Ethics and The Tuskegee Study 1

Ethical Outcomes Of The Tuskegee Syphilis Study

Carlos Maciel

Sociology/ Anthropology 100-05

Professor Griffith

March 3, 2011
 Ethics and The Tuskegee Study 2

Abstract

Ethical parameters are expected to be followed in all kinds of scientific research.

However such expectations only emerged after a few tragically mislead studies caught

the attention of academia and of all society itself. Among these works, the Tuskegee

Study of Untreated Syphilis In the African American Males is held as one of the main

causes for the new institutionalization of ethic. The ethical issues of the study held in

Macon County, Alabama will be discussed in this paper as well as the consequences of

those issues to medicine, the social sciences and society. The lessons taught by the

mistakes made by the Tuskegee researchers must be applied to all scientific work so that

the Study’s tragic outcomes may not be repeated.

 Ethics and The Tuskegee Study 3

The word ethic is defined by the Oxford Student’s Dictionary as society’s “rules

of behavior.” Analyzing the role of ethic within the social sciences, therefore, is

analyzing what society, as well as academia itself, finds to be appropriate conduct for a

social scientist. The International Encyclopedia of the Social Sciences (IESS:632) states

that there are two types of ethics in the social sciences, the normative ethics which

“inquiries into the proper guidelines of conduct for a responsible human being”; and

metaethics which sees ethic as a field of study for the social scientist. This paper is

focused in the discussion of normative ethics in the social sciences, and in the great role

the Tuskegee Study played in changing this discussion.

“The Tuskegee Study of Untreated Syphilis In the African American male is the

longest nontherapeutic experiment on human beings in medical history,” says Carol A.

Heintzelman (2003:4). It started in the early 1930s with the goal of exploring the effects

of unthreaded syphilis in black males in the county of Macon, Alabama. During the

beginning of the 1900s Macon county’s population, as a consequence for its deficient

educational system and the harmful effects of economic depression, was composed

mostly by illiterate farm workers (Harter et al 2000:21). The researchers “took

advantage” of such conditions (Heintezelman 2003:4) in a way that is, by many authors,

compared to the Nazi experiments during the II World War for the experiments abused

individuals who society is “duty-bounded to protect” (IESS:635).

A total of six hundred African American males, 399 infected and 201 not

infected were analyzed for roughly forty years (IESS: 472). Treatment for the men was

not a scientific or a financial option for the experience’s leaders; it was believed that the

effects of drugs could mask the real nature of Syphilis and therefore invalidate the study

(Sargent et al.:1997). Furthermore, the subjects were given no information about their

condition or about treatment options. By the end of the study, in the year of 1972, only
 Ethics and The Tuskegee Study 4

seventy-four were still alive; it is estimated that more than a hundred died from

“Advanced syphilis lesions” (Allam M. Brandt: 60; Harter et al 2000: 21). Only in 1997

the U.S. Government formally apologized for the Tuskegee Experiment in what is

considered by Harter et al (2000:22) as an attempt to “generate constructive dialogue

about race relations.”

Based on eugenic and deterministic affirmations, as well as on the ideas of

Social Darwinism, the top researchers considered that male African Americans were the

best for such research due to their corrupted morale and “excessive sexual desire”, as

noted by Allan M. Brant (2009:61). As a matter of fact, according to Paul A. Lombardo

and Gregory M. Dorr (2006:292), Tuskegee Experiment’s chief scientists found

“‘scientific’ validation in eugenic theory”. For the eugenic theory, writes Lombardo et

al., not only moral principles and looks were different between the races but that were

also “differential susceptibility to disease” (2006: 294); Joseph E. Moore, a reputed

expert in venereal diseases at the time, implied that syphilis in African Americans was

an illness almost entirely different from syphilis in the Caucasian population (IESS, p.

472).

Social outcomes from the Tuskegee Study are observed in the attitudes African

American have towards government medical initiatives. The Study’s impact on the

governmental actions against the AIDS epidemic is its longest lasting consequence

(Heintzelman 2003:5). Because of the Tuskegee Study many black individuals lost

confidence in the government and its health policies, it made those individuals believe

that AIDS as well as the actions against it are part of a scheme to exterminate African

Americans. No other scientific research caused more harm on the psychological health

of African Americans as a group than the Tuskegee study. It is viewed by many blacks

as the representation of white oppression and medical mistreatment, “if not outright
 Ethics and The Tuskegee Study 5

racial genocide” (Hasting Center Report 1992:38-39). Health harms were caused by the

Study as well, the continuous contact with syphilis fated Macon County to a sustained

existence and spread of syphilis (IESS:472).

Many were the ethical failures of the Tuskegee Study that can be used examples

of lack of medical protocol. The major ethical problem is the one of informed consent.

