuals, and other
groups during the Holocaust. Both instances involved medical experiments
on persecuted groups of people. The Nazi experiments were much more
harsh and grotesque, and they almost always lead to immediate death.
The Tuskegee study involved the hidden injustice of mistrust and deception
against its participants. Although the Tuskegee study did not result
in the immediate deaths of the subjects, the participants' lives were surely
cut short because they were not receiving treatment. After WWII, the
Nazi war criminals were put on trial at Nuremburg, and from their testimonies
a lot of attention gathered around the discussion of the morality of human
experimentation. According to Gray, at this time, the study was completely
unaffected by these guidelines, and it continued on. In 1972, when the
study was revealed publicly, many comparisons to Nazi experiments were made.
One Public Service employee wrote a letter to his superiors describing
how "the Tuskegee study could be compared to the German medical 'experiments'
at Dachau, and that the Proceedings of the International Military Tribunal
in Nuremburg could be used in an attack upon the moral justification for the
study" (76). That is exactly what Gray did; he gathered information
from the Nuremburg Trials along with evidence from the actual study which
proved that the study was unconstitutional, and using it he won the case for
the Tuskegee study participants. His book is a tribute to all of the
participants, and his main focus is to tell their story.
The website, www.tuskegee.edu/bioethics, is the official website
of the Tuskegee University National Center for Bioethics. This center
was created in 1999 as a result of President Clinton's 1997 apology to the
participants of the Tuskegee Syphilis Study. In his 1997 speech, President
Clinton called for the establishment of a center for "bioethics in research
and health care." He described that "the center will serve as a museum
of the study and support efforts to address its legacy and strengthen bioethics
training." The website claims that the center is "the nation's first initiative
dedicated to the inclusion of African Americans and other communities of color
in response to issues of human values in science, technology, and society."
In the general
background section of the website, there are several links that connect to
articles that deal with different aspects of the Tuskegee Syphilis experiment
and its effects. The first of which is called America's Dirty Little
Secret from The Association of the Advancement of Blacks in Health
Sciences. This article details the horrible circumstances of the Tuskegee
Syphilis Study, and how the black victims were misled and mistreated by the
white doctors. This article also draws comparisons to Nazi Germany, asking
if the study was "government sanctioned, premeditated genocide." Although
the survivors and their relatives were eventually granted compensation after
their lawsuit was settled out of court, the author describes that none of the
doctors received punishment or even feel remorse. This article provides a
short summary of the experiments and the lawsuit against the government, and its
main goal is to reveal "America's dirty little secret" so that the public will
know that this injustice happened.
There are about 4
other links to similar articles that briefly describe the study. All of
these articles have the same layout; they all first describe the experiments and
then they describe the injustices that were performed against the African
Americans. The articles all address the fact that the study was racially
based, the participants did not know they were part of the study, and that
adequate treatment was not given to the participants.
The next section
is filled with articles responding to President Clinton's apology speech.
A dozen newspaper articles deal with different issues of the apology from the
beginning when it was originally planned to take place in Alabama, to the
survivor's families feelings concerning the apology, and finally to detail that
Clinton made the apology to improve relations with blacks who still mistrust the
government because of the incident in Tuskegee. All of these articles
provide insight into the feelings of both the survivors and their families and
the President and government officials. The articles are intended to
spread knowledge about the Tuskegee Syphilis Study and the government's
manipulation of these 600 African Americans.
Another section
from the website is devoted to the discussion of the Tuskegee Syphilis Study's
impact on health care. Several articles deal with what they describe as
the "new Tuskegee" or "Tuskegee part II." They describe that AIDS patients
are being refused proper treatment and in another situation anonymous infants
were being tested for pediatric AIDS without the parent's consent. Another
article involves the claim that the Clinton's apology was not enough, and that
the white doctors responsible for the study should be prosecuted. Other
articles deal with the continued mistrust of the government and doctors that
still rings true in Tuskegee. All of these articles deal with the
consequences of the government's decision to mislead the participants in the
study, and how that mistrust has continued on for more than 60
years.
In the general
background section, there is an article that deals with the similarities between
the Tuskegee Syphilis Study and the Nazi experiments performed during the
Holocaust. The article opens with a quote from the Nuremburg Code, "The
voluntary consent of the human subject is absolutely essential." The
author, Howard Wolinsky, describes that in 1947, the same year that the
Nuremburg Code was created, penicillin was also discovered as the foremost
effective treatment for syphilis. Yet, the Tuskegee study still continued
on after this year, without intervention by the government and without the
treatment of penicillin. He describes that seven Nazi doctors were
executed for their crimes against humanity, while the American doctors of the
Tuskegee study roam free without regret. Wolinsky also regards the
Tuskegee study as a wakeup call for Americans. He quotes from Arthur
Caplan, director of the medical ethics program at the University of
Pennsylvania, "Tuskegee was really the experiment that set American medicine on
its ear. I think Americans had this belief that they couldn't or wouldn't
do the kind of evil things that the Germans did. Tuskegee was a giant wake
up call." And the effects of the government's violation of trust have not
yet disappeared from new generations of African Americans in Alabama. They
still have not been able to trust the government or doctors, and that is a
direct result from the persuasive means that the Tuskegee doctors used to find
test subjects. Wolinsky describes that after WWII, Americans could not
believe the atrocities that the Nazi doctors performed on their victims, and to
fully understand the Nazi crimes they had to "demonize or peripheralize" that
Nazis. The Tuskegee Syphilis Study forced Americans to also find demons within
our own country.
This website is
basically dedicated to the remembrance of the Tuskegee Syphilis Experiment
itself, but especially to the participants in the study who were both misled and
mistreated. The Tuskegee Center for Bioethics is living proof that
the American government realized its wrong, and that it is now trying to right
it.
Annotated
Bibliography
Gray, Fred D. The Tuskegee Syphilis Study.
Montgomery: New South Books, 1998.
www.tuskegee.edu/bioethics