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Introduction
Ethical behavior has always been assumed to be the foundation of a productive and well functional society. Ethics are especially significant in medical circles since unethical practices can have dire impacts on the society. One of the most infamous unethical research studies in American history was the Tuskegee Syphilis Study.
This study resulted in research abuses on the test subjects and had dire consequences that continue to be felt to date. This paper shall review the Tuskegee Syphilis Study (TSS) which resulted in widespread outcry over allegations of gross unethical practices. The paper shall begin by a brief description of the study and its findings. The unethical aspects that characterized the experiment shall then be reviewed.
Description of the Study
The now infamous Tuskegee Syphilis Study was commissioned by the United States Public Health Service (USPHS) and the study was conducted from 1932 through to 1972.
The motivation for this study was the prevalence of syphilis among blacks and the possibility of coming up with mass treatment of the condition. Macon County, Alabama was chosen as the town of choice due to the fact that it had the highest syphilis rate in the counties surveyed. The main aim of the study was to test the effects of untreated syphilis over a long period of time.
The test subjects were 399 sharecroppers from Alabama who were all African American (Katz, 2009). The study sought to determine the natural course of syphilis and as such, the test subjects were all suffering from syphilis before the study began. 200 uninfected men served as controls for the study. Another aim of the experiment was to demonstrate that antisyphilic treatment was unnecessary for treating latent syphilis.
Ethical Issues
From the very onset, TSS was characterized by blatant lying to the subjects by the experimenters. The test subjects were not informed of their involvement in an experiment. Instead, they were told that they suffered from “bad blood” and they were required to regularly attend the clinic for free treatment.
In reality, the subjects were not being treated for syphilis but were instead given placebo treatments so as to give the researchers a chance to observe the progression of their syphilis. The subjects therefore unwittingly participated in the study under the guise of treatment.
Another ethical issue from this experiment was that the study subjects were denied access to physicians who could have correctly diagnosed them with syphilis and proceeded to give them the necessary treatment.
Brandt (1978) reveals that in the course of the 40year experiments, the experimenters colluded with local physicians to ensure that the text group was not given medical care. Letters were distributed requesting that the subjects be referred back to the USPHS (where the study was taking place) if they sought health care from other hospitals.
While at the onset of the study in 1932 there was no widely available cure for syphilis, penicillin emerged as the preferred treatment for syphilis in the early 1950s. Gray (1998) reveals that despite this, the men who were a part of the TSS did not receive any therapy. This was unethical since the health status of the men was known and the physicians could have intervened to restore the health of the test subjects. This action went against the basic code of nonmaleficence which obligates physicians not to do harm.
Discussion and Conclusion
Unethical conducts have many adverse effects both to the individual and the society at large as was demonstrated by the TSS. Katz et al (2009) reveals that the TSS resulted in great mistrust for public health efforts by African American’s. In addition to this, the black community began to demonstrate great reluctance for clinical research studies; a legacy that continues to date.
This paper set out to discuss the TSS which is hailed as one of the most unethical studies carried out in American history. From this paper, it is clear that unethical practices can result in great loses for the society and the individual. The Tuskegee Syphilis Study is one of the research studies whose unethical nature resulted in the death of subjects as well as mistrust by the black community for public health initiatives.
References
Brandt, A. M. (1978). “Racism and Research: The Case of the Tuskegee Syphilis Study”. Hastings Center Magazine.
Gray, D.F. (1998). The Tuskegee Syphilis Study: the real story and beyond. NewSouth Books.
Katz, V.R. et al. (2009). “Exploring the “Legacy” of the Tuskegee Syphilis Study: A Follow-up Study from the Tuskegee Legacy Project.” Journal of the National Medical Association Vol. 101, NO. 2, 179.
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