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Protection from Harm:
The Tuskeegee Syphilis Study
In 1928, the director of medical service for the Julius Rosenwald Fund, a
Chicago-based philanthropy, approached representatives of the U.S. Public
Health Service (PHS) to discuss ways to improve the health of African Americans
in the South. At the time, the PHS had just completed a study of the prevalence
of syphilis among over 2,000 black employees of the Delta Pine and Land Company
of Mississippi. About 25% of the sample had tested positive for syphilis.
The PHS and the Rosenwald fund collaborated in treating these individuals.
This collaboration led to an expansion of the treatment program to five counties
in the southern U.S.: Albemarle County, Virginia; Tipton Counrty, Tennessee;
Pitt County, North Carolina; Glynn County, Georgia; and Macon County Alabama.
As the testing for the program was implemented, it was found that between
35% and 40% of all age groups in Macon County tested positive for syphilis
Before the treatment phase of the project could be implemented, the Great
Depression began. The Rosenwald Fund's resources were particularly hard hit.
Without the financial support of the Rosenwald Fund, the PHS did not have
the resources to carryout the treatment program.
At the same time, there was a debate occurring among health researchers about
possible racial differences in the effects of syphilis. Dr. Taliaferro Clark
of the PHS suggested that the treatment project could be partially salvaged
by conducting a prospective study on the effects of untreated syphilis on
Early on in the project, the PHS enlisted the support of the Tuskeegee Institute.
Since the Tuskeegee Institute had a history of service to local African Americans,
its participation insured a smooth execution of the experiment. In return,
Tuskeegee Institute received money, training for its interns, and employment
for its nurses. In addition, the PHS recruited black church leaders, community
leaders, and plantation owners to encourage participation.
The fact that African Americans had almost no access to medical care resulted
in an increased willingness on the part of African American men to participate
in the study. For many study participants, the examination by the PHS physician
was the first medical examination they had ever undergone. In addition to
free medical examinations, food and transportation were supplied to participants.
Burial stipends were used to get permission from family members to perform
autopsies on study participants (Jones, 1981).
While the study participants received medical examinations, none were told
that they were infected with syphilis. They were either not treated or were
treated at a level that was judged by PHS researchers to be insufficient to
cure the disease.
During World War II, about 50 of the study subjects were ordered by their
draft boards to undergo treatment for syphilis. The PHS requested that the
draft boards exclude study subjects from the requirement for treatment. The
draft boards agreed to exclude the men.
In 1943, the PHS began to administer penicillin to patients with syphilis.
Study subjects were excluded from the treatment.
Beginning in 1952, the PHS began utilizing local health departments to track
study participants who had left Macon County. Until the termination of the
study in the 1970s, local health departments worked with the PHS to keep the
study subjects from receiving treatment.
The project was finally brought to a stop 1972 when Peter Buxton told the
story of the Tuskeegee Study to an Associated Press reporter. Buxton was a
venereal disease interviewer and investigator for the PHS who had been attempting
to raise the issue within the PHS since 1966. Despite his protestations, the
"experiment" was still being carried out when the story appeared
on the front pages of newspapers around the country (Jones, 1981).
Congressional subcommittee meetings were held in early 1973 by Senator Edward
Kennedy. These resulted in a complete rewrite of the Health, Education, and
Welfare regulations on working with human subjects. In the same year a $1.8
billion class action suit was filed in U.S. District Court on behalf of the
study subjects. In December of 1974, the U.S. government paid $10 million
in an out of court settlement.
The Tuskeegee Syphilis Study remains one of the most outrageous examples of
disregard of basic ethical principles of conduct (not to mention violation
of standards for ethical research). In 1976, historian James Jones (1981)
interviewed John Heller, director of the Venereal Diseases unit of the PHS
from 1943 to 1948. Among Heller's remarks were the following: "The
men's status did not warrant ethical debate. They were subjects, not patients;
clinical material, not sick people" (p. 179).
The suspicion and fear generated by the Tuskeegee Syphilis Study are evident
today. Community workers report mistrust of public health institutions within
the African American community. Alpha Thomas of the Dallas Urban League testified
before the National Commission on AIDS: "So many African American people I
work with do not trust hospitals or any of the other community health care
service providers because of that Tuskeegee Experiment" (National Commission
on AIDS, 1990).
The Southern Christian Leadership Conference (SCLC), one of the country's
major civil rights organizations, has been providing AIDS awareness education
through a program called RACE (Reducing AIDS through Community Education).
In 1990, the SCLC conducted a survey among 1056 African American Church members
in five cities. They found that 34% of the respondents believed that AIDS
was an artificial virus, 35% believed that AIDS is a form of genocide, and
44% believed that the government is not telling the truth about AIDS.
The materials for this page were largely derived from --
Jones, J. (1981). Bad blood: The Tuskeegee syphilis experiment: A tragedy
of race and medicine. NY: The Free Press.
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