How the Tuskegee Syphilis Experiment violated the American Psychological Association’s ethical principle for research with human participants
The Tuskegee Syphilis Experiment was an infamous case conducted between 1932 and 1972 in Tuskegee, Alabama by the U.S. Public Health Service. The study was the natural movement of untreated syphilis in poor, country Black men who thought they were receiving free health care from the U.S. government.
Syphilis is a venereal disease that, if untreated, undergoes a stage during which lesions may develop in any organ or tissue throughout the body. In 1932, a group of researchers undertook a long-term evaluation of the effects of untreated syphilis. At that time penicillin was unknown, but less effective treatment compounds were available. The interest in the study was in the natural progression of the disease if left untreated. Earlier observations suggested that some individuals left untreated apparently recovered from the disease spontaneously. Therefore, some physicians felt it might be better not to use drugs known to be hazardous. This was apparently the justification for the study. However, with the advent of penicillin in the early 1940s, an effective cure for syphilis had been found. This cure was withheld from the participants in order to complete the research findings. The public became aware of the study in a story printed by the New York Times on July 26, 1972. People were outraged. Four months later, the study was terminated.
According to The American Psychological Association (APA), the study violated many ethical principles in several ways.
The freedom from coercion principle states that every human being has rights to make choices about their lives and not to be forced in certain activities. In the Tuskegee Syphilis Experiment the participants were not sufficiently informed about the study so that they can make a knowledgeable decision whether to participate or not. Researchers had not informed the men of the actual name of the study, “Tuskegee Study of Untreated Syphilis in the Negro Male,” its purpose, and potential consequences of the treatment or non-treatment that they would receive during the study.
During Tuskegee Syphilis Experiment, none of the subjects was told he had Syphilis or that he would not be treated for the disease. The patients were told they were being treated for “bad blood”. They were not informed that a cure for syphilis had become available, and that studying the natural history of untreated syphilis was no longer needed. Treatment was basically withheld from participants in the Tuskegee Syphilis Study, even though the Public Health Service began treating syphilis with penicillin in 1943. Study subjects who moved from Macon County were tracked by the Public Health Service to ensure that no treatment was administered at other local health departments. This ethical principle of information, which is a key ethical requirement in biometrical research involving human beings, was totally violated, as the participants were not given the choice to quit the research as it was no longer necessary.
The ethical principle of limited deception was also violated. The participants were not told the purpose of the study; they were totally misled about the reasons for the research. The men never knew of the debilitating and life threatening consequences of the treatments they were to receive, the impact on their wives, girlfriends, and children they may have conceived once involved in the research. As the study continued for a long time, there were numerous victims: men who died of syphilis, wives who contracted the disease, and children born with congenital syphilis.
There was no diversity of the participants. A total of 600 men were enrolled in the study. Of this group, 399 who had Syphilis, were a part of the experimental group and 201 were control subjects. Most of the men were poor and illiterate sharecroppers from the county.
In conclusion, while the Tuskegee Syphilis Experiment stated that the men participated in the study freely, agreeing to the examinations and treatments, there was evidence that scientific research protocol applied to human subjects was deeply violated and the safety and well-being of the men involved was totally ignored.
Shamin M. Baker, Otis W. Brawley, and Leonard S. Marks. Effects of untreated Syphilis in the Negro Male, 1932 to 1972: A closure comes to the Tuskegee Study, 2004.
Shafer, J. K., Usilton, L. J., & Gleeson, G. A. (1954, July). Untreated syphilis in the male Negro: A prospective study of the effect on life expectancy. Public Health Reports, p 684–690.