The Tuskegee syphilis study was a set of experiments conducted between 1931 and 1972 by the US Public Health Service, seeing the effects of untreated syphilis in African-American men. The subjects involved were never told that they had syphilis and did not receive treatment for it, even after the development of penicillin. This study became one of the most egregiously unethical experiments conducted in American history, and was a watershed moment for ethics laws that required informed consent and accurate reporting of medical diagnoses. Looking at the experiment through the lens of the IRB’s ethical standards (as well as scholarly perspectives on the racial element of the study), the unethical nature of the Tuskegee syphilis experiment is clear.
First and foremost, the lack of informed consent is one of the chief violations the Tuskegee study would have performed – under the principle of ‘respect for persons,’ researchers are bound to provide a complete rundown of what is going to happen to human subjects over the course of an experiment, and those subjects must then give their consent to undergo the research. To do otherwise would be to deceive the human subjects, making them consent to something they may not want if they knew about it. In the case of the Tuskegee study, a long, slow death by syphilis would likely have not been preferred by the subjects, and so informed consent was doubly important in that case.
The Tuskegee study also fails from a beneficience perspective; researchers adhering to the IRB must act in the best interests of the human subjects, protecting them from harm. In this case, the experiment required the subjects to be exposed to harm, and the lack of treatment of a disease the researchers knew they had was a dangerous and unethical standard to set. The IRB also requires the principle of justice to be applied, where fair distribution of the “benefits and burdens of research” occurs. This did not happen with the Tuskegee study; the selection criteria of the study was restricted to blacks only, which focused the subject pool to those considered ‘undesirables’ at the time – a perspective soundly rejected by the IRB.
Other scholars have discussed the ethical nature of the Tuskegee study in depth. The Rothman article compares the Tuskegee syphilis experiment to the Willowbrook experiments of the 1950s and 1960s and discusses their ethics, or lack thereof. Arguing these experiments as “science gone mad,” Rothman states that these types of research methods are ambivalently feasible as ‘studies in nature,’ where researchers are examining diseases that they can currently not stop in any way. The Tuskegee experiment in particular is chalked up to bad science, as the research had no formal protocols, it was sloppily executed and did not provide any findings of value.
Thomas & Quinn (1991) believe that the aftereffects of the Tuskegee experiments have wide-reaching implications for the risk education programs involved in HIV and AIDS. By having such a long-standing blind bias against the Tuskegee Study, many African-Americans believe that AIDS was created as a form of genocide against blacks. Only through clear and honest discussion of the Tuskegee study in AIDS education programs can these rumors be dispelled and the ethnically acceptable and scientifically plausible supply of information about these diseases to the black community can be facilitated.
Both of these articles take different approaches to the implications of the Tuskegee syphilis study. In the case of Rothman, he looks at the feasibility of the study from a scientific point of view – in his eyes, the way in which the experiment was performed was not only unethical, it was also incorrect and sloppy, making the ‘study in nature’ completely useless. However, Thomas & Quinn place a higher emphasis on how the political fallout from the study led to an increasing distrust of whites on the part of African-Americans, and how that can negatively impact AIDS education.
The Tuskegee study is an important footnote in African American history due to the stigmatization of African Americans it demonstrated in the eyes of many Americans in the 1930s and beyond; by studying them instead of treating them, they were denied the help they should have gotten, and also singled out blacks as carriers of sexually transmitted diseases. This placed a significant setback in race relations, as blacks were literally treated like lab rats, and was a nasty instance of the flexible ethics of some scientists at the time. Furthermore, from an ethical standpoint, the study became a benchmark for ethics reform in scientific research with human subjects, as the study failed to enact the principles of respect for persons, beneficience, and justice. Due to the spectacular lack of human empathy displayed by the Tuskegee researchers, many African-American subjects died as a result of deliberate lack of treatment, and became the victims of unethical research.
Rothman, D.J. (1982). Were Tuskeegee & Willowbrook ‘studies in nature’? Hastings Center Report, 5-7.
Thomas, S.B. & Quinn, S.C. (1991). The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV education and AIDS risk education programs in the black community. American Journal of Public Health 81(11): 1498-1504.