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THE GUATEMALA SYPHILIS STUDY – ANOTHER SAD CHAPTER IN MEDICAL RESEARCH. NEXT?

Earlier this week, the President’s Commission for the Study of Bioethical Issues announced it had concluded its investigation into venereal disease research conducted by U.S. scientists in Guatemala from 1946 to 1948.  Part of the research, which was funded by the United States’ Public Health Service, involved infecting approximately 1,300 Guatemalans with syphilis, gonorrhea or chancroid.  According to the PCSBI, the research “participants,” or victims, consisted largely of “people in mental institutions, prisoners, commercial sex workers, and members of the Guatemala army” — i.e, vulnerable populations who were not in a position to object to the research, and whom researchers may have viewed as undeserving of consideration.

As the New York Times relates, at hearings earlier this week PCSBI panelist John Arras described the treatment of one mental patient in the study:

She was first deliberately infected with syphilis and, months later, given penicillin.  After that, Dr. John C. Cutler of the Public Health Service, who led the experiments, described her as so unwell that she “appeared she was going to die.”  Nonetheless, he inserted pus from a male gonorrhea victim into her eyes, urethra and rectum.  Four days later, infected in both eyes and bleeding from the urethra, she died.

(Arras went on to express, in an oddly tepid pronouncement, that he “really do[es] believe that a very rigorous judgment of moral blame can be lodged against some of these people.”  Do tell.)  To add insult to injury, the “research” apparently produced no valuable scientific knowledge.  The Times reports that “[t]he results were never published in medical journals, note-keeping was ‘haphazard at best’ and routine protocols were not done,” which would seem to render the researchers’ activities little more than torture, and possibly murder.

President Obama has apologized to Guatemalan President for the studies, and the PCSBI will release a report — presumably expressing “a very rigorous judgment of moral blame” — later this month.  One can only hope that such egregious violations of human dignity by scientists are a thing of the past.  But notwithstanding the bioethical infrastructure that has been developed over the past several decades to protect research subjects, sixty years hence observers may look back on our contemporary research practices with an equal measure of amazement and disgust.  Which practices?  I would welcome your ideas and predictions.  My guess: our treatment of animals in scientific research.

Matt Lamkin
Twitter: @lawbioethics

2 Responses to “THE GUATEMALA SYPHILIS STUDY – ANOTHER SAD CHAPTER IN MEDICAL RESEARCH. NEXT?”

  1. Hank Greely says:

    Two things. First, I agree that, as quoted, John Arras does sound a bit tepid, but, having been quoted before, I’m not quick to assume that what he said, and how he said it, necessarily came through fully in the quoting process. I am confident that John’s feelings about the (im)morality of some of these studies were not tepid.

    Second, I disagree with your guess about lab animals, but in a way that may illustrate a useful distinction. I feel comfortable saying that what the US did in Guatemala, to the extent I understand it, was immoral, even under the circumstances of the time. I can well imagine that if, as I hope will happen someday, we develop fully useful substitutes for laboratory animals in research, people will look back and say “how barbaric,” just as we may respond to the widespread use of “bleeding” as a medical treatment. (See Bone in Star Trek IV.) But I don’t think they will say it was immoral under the circumstances of our time. (But then, I’m an omnivore so this may just be wishful thinking on my part!)

  2. Ingrid Callies says:

    What is surprising is that this story should come as a surprise at all! After all, in the Tuskegee syphilis experiment, the investigators knowingly failed to treat patients appropriately even after the validation of penicillin as an effective cure for syphilis (in the 1940s). And it was taking place in the United-States!
    A student in one of my classes told me the other day that she did not understand how medical research could have taken place without the prior consent of the participant even after the Nuremberg Code! But in fact, it did take place. At the time of the Nuremberg trial, one of the main arguments of the lawyers for the defence was that the Nazi investigators were conducting valid research, and if it was without the consent of the “participants”, investigators in other countries, including the US, had been doing the same for years.
    I think that the main issue to raise in order to go forward today is how to conduct research in other countries, especially when there are no local laws protecting the research participants. There are a number of initiatives by the FDA, the EMA, the Council of Europe, the UNESCO, WHO… Let’s hope that it does help and that the errors of the past of not repeated in the future.

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