Science, Syphilis, and the Evolution of Ethics

How often does an academic historian’s paper lead to its publication being directly connected to a personal apology from the President of the United States to another head of state—much less a near-simultaneous public apology from the US Secretary of State?

That’s just what happened this month to Wellesley historian Susan Reverby and her paper on syphilis experiments in Guatemala carried out by the US in 1946. The paper was published online on the Wellesley website at 9 a.m. EST, October 2, 2010, while President Obama called Guatemalan President Àlvaro Colom Caballeros to apologize.

Sixty-four years ago, as the Nuremburg trials investigating Nazi abuse of people in the name of science were going on in post-WWII Germany, the United States Public Health Service was intentionally exposing Guatemalans to the bacterium that causes syphilis, so that different therapies for the disease could then be tested on them.

First, infected prostitutes were identified and made freely accessible to ‘volunteer’ prisoners for sex. When this didn’t work so well, attempts were made to infect patients in an asylum for the mentally ill, through such methods as abrading the skin on men’s genitalia.

Reverby stumbled on the story while researching the better-known and just as disturbing experiments on black men with syphilis in Alabama from 1932-1972. In Alabama, the disease wasn’t given to the men, but rather they were identified as having the disease and followed for many years to see its progression. The men were deceived into believing they were being treated for syphilis, while attempts were made to actually withhold from them the best treatments of the day (even when penicillin was introduced as an effective cure).

John Cutler, a US Public Health Service physician, who was also deeply involved in the Alabama experiments on black men, ran the Guatemala experiments as well. Unlike the Alabama experiments, which were public knowledge and were published on in the scientific literature— with such striking conclusions that syphilis disease progression is no different in blacks than in whites—Reverby has discovered no public mention of the experiments in Guatemala. She only found records of them by chance when opening a box of documents at the University of Pittsburgh archives, a box that had been donated by Cutler himself.

Why didn’t Cutler destroy the documents instead? He’s dead, so we’ll never know for sure. When he was interviewed in the early 1990’s for a NOVA special on the Alabama experiments and was confronted with the irony of their being carried out also during the Nuremburg trials, Cutler responded, “Yes, but they’re Nazis.”

Admittedly, those were different times. Similar experiments were carried out on ‘volunteer’ prisoners throughout the early 1900’s. And scientists genuinely wondered whether different races respond differently to the same disease.

Do humans become more ethical over historical time? Reverby points out that one-third of all the drugs approved by the FDA last year were tested on people outside the United States—and probably most of those in third-world countries.

What practices am I and are other scientists carrying out now that will make my grandchildren shudder?

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