A front page report in The New York Times adds important
information about the abhorrent syphilis experiment conducted by physicians
with the US Public Health Service and the National Institutes of Health on
non-consenting Guatemalan mental patients, prisoners and soldiers.
"In a twist to the revelation, the public health
doctor who led the experiment, John C. Cutler, would later have an important
role in the Tuskegee study in which black American men with syphilis were
deliberately left untreated for decades. Late in his own life, Dr. Cutler
continued to defend the Tuskegee work."
"His unpublished Guatemala work was unearthed
recently in the archives of the University of Pittsburgh by Professor Susan Reverby,
a medical historian who has written two books about Tuskegee. Dr. Reverby has certainly earned her place in
history--not just as a scholar who dug deeply into covered-up evidence that
sheds a harsh light on the morally depraved culture among medical doctors in high
government positions.
Another disturbing aspect: Professor Reverby presented her
findings about the Guatemalan experiments at a conference in January, but
nobody took notice!
In June, she sent a draft of an article she was preparing
for the January 2011 issue of the Journal of Policy History to Dr. David J.
Sencer, a former director of the Centers for Disease Control. He prodded the
government to investigate.
We are gratified that at least one prominent physician /
ethicist, Dr. Mark Siegler, Director, Maclean Center for Clinical Medical
Ethics at the University of Chicago medical school, acknowledged the moral
depravity of the experiment and those who sponsored it.
"...it's appalling — that, at the same time as the
United States was prosecuting Nazi doctors for crimes against humanity, the U.S.
government was supporting research that placed human subjects at enormous
risk.”
AHRP Recommends: At the very least, we believe that doctors who are found
to have engaged in unethical human experiments in violation of the Hippocratic
Oath to "do no harm," and in violation of the human right to
voluntary, informed consent, should be publicly identified and their
publications retracted from the scientific journals.
October 1, 2010
THE NEW
YORK TIMES
From 1946 to 1948, American public
health doctors deliberately infected nearly 700 Guatemalans — prison inmates,
mental patients and soldiers — with venereal
diseases in what was meant as an effort to test the effectiveness of penicillin.
American tax dollars, through the National Institutes
of Health, even paid for syphilis-infected
prostitutes to sleep with prisoners, since Guatemalan prisons allowed such
visits. When the prostitutes did not succeed in infecting the men, some
prisoners had the bacteria poured onto scrapes made on their penises, faces or
arms, and in some cases it was injected by spinal puncture.
If the subjects contracted the disease, they were given antibiotics.
“However, whether everyone was then cured is not clear,” said Susan M.
Reverby, the professor at Wellesley College who brought the experiments to
light in a research paper that
prompted American health officials to investigate.
The revelations were made public on Friday, when Secretary of State Hillary Rodham Clinton
and Health and Human Services Secretary Kathleen Sebelius apologized
to the government of Guatemala and the survivors and descendants of those
infected. They called the experiments “clearly unethical.”
“Although these events occurred more than 64 years ago, we are outraged that
such reprehensible research could have occurred under the guise of public
health,” the secretaries said in a statement. “We deeply regret that it
happened, and we apologize to all the individuals who were affected by such
abhorrent research practices.”
In a twist to the revelation, the public health doctor who led the
experiment, John C. Cutler, would later have an important role in the Tuskegee
study in which black American men with syphilis were deliberately left
untreated for decades. Late in his own life, Dr. Cutler continued to defend the
Tuskegee work.
His unpublished Guatemala work was unearthed recently in the archives of the
University of Pittsburgh
by Professor Reverby, a medical historian who has written two books about
Tuskegee.
President Álvaro Colom of Guatemala, who first learned of the experiments on
Thursday in a phone call from Mrs. Clinton, called them “hair-raising” and
“crimes against humanity.” His government said it would cooperate with the
American investigation and do its own.
The experiments are “a dark chapter in the history of medicine,” said Dr. Francis S. Collins, director
of the National Institutes of Health. Modern rules for federally financed
research “absolutely prohibit” infecting people without their informed consent,
Dr. Collins said.
