|The error of the medical establishment
Historically, human research subjects were never treated ethically, as mentioned previously the atrocities of World War II led to the development of the Nuremburg code of international ethics in 1947 that stipulated, “Any human subject must give informed consent to the research undertaken” (Sparks, 2002), in the 1930s there was no such code. Why would the U.S. Public Health Service and scientists consider such an experiment? The history of the Tuskegee area may shed some light as to why the study began; in the early 1900s efforts began to encourage black economic development with funding from noteworthy philanthropists. It became evident that poor health particularly the spread of syphilis was a contributing factor in the slow growth of developing the area, the prevalence rate of the disease was at 35% (CDC, 2013). The only available treatment of mercury and bismuth did nothing to abate the disease, it caused untold misery even death due to its caustic nature and had a cure rate of less than 30%. As the economic depression began philanthropic funding lessened; Dr. Taliaferro Clark of the U.S. Public Health Service recommended a prospective study to be conducted on the effects of syphilis among African American men, he intended the study to be six months long with a follow up treatment plan. The Tuskegee institute was enlisted to aid with recruitment of participants since it had a history and relationship with the community and in return the institute received training and employment for the nurses and doctors within the establishment. Dr Taliaferro Clark original intention was to justify more funding from the government by proving that these men needed more treatment; consequently, the medical intervention started as a worthy cause to help the community, even local black doctors and nurses were involved with the hope to curtail the disease (CDC, 2013). As the plan progressed some of the scientists through misguided intentions wanted to continue the study at this point Dr Clark left the study due to the unethical behavior of his peers. Unfortunately the study continued unhindered, the participants were still not informed, penicillin was proven to be a treatment for the disease but was not offered to these men. Many opportunities to treat the subjects were available:
in 1936, local doctors were instructed not to treat the men for there was speculation some of them may have been treated thus skewing the study
in 1947 the U.S. Public Health Service created rapid treatment centers for treatment of syphilis but the men were excluded from these
In 1969 the CDC reconfirmed the study and received additional support from local medical societies. (CDC,2013)
Eventually, in 1972 the study came to light due to the work of Peter Buxton an employee of the U.S. Public Health Service and the rest is history. These scientists who undoubtedly took some form of Hippocratic Oath during their training could not comprehend that they were doing wrong, the wanton disregard for the participants continued with support from the government thus providing a sense of elitism and paternalism towards the subjects (Beatty, 1982). Obviously, the era of the study was a contributory effect; racism was the norm and the treatment or mistreatment of African Americans did not raise any alarm.
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