Global Health Ethics Essay

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Lynnette Durham
Professor Duarte
Global Health
December 20, 2022
The Tuskegee Syphilis Study
In 1932, The U.S. Public Health Service began to work with Tuskegee Institute in
Macon, AL with the goal of recording the history of Syphilis; Now known as the “USPHS
Syphilis Study at Tuskegee”. Initially, this all started from a campaign back in 1930, one of 6
pilot projects in the south targeting prominently poor black communities. Health officials had the
ambitious goal of diagnosing and treating as many as 10,000 people. Due to underestimating the
cost of treating so many people, by 1931 only 1,400 people ended up being treated and soon
after, the project was abandoned. Public health officials wanted to salvage some scientific benefit
from the discontinued program leading to create a plan with less funds for research. Thus, in
1932 this became the tendentious six-month study of untreated syphilis in the black male
population involving 600 men; 399 of them diagnosed with syphilis and 201 of them without the
disease.
The syphilis treatment program was transformed into a scientific study designed to
collect data but was advertised as being able to become a “special government patient” who
would be eligible to get free medicine for yourself, specifically appealing to the population of
Macon at the time who could not afford healthcare. Doctors said they came to cure “bad blood”
and in exchange for taking part in the study, they were promised to receive free medical exams,
free meals, and insurance. Bad blood was a euphemism that could mean syphilis, fatigue, anemia
and a range of other physical ailments in which all of the participating men were told they had
and would be treated for, only that, they never were. There were no questions on the welfare or
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rights of any of the men “treated”. In the 1930’s there were no regulations to ensure subjects
were fully informed about experiments or protected from unnecessary risks. The fact this
happened alone was in major violation of the Nuremberg Code which was not implemented until
1947.
Part of the first point in the code statement reads: “The voluntary consent of the human
subject is essential. This means that the person involved should have legal capacity to give
consent; should be situated as to be able to exercise free power of choice, without the
intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of
constraint or coercion, and should have sufficient knowledge and comprehension of the elements
of the subject matter involved as to enable him to make an understanding and enlightened
decision.” Intervention of element forces, fraud, deceit, duress and other ulterior forms of
coercion played a big role in the syphilis study. Along with the false advertisements endorsing
the study, no participant was ever informed of the real reason or motive for the treatment project.
Another point the syphilis study highly violated was point number four stating “The experiment
should be so conducted as to avoid all unnecessary physical and mental suffering and injury.”
Every participant in the Tuskegee syphilis study was put through unnecessary painful
procedures. One such as the spinal tap which they claimed was a “very special free treatment”
which is complete deceit in itself. In fact, those participating in the study were purposely not
treated for any of their illnesses. Even in the mid 1940’s when Penicillin became the treatment of
choice for syphilis, the men in the study were under strict rule to be turned away from any
facility that gave this treatment out. The rejection of any medication or remedy to the disease led
to more pain and quicker death of the patients being studied. The Tuskegee Syphilis study was in
violation to every point stated in the Nuremberg Code. Another being the ninth point of the 10
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statements, “During the course of the experiment the human subject should be at liberty to bring
the experiment to an end if he has reached the physical or mental state where continuation of the
experiment seems to him to be impossible.” No man participating in the syphilis study was
allowed to back out, only death would mean the end of this study to the participant. The
government assigned strict rules these men now lived under. While not being able to be drafted
for war may seem preferable, every man had to adhere to other cruel rules of such deceitful study
as well, meaning they could not be relieved of any pain syphilis had given them. It was not until
1972 that the few remaining survivors were able to move on with their lives, forever changed by
the suffering they were forced to endure.

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Works Cited
Centers for Disease Control and Prevention. (2022, December 5). Tuskegee Study - Timeline -
cdc - os. Centers for Disease Control and Prevention. Retrieved December 20, 2022, from
https://www.cdc.gov/tuskegee/timeline.htm
Nuremberg Code. UNC Research. (2022, October 28). Retrieved December 20, 2022, from
https://research.unc.edu/human-research-ethics/resources/ccm3_019064/#:~:text=The
%20Nuremberg%20Military%20Tribunal's%20decision,medical%20experimentation
%20on%20human%20subjects
Tuskegee University. (n.d.). Retrieved December 20, 2022, from
https://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/about-the-
usphs-syphilis-study

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the suffering they were forced to endure.

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