EXAMPLE 4 The Tuskegee syphilis study

In the 1930s, syphilis was common among black men in the rural South of the United States, a group that had almost no access to medical care. The Public Health Service recruited 399 poor black sharecroppers with syphilis and 201 others without the disease in order to observe how syphilis progressed when no treatment was given. Beginning in 1943, penicillin became available to treat syphilis. However, the study subjects were not treated, even after penicillin became a standard treatment for syphilis. In fact, the Public Health Service tried to prevent any treatment until word leaked out and forced an end to the study in 1972.

The Tuskegee study is an extreme example of investigators following their own interests and ignoring the well-being of their subjects. A 1996 review said, “It has come to symbolize racism in medicine, ethical misconduct in human research, paternalism by physicians, and government abuse of vulnerable people.” In 1997, President Clinton formally apologized to the surviving participants in a White House ceremony.

The Tuskegee study helps explain the lack of trust that lies behind the reluctance of many blacks to take part in clinical trials.