Tuskegee

In 1932, an organization of the United States Government called the U.S. Public Health Service (PHS) began to conduct an experiment on the effects of untreated syphilis on black men in Macon County, Alabama. The commonly used name for this study became known as The Tuskegee Syphilis Experiment because the Tuskegee Institute’s affiliated hospital let the PHS use their medical facilities for the study. The experiment involved 399 black men who were infected with syphilis and another 200 uninfected men who served as a control group. The information for the experiment was to be gathered from the men’s autopsies, which means that the subjects used were purposely being untreated to see the last stages of syphilis. This means that the Tuskegee study was a non-therapeutic experiment. The men involved in the study were mostly illiterate black sharecroppers from one of the most impoverished counties in Alabama. Since they were very disadvantaged in life and many of them have never seen a doctor before, it made them very easy to manipulate. The men cooperated in the study because the PHS gave them free physical examinations, free rides to and from the clinics, hot meals on examination days, and other free treatment. Spinal taps were used to gather scientific data, but were used without anesthesia and were very painful and potentially dangerous. Still though the patients showed up thinking they were receiving special treatment. The real nature of the study had to be kept secret from the subjects to also guarantee cooperation. The black men were never told they had syphilis, but were informed that they were being treated for “bad blood.” The experiment went on for forty years and was halted early in 1972, due to the story being broken out into the press. Jean Heller of the Associated Press wrote an article in the Washington Star discussing the experiment and her source was a man by the name of Peter Buxtun. Buxtun was a former PHS venereal disease interviewer and his testimony given to Heller led to the termination of the program because the PHS became under heavy public glare. By the government finally ending their experiment, the men in the study were finally given effective medical treatment for syphilis. However it was too late for many. Evidence shows that in 1969, at least 28 men died because of the direct complications caused by syphilis. Another 100 men were dead because of serious heart conditions that were syphilis-related and only 74 of the original 399 men were still alive. As you can see with the discrepancy of this entire experiment’s moral status, it can bring about many questions to ethicists. The study was never trying to find a treatment, cure, or in anyway tried to prevent the patients from the harmful effects of syphilis. There are truly no benefits to society in studying the late stages of syphilis and how it kills someone. It is clearly a racist case that excludes the patient’s rights as human beings. The PHS doctors clearly don’t care about the patients lives and mislead them by lying to them in order for them to cooperate. These are just a few of the points that make this case so interesting to ethicists. I also believe that this case is in particular interest to ethicists because it was something that was done by a U.S. government organization, which totally contradicts what our nation is founded on. The four paradigms of ethical analysis are utilitarianism, rights, justice, and caring. I will discuss how the Tuskegee Syphilis experiment violates all of these four paradigms and is considered to be an unethical case. The definition of utilitarianism is the general term for any view that holds that actions and policies should be evaluated on the basis of the benefits and costs they will impose on society. In 1932, the treatment for syphilis consisted of mercury and two arsenic compounds, which were considered toxic, painful, and usually required up to a year to conclude. The PHS, in their defense, stated that little harm was done since the treatment was ineffective and would have caused more harm than benefit so it didn’t matter if they were left untreated. However, in 1947, penicillin was discovered to be a very effective treatment for syphilis and was considered to be the first real cure. PHS officials had a very troublesome time justifying why their patients weren’t treated with penicillin during the 1940s. One PHS spokesman explained, “The denial of penicillin treatment in the 1940s was the most critical moral issue about this experiment and I cannot see any reason that they could not have been treated at that time.” At this time it seems that the study could have been concluded since penicillin could cure syphilis but still the patients were left untreated. From this situation it is obviously clear that the experiment violates the ethical paradigm, utilitarianism. The actions by the PHS impose no benefits to society by leaving the patients left untreated. Another person involved in the study reported, “Nothing learned will prevent, find, or cure a single case of infectious syphilis or bring us closer to our basic mission of controlling venereal disease in the U.S.” The study of untreated syphilis does not benefit society and once penicillin was discovered it should have been used to treat and save these patients lives. From the perspective of the ethical paradigm utilitarianism, this is an unethical case because the costs to the individuals definitely outweigh the benefits to society. The next major ethical paradigm used to analyze this case is rights. A right is defined as a person’s entitlement to something. In our nation’s bill of rights, the Fifth Amendment includes lockean rights, which are that no person should be deprived of life, liberty, or property. News Anchor Harry Reasoner stated that “the experiment used human beings as laboratory animals in a long and inefficient study of how long it takes syphilis to kill someone.” All of the black men involved in the study were being deprived of their lockean rights and were essentially used as laboratory animals. Also, their moral rights or “human rights” are ignored. It seems that the PHS thinks it’s acceptable to use human beings as test dummies for an unreasonable scientific study. The patient’s right to live is being violated because the whole purpose of the experiment was to collect data from the autopsies of the men. Instead of treating them and helping them survive the disease, they deliberately didn’t treat them and wanted them to die as a result of syphilis. This study is essentially an unethical case in the perspective of the ethical paradigm: rights. The PHS officials clearly do not respect the rights of the black men being used in the experiment. Their actions and policies greatly affect the men’s welfare and freedom as human beings. The third ethical paradigm used to analyze this study is justice. Justice is defined as the quality of being just, impartial, or fair. It is concerned with the comparative treatment given to the members of a group when benefits and burdens are distributed. The only way this distribution is fair is when each person has an equal right to the most extensive basic liberties compatible with equal liberties for all. The white doctors in the PHS picking poor class black men to be used in the experiment clearly show this as a racist case. The black men were not getting a fair chance to be treated for their disease and were being deprived of the best medication available. Instead, the men were being lied to and manipulated into performing different tests and procedures. This proves that from the perspective of the paradigm of justice, the case is considered unethical. The actions by the PHS do not lead to a just distribution of benefits and burdens. The burdens to the individuals in the experiment are far too great than any benefit. .