Professor Reverby presented her findings about the Guatemalan experiments at
a conference in January, but nobody took notice, she said in a telephone
interview Friday. In June, she sent a draft of an article she was preparing for
the January 2011 issue of the Journal of Policy History to Dr. David J. Sencer,
a former director of the Centers
for Disease Control. He prodded the government to investigate.
In the 1940s, Professor Reverby said, the United States Public Health
Service “was deeply interested in whether penicillin could be used to prevent,
not just cure, early syphilis infection, whether better blood tests for the
disease could be established, what dosages of penicillin actually cured
infection, and to understand the process of re-infection after cures.”
It had difficulties growing syphilis in the laboratory, and its tests on
rabbits and chimpanzees told it little about how penicillin worked in humans.
In 1944, it injected prison “volunteers” at the Terre Haute Federal
Penitentiary in Indiana with lab-grown gonorrhea,
but found it hard to infect people that way.
In 1946, Dr. Cutler was asked to lead the Guatemala mission, which ended two
years later, partly because of medical “gossip” about the work, Professor
Reverby said, and partly because he was using so much penicillin, which was
costly and in short supply.
Dr. Cutler would later join the study in Tuskegee, Ala., which had begun
relatively innocuously in 1932 as an observation of how syphilis progressed in
black male sharecroppers. In 1972, it was revealed that, even when early
antibiotics were invented, doctors hid that fact from the men in order to keep
studying them. Dr. Cutler, who died in 2003, defended the Tuskegee experiment
in a 1993 documentary.
Deception was also used in Guatemala, Professor Reverby said. Dr. Thomas
Parran, the former surgeon general who oversaw the start of Tuskegee,
acknowledged that the Guatemala work could not be done domestically, and
details were hidden from Guatemalan officials.
Professor Reverby said she found some of Dr. Cutler’s papers at the
University of Pittsburgh, where he taught until 1985, while she was researching
Dr. Parran.
“I’m sifting through them, and I find ‘Guatemala ... inoculation ...’ and I
think ‘What the heck is this?’ And then it was ‘Oh my god, oh my god, oh my
god.’ My partner was with me, and I told him, ‘You aren’t going to believe
this.’ ”
Fernando de la Cerda, minister counselor at the Guatemalan Embassy in
Washington, said that Mrs. Clinton apologized to President Colom in her
Thursday phone call. “We thank the United States for its transparency in
telling us the facts,” he said.
Asked about the possibility of reparations for survivors or descendants, Mr.
de la Cerda said that was still unclear.
The public response on the Web sites of Guatemalan news outlets was furious.
One commenter, Cesar Duran, on the site of Prensa Libre wrote: “APOLOGIES ...
please ... this is what has come to light, but what is still hidden? They
should pay an indemnity to the state of Guatemala, not just apologize.”
Dr. Mark Siegler, director of the Maclean Center for Clinical Medical Ethics
at the University of Chicago’s
medical school, said he was stunned. “This is shocking,” Dr. Siegler said.
“This is much worse than Tuskegee — at least those men were infected by natural
means.”
He added: “It’s ironic — no, it’s worse than that, it’s appalling — that, at
the same time as the United States was prosecuting Nazi doctors for crimes
against humanity, the U.S. government was supporting research that placed human
subjects at enormous risk.”
The Nuremberg trials of Nazi doctors who experimented on concentration camp
inmates and prisoners led to a code of ethics, though it had no force of law.
In the 1964 Helsinki Declaration, the medical associations of many countries
adopted a code.
The Tuskegee scandal and the hearings into it conducted by Senator Edward M. Kennedy became the
basis for the 1981 American laws governing research on human subjects, Dr.
Siegler said.
It was preceded by other domestic scandals. From 1963 to 1966, researchers
at the Willowbrook State School on Staten Island infected retarded children
with hepatitis to
test gamma globulin against it. And in 1963, elderly patients at the Brooklyn
Jewish Chronic Disease Hospital were injected with live cancer cells to
see if they caused tumors.
Elisabeth Malkin contributed reporting from Mexico City.
