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Tuskegee Syphilis Case Study & U.S. Health Care

Instructor: Julie Zundel

Julie has taught high school Zoology, Biology, Physical Science and Chem Tech. She has a Bachelor of Science in Biology and a Master of Education.

Withholding treatment and allowing people to die during an experiment sounds unimaginable. However the Tuskegee Syphilis Experiment did just that, which resulted in the deaths of numerous African American males. This lesson describes the experiment and the racial issues at the time that allowed it to occur.

Syphilis

In 1932, the United States Public Health Service (USPHS) designed a study to see the long-term effects of syphilis on human beings. Syphilis is a sexually-transmitted disease, meaning it is a disease that is contracted through sexual contact. Before we delve into the study, let's take a moment to look at syphilis, which is caused by bacteria, and can be divided into three stages.

  • Stage 1: A sore develops where the disease entered the body. This sore typically lasts 3-6 weeks.

A sore, or chancre, caused by syphilis
sylph

  • Stage 2: More sores or innocuous rashes may appear. Symptoms also include fatigue, fever, and swollen lymph nodes.
  • Stage 3: The symptoms of stage 1 and 2 fade, however, syphilis remains in the person's body. It can take 10 to 30 years for symptoms to appear again, but when they do they are more severe than stages 1 or 2. Stage 3 symptoms include paralysis, blindness, dementia, and death.

Tuskegee Syphilis Experiment

Okay, back to the experiment. The Tuskegee Syphilis Experiment, named after the region in which it occurred, Tuskegee, Alabama, involved approximately 400 African American males. The men all had syphilis and were promised food, transportation, medical treatment, and burial services. However, they did not realize they were participating in a research project. While the men received the standard treatment protocols that were used in the 1930s to treat syphilis, they did not receive antibiotics in the late 1940s/early 1950s, even after it was learned that antibiotics could cure the disease. What's worse, the USPHS prevented the men from receiving treatment from other doctors.

The experiment continued, without effective treatment for the men, until 1972, when it was stopped because word of the experiment hit national news. At this time, between 28 and 100 of the men had died directly from syphilis (the numbers are unclear because some men had ambiguous causes of death). Scientific papers were written every four to six years throughout the experiment, starting in 1936, detailing what was happening to the men.

In 1992 it was determined that the men should have received penicillin, and it was unethical to prevent the men from receiving treatment. Let's take a look at the specific ethical issues from the Tuskegee Syphilis Case.

Racism and Gender

You might be wondering how this could happen. When the experiment began, much of the racism seen in the United States was driven by social darwinism, meaning that the humans best suited to survive would, while those not suited would die. Many believed that African Americans could not fit into an advanced 'white' society, and they would eventually go extinct, and nothing could be done to stop this (whether that be education or assistance). The medical field agreed, to some extent, with social Darwinism, deducing that African Americans were not 'built' as well as Caucasians.

Also, many in the medical field also believed African Americans were overly sexual, especially African American males. Doctors believed that African Americans were immoral and nothing, including religion, would stop them from exercising their sexual urges. Many believed that African American males had a preference and strong desire for white females, which would result in attacks on white women.

All of this, coupled with the belief that African-Americans were inferior in other ways to whites, led doctors to predict that they would acquire STD's like syphilis. Many believed that African Americans could not be treated for syphilis because they would not seek treatment or follow through with treatment if it was offered.

So, because the medical field believed African Americans were inferior, were overrun with sexually transmitted diseases, had immense sexual urges that would cause them to prey upon white women, and would not seek treatment anyways, it set a tone of acceptance for this experiment.

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