Tuskegee Study

Ezequiel W. Ferreras

EN1320 - Composition 1

ITT Technical Institute

ABSTRACT

This paper is to prove how the Tuskegee study was morally and ethically wrong. Many of the men involved in the study died due to the experiments. This study has made it important for all patients to understand their options for treatment and outcomes and know that they have a choice. Any one can deny treatment if they wish to do so. Many doctors devote their lives to their patients and have learned from this major medical error.

Tuskegee Study

Some people may believe they don’t need to try as hard if they already achieved their goal, but if a physician does not do their best a patient can die and if no one did their best then there would be no doctors, lawyers or even teachers. However, when you apply the unethical concepts in this study it violates the professional code of ethics and the moral reasoning of the study. Albeit it is for a test to make history the obligations of a nurse are very important and must be followed.

In Miss Evers’ Boys, physicians investigate in a medical study that takes place in Tuskegee Alabama, which dealt with watching African-American subjects discover the effects of untreated syphilis. The major objective of the study was to search for African-American males in the second stage of syphilis, and then from time to time perform exams on these men to find out the effects that syphilis had on their bodies. (Grey 1998) Raymond A. Vonderlehr told the men that they were getting treatment for “bad blood,” but instead, they never received penicillin, which was the most successful action for syphilis.

After 40 years of this experiment, the story broke nationwide, and for the first time the test subjects took grasp of the fact that they had been a part of the experiment and that they had not received any treatment The research project was finally ceased after Peter Buxtun, spoke the truth about the study’s unethical methods to the Associated Press. On July 25, 1972, the news

sparked a public outcry that ultimately brought the notorious experimentation to a stop. Congressional hearings were conducted, which led to federal legislation guidelines for protection of humans for scientific research. Fred Gray filed a lawsuit on behalf of the men that resulted in a $10 million out-of-court settlement for the wounded and their families (Grey 1998).

By this time, many of the partakers in the experiment had died, but a handful of survivors led by Charlie Pollard began to accumulate information to put together a lawsuit against the doctors who carried out the medical experiment and the federal regime who had financially backed the project. In 1973, the lawsuit ended in victory for the participants. In 1997, President Bill Clinton formally apologized for the horrible wrongdoings done to these African-American men, but only few of them were alive to witness it.

During the White House ceremony, the president spoke directly to Sam Doner, Carter Howard, Ernest Hendon, Frederick Moss, Herman Shaw, Charlie Pollard, Fred Simmons, and George Key, the study’s only survivors, all of whom are more than 85 years of age and the first five of whom were present for the occasion:

“They are a living link to a time not so very long ago that many Americans would prefer not to remember but we dare not forget. It was a time when our nation failed to live up to its ideals, when our nation broke the trust…that is the very foundation of our democracy. The United States government did something that was wrong, deeply, profoundly, and morally wrong. To the survivors, to the wives and family members, the children and the grandchildren, I say what you

know: No power on Earth can give you back the lives lost, the pain suffered, the years of internal torment and anguish. What was done cannot be undone. But we can end the silence. We can stop turning our heads away. We can look at you in the eye and finally say on behalf of the American people, what the United States government did was shameful, and I am sorry.”(Stephen 2013)

The Tuskegee study involved mistrust and deception against its participants. Although the Tuskegee study did not result in the immediate deaths of the subjects, the participants’ lives were definitely cut short because they were not receiving treatment. Since the beginning of the Tuskegee study it was based on making the African Americans believe that there was another public health treatment program. The public health officials, including the white doctors involved, knew that they were lying to the African Americans about the true reason of what they were there for. The entire experiment broke all the ethics; participants weren’t told they were a part of an experiment, and were not treated with penicillin.

The nightingale pledge is a pledge modeled after the Hippocratic Oath, which is typically recited by nurses before graduating from nursing school, indicating their commitment to professionalism and patient care. The oath was written in 1893, the pledge states:

I solemnly pledge myself before God and in the presence of this assembly:
To pass my life in purity and to practice my profession faithfully.
I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of

my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care (Saunders 2007).

A large component of the problem with this study was the view of the people who ran it. Instead of viewing the men as patients they were viewed as lab rats. When you do not actually look at the people in the study as human, then it is easy to behave unethical. Due to the fact these men were black and broke they were made as obvious targets for people in a position of knowledge. The African-American people had no knowledge to protect themselves with.

The first unethical thing the project did was telling the people that they were receiving free treatment when in actuality they were probing for new “lab rats”. The people at first did not believe that they were actually receiving free treatment because the regime did not want to help them before so “why now”? From the first day of the study, rules and oaths were broken. The doctors tested the subjects and to this day no one knows for sure how they knew which men had syphilis. So it is verbally expressed the men already had syphilis, the doctors just did not tell them precisely what they had, but called it “bad blood”. One doctor verbally expressed, "If the colored population becomes aware that accepting free hospital care means a post-mortem, every dark man will leave Macon County (Brett 2011.) His statement proves they knew what they were doing was unethical. They did not care for their patients’ well being only for their study’s outcome.

