The mystery of diseases has been a challenge for public health, the discipline of epidemiology “describes, quantifies, postulates causal mechanisms for diseases in populations, and develops methods for the control of diseases” (Friis & Sellers, 2014). Epidemiology studies are observational and have strict ethical limitations to ensure human subjects come to no harm; these regulations came about due to historical events such as Dr. Joseph Mengele’s medical experiments on prisoners during World War II (Schneider, 2011). The unconscionable example of a program that should have been stopped even before it was begun is the Tuskegee syphilis study, from 1932 to 1972; a group of African American men were used as a control group and denied treatment for syphilis even though antibiotic treatment had proven to be successful.
Syphilis is a deadly disease spread by sexual contact, if left untreated the unfortunate carrier will eventually succumb to blindness, heart disease, dementia and paralysis. Before antibiotics, the treatment for syphilis was a medication named salvarsan, which cured the disease in rabbits but was not always effective in humans, some of whom died from the treatment itself. At the time scientists believed the treatment effects far outweighed the disease and this premise concluded after a study in Norway that if left untreated up to 75 percent of patients were symptom free after more than twenty years of the disease (Schneider, 2011). In 1932, the U.S. Public Health Service and scientists from Tuskegee institute began a similar study of 400 black men in Macon County, Alabama where syphilis was prevalent for the purpose to observe the manifestations of the disease as it progressed. As was the norm at the time of the study choosing participants who were poor and disadvantaged did not trigger any alarm, therefore a group of non-illiterate African Americans would not appear to be an issue. The deceitfulness of the scientists continued as they enticed the study participants with free treatments, meals, physical examinations and burial assistance as well as the knowledge that their involvement in the study would be seen as a deed done for the greater good ( Kang, 2011; Schneider, 2011). The study continued unethically even after the discovery of penicillin as a standard treatment for syphilis in the 1940s. The details of the study materialized in 1972 leading to an outcry of disbelief and eventually ending the study. There were some that believed the participants came to no harm since they were in the late, noninfectious stage of syphilis and any form of treatment would not have helped but the legacy of the study continues to this day with many African Americans distrusting the medical system (Kang, 2011).