The Moral of the U.S. Syphilis Experiments in Guatemala
"I don't
write about this to demonize the Americans, although it's always useful to
qualify our admiration for the high standards of medical research in the
U.S. I do it to put my finger on a more painful wound: the long history of
evil, or the unsettling fact that moral and ethical standards vary over time. …
we have to content ourselves with the fact that
experiments like these are already seen as obviously criminal and disgraceful.
It is one more step - but it is far from the last."
Read this account of the
experiments carried out in the 1940s by "scientists" from a
"civilized" nation in another country that was under its influence:
The initial experiments involve the study of sex workers intentionally
infected with Treponemapallidum [photo, left]
as the source of infection for male inmates. At that time, the sex workers were
admitted into the prisons. When the rate of male-female transmission proved
low, the research approach changed to direct inoculation of inmates and
patients in the psychiatric hospital. Most of the experiments involved subcutaneous
injection of T. pallidum or exposure of the penile
foreskin to infectious material. The majority of research subjects were treated
with penicillin, although the available research records don't document therapy
or the completion of therapy for all participants; some received only partial
treatment.
One research subject, a
patient with a history of severe epilepsy, died of "status epilepticus" during treatment with penicillin. Although
additional deaths occurred during the study in the psychiatric hospital, they
were probably related to high rates of previous illnesses like tuberculosis.
The researchers provided some items of institutional support, such as
anti-convulsants and refrigerators for storing vaccines; and offered cigarettes
as an incentive for to the research subjects. The records provide no indication
that the individuals have understood that they are participating in research.
The majority of the experiments
on gonorrhea and cancer were carried out on soldiers. While the initial studies
involved sexual contact between soldiers and sex workers who had been infected
with gonorrhea; subsequent participants were infected with intraurethral
inoculations with Neisseria gonorrhea and cutaneous
inoculations with Haemophilusducreyi, which
were then treated with penicillin and sulfa drugs, respectively.
Ethical violations in this
study include the following: (1) the participants were members of vulnerable
populations, including people with mental illnesses and the institutionalized,
prisoners and soldiers (who were incapable of giving valid informed consent);
(2) subjects were intentionally infected with pathogens that could cause severe
illnesses; and (3) lies were told in order to carry out the experiments. The
correspondence between the researchers and their superiors also recognizes the
unethical nature of their work. A letter written
in 1948 states: "I am a bit, in fact more than a bit, leery of the
experiment with the insane people. They cannot give their consent, do not know
what is going on, and if some goody organization got wind of the work, they
would raise a lot of smoke." The study was never published.
For many people, the first
impulse would be to conclude that these experiments were conducted by Nazis in
Poland, but that is not the case. The author of the letter I just quoted was R.C. Arnold, the supervisor of the physician John Cutler,
who carried out the experiments in Guatemala between 1946 and 1948. This was,
therefore, the end of World War II, and coincided with the exposure of the
horrors at German concentration camps and the work of butchers like Josef Mengele. Arnold and
Cutler worked for the U.S. Public Health Service.
Posted by WORLDMEETS.US
The documents relating to this
barbaric research were discovered by Susan Reverby of
Wellesley College in the U.S. She was looking for documents from another
inhumane experiment with syphilis, this one on North American soil (Tuskegee),
but found the Arnold letter and other overwhelming documentation on the
Guatemalan case. Reverby's discovery is available on the Internet, and the above
report was translated from the article of recognition - almost an apology -
written by Thomas R. Frieden and Francis S. Collins, directors of the Centers
for Disease Control and Prevention (CDC) and the National Institutes of Health
(NIH), respectively, both in the U.S. The commentary
was published in the Journal of the American Medical Association (JAMA).
I don't write about this to
demonize the Americans, although it's always useful to qualify our admiration
for the high standards of medical research bodies in the U.S. I do it to put
my finger on a more painful wound, which appears to have scarred over, but
which hides an abscess that remains untouched: the long history of evil, or the
unsettling fact that moral and ethical standards vary over time.
After all, despite the
discomfort of the writer, there were more than a few people in that decade who
would perhaps have considered the harmful research on people who are
"objectively" inferior as legitimate, such as those - prostitutes, the
insane and criminals, and above all, in a Banana Republic.
It seems inconceivable today.
But I never tire of remembering that my paternal grandmother, Dona Sinhá, who
was born in 1885, had a Black mammy. We don't know if she was a slave. The
effects of slavery in Brazil aren't as remote as ideologues of the nonexistence
of racism among us would have you believe. In the middle of the 20th century, eugenics was still current
doctrine in medicine, and not just in the U.S., Germany or Brazil.
Fortunately, we have evolved.
Exposure to such horrors as concentration camps, or the Soviet Gulag, or Pol
Pot's Cambodia, or the mere sight of instruments used to punish fleeing slaves
in Brazil (to say nothing of the killing of Indians in western São Paulo in the
20th century), almost inevitably led to a widening circle of morality. Beings
that were inferior before - Blacks, women, murderers, fetuses, Indians,
foreigners, children, adulterers, and perhaps even animals - have acquired
rights and dignity.
The lesson I draw from this little
story is that there is no great index for morality. We tend to consider our own
convictions as the most universal and valid, but they, too, always end up
changing. Just give it time.
If the Catholic Church has changed
and is changing, and even the myths of indigenous peoples have changed to
incorporate historical experiences (such as contact with Europeans), then why
would current notions of human rights not also change?
Posted by WORLDMEETS.US
In place of
"changeable," however, I should say "expandable." It is inappropriate
to change concepts of dignity and rights to exclude other beings, or to accept
that they, setting aside their history, are culturally dependent.
The killing of Jews and
Gypsies during World War II is as abhorrent today as it was in the past - in
Germany, in Iran or in France. Revenge in the guise of punishment as is the
case with the death penalty will one day be universally recognized as repulsive
- in the United States, Iran, Israel or China.
For now, we have to content ourselves
with the fact that experiments like Tuskegee, Guatemala or Auschwitz are
already seen as obviously criminal and disgraceful. It is one more step - but
it is far from the last.
*Marcelo Leite is a special reporter for Folha, and author of the
books Folha Explains Darwin (Publifolha) and Science -
Handle with Care" (Unicamp), and is responsible
for the Science Today blog. He writes in this space on Wednesdays.
Marcelo Leite is a special reporter for Folha, and author of the
books Folha Explains Darwin (Publifolha) and Science
- Handle with Care" (Unicamp), and is
responsible for the Science Today blog. He writes in this space on Wednesdays