Second, the doctors knew the patients had syphilis and did not desire to treat them. In fact they gave a list of names of the people who partook in the experiment so they could not receive any treatment to better their health. Not helping patients become healthier breaks many of the obligations such as no malfeasance. They were causing the patients harm by allowing the syphilis to take its control over their body. They definitely did not do the best possible. If they had done the best possible they would have given then penicillin as soon as it became available instead of lying to them saying that it could harm them even more instead of curing them. The doctors knew the men wanted to get well. The men constantly showed up to their appointments and received “treatment.” The doctors knew if they would have told the men they would not be given treatment the men would have not wanted to be a part of the study. The men did not have a fare share to life. Others around the country were given penicillin but these men weren’t. They were waiting for the men to die to perform an autopsy.

In order for the men to be a component of the study, the doctors should have received written consent. There was no proof that these men wanted to even be a part of an experiment. Patients have the right to refuse treatment and must be acknowledged even if it threatens their lives. If the patients were unable to give consent then the doctors could perform action to save the patients life. This, however; was not the case in the Tuskegee study. There was not even verbal consent. The definition of informed consent states that the patient is aware of all the risks involved. The patients were not aware of any risk involved, the doctors only verbally expressed “you have bad blood and were going to give you treatment for it (Miss Evers Boys)”. Yes, the men were too ignorant to ask what bad blood was and if there were going to be any risks but it is the physicians’ obligation to notify the patient of the risks involved and all possible outcomes.

The purpose of the study was to discover how syphilis affected black as opposed to whites. The theory was that the whites experienced more nervous system damage, whereas blacks were more open to experiencing cardiovascular damage from syphilis (Rucker 2009). The study did not bring a cure to syphilis, or bring them any closer to discovering how to control the disease.

The thought of informed consent became more important as years passed. The proof that the men involved in the study were abused, led to the classification of informed consent requirements for clinical research. The Tuskegee Syphilis Study is what began the protection of vulnerable people for experimental research and began the importance of informed consent. “Informed consent seats the responsibility on the medical researcher to guarantee that the consent of research is completely informed” (Mosby’s Dictionary 2009.)

The Tuskegee study affected the trust of many people around the world. The people involved in the study were not the only ones affected by the unwise experiment. The wives, the children, family members and others around the globe were affected as well. When the announcement was made that the doctors were going to give free treatment, the men were hesitant about going. Although they knew they couldn’t resist such a great offer. They needed help and wanted it.

The designers utilized a misleading advertisement: The researchers advertised for participants with the slogan; "Last Chance for Special Free Treatment"(Paper Camp 2011.) The subjects were not given a treatment, instead being recruited for a very risky spinal tap-diagnostic. Automatically that is unethical, it is very important for every patient to know the truth. The men were lied to from the beginning. They were simply not smart enough to know what was right and wrong. The advertisement was misleading therefore it was false advertisement, but yet some how no one was charged. I am baffled by the fact that the people involved with the study just had a slap on the wrist compared to the “lab rats”. People go to death row for killing one person, yet everyone who partook in the experiment killed tons of people and were not even charged.

Times have changed. Today it is required to have some form of consent while in a physician’s office and many other places. Thanks to the study less and less ethical problems have raised over the years. The Tuskegee syphilis study is the reason why African Americans do not trust their doctors entirely, but the study is also the reason why the Office protects everyone for Human Research Protections (OHRP).

The study should have never been conducted from the start. It was unethical to the participants because they were not aware of all the known dangers. They did not know that the doctors were waiting for them to die so they can do an autopsy. Some men were even refused treatment. It is stated that no one should be refused treatment if it will better his or her health. The scientist denied treatment just so they can observe the dangers and fatal progression of the disease.

The study should have never been conducted from the beginning. It was unethical to the participants because they were not aware of all the known dangers. They did not know that the doctors were waiting for them to die so they can perform an autopsy. Second, if the men did not agree to autopsies, they’re funeral cost were not going to be covered. They were basically backed into a corner and forced to agree.

The men should have been given the cure for syphilis (penicillin) once it became available. Due to the lack of treatment, 28 of the men died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with syphilis (Rucker 2009.) The entire study was unethical.

References

Gray, Fred D. The Tuskegee Syphilis Study. Montgomery: New South Books, 1998.

The Tuskegee Syphilis Experiment, James H. Jones, expanded edition (New York: Free Press, 1993).

Bad Blood: The Tuskegee Syphilis Experiment, James H. Jones, expanded edition (New York: Free Press, 1993).
Miss Evers Boys, Joseph Sargent (Home Box Office, 1997)
(2009). Mosby’s Medical Dictionary
Paper Camp (2011). Tuskegee Syphilis Study
Rucker, Paul (2012). Tuskegee Experiment
Thomas, Stephen (2013). Presidential Apology For The Study At Tuskegee