Tuskegee Syphilis Experiment…1 A Treatise on Tuskegee Syphilis Experiment Davies Okoke Institute of Management and Technology September, 2011 Tuskegee Syphilis Experiment…2 Introduction In the 1930s, there was an epidemic of syphilis(popularly called “Bad Blood”) in Macon County, Alabama. During that period, about 600 African Americans who resides in the county were promised free treatment for syphilis by the U.S. government. However, these men did not receive any treatment for syphilis and were, unknown to them, used as the guinea pigs for the government approved medical investigation, known as the Tuskegee Study of Untreated Syphilis in the Negro Male. In this paper, I will examine the impact of the Tuskegee Syphilis Study as well as discuss the ethical implications of the experiment(Reverby, 2009; Gray, 1998; Jones, 1993). A fundamental premise to begin this analysis is to briefly examine the nature and scope of the Tuskegee Syphilis Study. The Tuskegee Experiment – An Overview The Tuskegee syphilis experiment was a clinical study conducted by the U.S. Public Health Service between 1932 and 1972 at Tuskegee, Alabama. The aim of the experiment was to study the natural progression of untreated syphilis among black men, most of which are poor and live in the rural areas. These black men were made to believe that they were receiving free health care from the U.S. government(Reverby, 2009; Gray, 1998; Jones, 1993). Working in conjunction with the Tuskegee Institute, the U.S. Public Health Service began the study in 1932. A total of 600 impoverished, African-American farmers who are natives of Macon County, Alabama, were enrolled in the study. Out of these groups of men, 201 do not suffer from syphilis while 399 of them had previously contracted syphilis before the study began. The men were given free meals, free medical care, and free burial insurance as compensation for participating in the study. The investigators did not tell the men that they have syphilis and they did not receive any treatment for the disease. Instead, they were informed that the government is Tuskegee Syphilis Experiment…3 giving them free treatment for “bad blood”, which was a local name which people of that era used to describe certain diseases, such as anemia, fatigue and syphilis (Reverby, 2009; Gray, 1998; Jones, 1993). For reasons related to ethical standards, this 40-year study is considered to be very controversial. First, after the 1940s validation of the penicillin as an effective cure for syphilis, the investigators involved in this study failed to treat the patients appropriately. However, major changes were made in the U.S. laws and regulation as it relates to the protection of participants in clinical trials after the Tuskegee experiment was revealed to the general public by a whistleblower. Presently, informed consent, accurate reporting of test results and communication of diagnosis are required for all clinical studies being conducted in the United States. The only exceptions to this requirement include those clinical trials that are conducted by some U.S. Federal agencies which are kept secret through an Executive Order(Reverby, 2009; Gray, 1998; Jones, 1993). Penicillin became the standard treatment for syphilis in 1947. Splitting off a control group for testing with penicillin, treating all the subjects with syphilis, and closing the study are among the choices available for the doctors involved in the Tuskegee experiment. However, these doctors do not only continue with the study without treating the participants but also withheld penicillin as well as information about it from the participants. Furthermore, accesses to syphilis treatment programs that are available to others in that area were restricted for the participants. Under the supervision of numerous U.S. Public Health Service supervisors, the Tuskegee study continued until 1972. The study was eventually terminated when it was leaked by the press that year(Reverby, 2009; Gray, 1998; Jones, 1993). It is important to note here that Tuskegee Syphilis Experiment…4 children born with congenital syphilis, wives who contracted the disease and numerous men who died of syphilis were among the victims of the study. Impact of the Tuskegee Experiment Generally speaking, the Tuskegee Syphilis experiment can be considered to be the most controversial and infamous biomedical experiment in the history of United States. The 1979 Belmont Report and the establishment Office of Human Research Protections(OHRP) were the main offshoots of the study. Several laws and regulations that require Institutional Review Board aimed at protecting human subjects involved in clinical trials were promulgated as a result of the experiment. In addition, the U.S. Congress passed the National Research Act in 1974 as well as created a Commission whose main role is to study and write regulations for governing every study that involves human participants. And President Bill Clinton formerly apologized to the Tuskegee Study participants in 1997 as well as held a ceremony to pacify them for the injustices they suffered(Reverby, 2009; Gray, 1998; Jones, 1993).. Before leaving this section, I deem it necessary to note that the trust of the black community towards public health efforts in the United States was significantly damaged by the Tuskegee Experiment. It is thus not surprising that many African Americans are reluctant to participate in programs such as organ donation and, generally distrust the U.S. medical community. It is equally arguable that many poor black Americans are reluctant to seek routine preventive care as a result of this experiment(Reverby, 2009; Gray, 1998; Jones, 1993). Ethical Implications of the Tuskegee Experiment It is important to recall here that the Tuskegee experiment continued for about 25 years even though penicillin was found to be effective in treating syphilis. But the study ended in one day when its consequences became front-page in the news. The establishment of a National Tuskegee Syphilis Experiment…5 Commission for the Protection of Human Subjects of Biomedical and Behavioral Research and the National Research Act are the major aftershocks of this study and other human experiments in the United States. Under the National Research Act, all the institutions receiving federal grants are required to establish Institutional Research Boards(Reverby, 2009; Gray, 1998; Jones, 1993). Conclusions I have, so far, examined the impact of the Tuskegee Syphilis Study as well as discussed the ethical implications of the experiment. In summary, I hereby conclude as follows: 1. The aim of the Tuskegee Experiment was to study the natural progression of untreated syphilis among black men, most of which are poor and live in the rural areas. These black men were made to believe that they were receiving free health care from the U.S. government. 2. The trust of the black community towards public health efforts in the United States was significantly damaged by the Tuskegee Experiment. It can also be argued that many poor black Americans are reluctant to seek routine preventive care as a result of this experiment. 3. The establishment of a National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research and the National Research Act are the major aftershocks of this study and other human experiments in the United States. Tuskegee Syphilis Experiment…6 References Gray F.D. (1998): The Tuskegee Syphilis Study – The Real Story and Beyond. Montgomery, AL: New South Books. Jones J.H. (1993 ): Bad Blood – The Tuskegee Syphilis Experiment. New York, NY: The Free Press. Reverby S.(2009): Examining Tuskegee – The Infamous Syphilis Study and Its Legacy. Retrieved September 18, 2011 from http://books.google.com/books?id=DXHsFLagEUC&printsec=frontcover&dq=tuskegee+syphilis+study&hl=en&ei=W7h2TryoNoL2 0gHyxt3sDQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDsQ6AEwAQ#v=o nepage&q&f=false 
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