Informed consent refers to “telling research participants about all aspects of the research

that might reasonably influence the decision to participate” (Heintzelman: 2003:4). The

subjects of study were attracted by the promises of treatment, which was never done,

and were never informed of the actual goal of the research nor its results (Bozeman et

al. 2009:1550). Denying the right for informed consent is denying the subjects of

research of their basic freedom of choice; it is doubtful that as many black males would

have accepted to be part of the experiment if they knew the exact conditions they would

have to endure for the rest of their lives. Other major ethic problem, considered by

Heintzelman (2003:4) as the “gravest charge against the study”, is the intentional

prohibition of treatment for the sick men, a choice that harmed not only the subjects of

study but also, as written beforehand, the whole county with the continued presence of

syphilis (IESS: 472).

Although it took forty years of “scientific” studies, the Tuskegee Experiment

had no positive outcome for the medical sciences (IESS: 473). Fortunately, the suffering

endured by all the men studied was not in vain. The Tuskegee Study set the basis for the

reconstruction of the notion of ethics and racism in the practice of medicine. Human

experimentation, especially those involving minority populations practices had to be

reconsidered after the Tuskegee Experiment gained public attention (Heintzelman

2003:4). In fact, among other studies of equal lack of ethics (Nazi experiments and the

plutonium experiment in the U.S. from 1944 to 1974), the Tuskegee Study started
 Ethics and The Tuskegee Study 6

discussions about individual rights and ethical duties of researches (IESS:635). It “Gave

rise to many of the human participant protections now in force” and was a clear

motivation for the “complex regulatory system” that regulates experiments with

“vulnerable” populations, however (it is important to note that) these populations are

still exploited (Bozeman et al.2009:1549-1550).

It is important to analyze the impacts of the Study upon the work of the social

scientists because the influence of social sciences in the ordinary man is just as big as

the influence of medicine. Social statistical work can validate certain ideas, like the

eugenic theories for example, that might fate a whole society to inequality and

prejudice. The problem of informed consent is not restricted to the medical sciences;

social experimentation involves manipulating certain conditions of the human nature,

which might be harmful to the subjects of study.

Most importantly, the Tuskegee Experiment gave ethics a new stand of

importance within the social sciences. In history, the issue of ethical treatment for the

members in experiments for the social sciences is related to sharp public reactions to all

kinds of studies with human subjects. Studies like the one done in Macon County

influenced significant questions about the “rights” of human subjects and the

“responsibilities” of researches (IESS:635). It motivated “new institutionalizations” of

ethics; codes for ethical conduct were created all over the world and for all kinds of

academicals activities (IESS:632). The new “standards of conduct for experimental

research” require all scientists to compare the risks for the participants to the possible

“benefits” of the research. Furthermore, the social scientist must not focus all attention

towards being ethical in the process of research and forget about being ethical with the

results for the final results of a study might be harmful to a society as a whole.
 Ethics and The Tuskegee Study 7

The last ethical lesson of the Tuskegee Study is that unethical procedures are

present even when no harm is intended. The researches of the Tuskegee study had no

bad intentions, they actually believed that understanding the “black syphilis” would be

beneficial for the black race whole and that the only way they could do so was to threat

the men like they did (Sargent 1997). Another proof of the lack of malice in the

researcher intentions was the African American doctors’ belief that the Study

represented a chance for the black to proof that it is not inferior to any other race.

(Sargent 1997). Furthermore, Bozeman et al. recognized the Tuskegee Study as “ahead

of its time” because it had minority individuals in all positions of its design, from the

subjects of study, to scientists and members of the subsidiary organization (2009:1550).

Bozeman at al. also concluded that the Study was one of the first “large-scale, highly

organized medical studies that paid any attention to problems differentially affecting

African Americans” (2009:1550). However, although no harm was intended the

Tuskegee Experiment is an example of lack of ethics in experimentation, showing that

good intentions do not secure ethical research.

The importance of ethical guidelines for the life in society is clear; a conjunct of

values must be present in the social life otherwise it can only lead to chaos. Especially

in the scientific field, much the awareness for such importance was born after the

Tuskegee Study showed society how tragic can be the results of unethical work. The

history of the Study plays a relevant role for the continuous appliance of ethics in

scientific research and therefore must never be forgotten. The teachings of the Tuskegee

must serve as an example for all scientific study to come in order to avoid the repetition

of unethical scientific practice.

 Ethics and The Tuskegee Study 8

References

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Harter, L. M., Stephens R. J. & Japp P.M. 2000. “President Clinton’s Apology for the

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The Tuskegee Legacy. (1992 Nov/Dec). Hasting Center Report, 22(6), 38-44.