The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service. The purpose of this study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.
The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama. Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected. As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS, who disguised placebos, ineffective methods, and diagnostic procedures as treatment. The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death. According to the Centers for Disease Control and Prevention, the men were told that they were being treated for "bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. "Bad blood"—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community. The men were initially told that the study was only going to last six months, but it was extended to 40 years. After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis. Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects. In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area. The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year. The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis. The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. Researchers knowingly failed to treat participants appropriately after penicillin was proven to be an effective treatment for syphilis and became widely available. Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis. The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent, communication of diagnosis and accurate reporting of test results. The U.S. Public Health Service Syphilis Study at Tuskegee, cited as "arguably the most infamous biomedical research study in U.S. history," led to the 1979 Belmont Report and to the establishment of the Office for Human Research Protections (OHRP). It also led to federal laws and regulations requiring institutional review boards for the protection of human subjects in studies involving them. The OHRP manages this responsibility within the United States Department of Health and Human Services (HHS). On May 16, 1997, President Bill Clinton formally apologized on behalf of the United States to victims of the study. [1] We march today for jobs and freedom, but we have nothing to be proud of. For hundreds and thousands of our brothers are not here. For they are receiving starvation wages, or no wages at all. While we stand here, there are sharecroppers in the Delta of Mississippi who are out in the fields working for less than three dollars a day, twelve hours a day. While we stand here there are students in jail on trumped-up charges. Our brother James Farmer, along with many others, is also in jail. We come here today with a great sense of misgiving. |