AP exposes the Tuskegee syphilis study: 50th anniversary

WASHINGTON (AP) – Editor’s note – On July 25, 1972, Jane Heller, a reporter for the Associated Press investigative team, then called the Special Assignment Team, broke news that shook the nation. . Based on leaked documents by Peter Buxton, a whistleblower for the US Public Health Service, the then 29-year-old journalist and the only woman on the team reported that the federal government had infected hundreds of black men with syphilis in rural Alabama. allowed to go without treatment. For 40 years to study the effects of disease on the human body. Most men were denied access to penicillin, even after it became widely available as a treatment. A public outcry ensued, and about four months later, the “Tuskegee Study of Untreated Syphilis in the Negro Male” came to an end. The investigation would have far-reaching effects: the men in the study filed a lawsuit that resulted in a $10 million settlement, Congress passed laws governing how subjects are treated in research studies, and More than two decades later, President Bill Clinton formally apologized. The study, called it “embarrassing.”

Today, the impact of the study still lingers—it is often blamed on the reluctance of some African Americans to participate in medical research.

On the 50th anniversary of Heller’s groundbreaking investigation, the AP is republishing the original report and a recent interview with him and others about how the story came together.

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For 40 years the US Public Health Service has conducted a study in which human guinea pigs, denied adequate medical treatment, died of syphilis and its side effects.

The study was conducted from postmortems to determine what the disease does to the human body.

The PHS officials responsible for starting the experiment have long since retired. Current PHS officials, who say they have serious doubts about the study’s ethics, also say it is too late to treat syphilis in any of the study’s surviving participants.

But PHS doctors say they are now providing whatever other medical services they can to survivors while the effects of the disease continue to be studied.

The experiment, called the Tuskegee Study, began in 1932 with about 600 black men, most of them poor and uneducated, from Tuskegee, Ala., an area with one of the highest rates of syphilis in the country at the time. .

One-third of the group was syphilis-free. Two-thirds showed evidence of disease. In the syphilitic group, half were given the best treatment then known, but the other half, about 200 men, received no treatment for syphilis, PHS officials said.

As an incentive to enter the program, men were promised free transport to hospitals, free hot lunches, free medicine for any disease except syphilis and free burial after autopsy.

The Tuskegee study began 10 years before penicillin was discovered to treat syphilis and 15 years before the drug became widely available. Dr. J. D. Miller says that, even after penicillin became common, and even though its use could have possibly helped or saved a large number of experimental subjects, by refusing the drug given.

He is chief of the Division of Neurology at the PHS Center for Disease Control in Atlanta and is now in charge of the remnants of the Tuskegee Study. Dr. Miller said in an interview that he had serious doubts about the program.

“I think there was a definite serious ethical problem when this study was done, an even more serious ethical problem was overlooked in the post-war years when penicillin became available but not given to these people, and an ethical problem now. also exists,” Dr. Miller. said.

“But the study began at a time when attitudes on treatment and experimentation were very different. At that time, with our current knowledge of treatment and disease and the revolutionary change in our approach to human experience, I’m not sure what started the program. Will go,” he said.

Syphilis, a highly contagious sexually transmitted infection, can cause bone and tooth decay, deafness, blindness, heart disease and central nervous system disorders if left untreated.

No data were available on when the last death occurred in the program. And one official said there appears to have been no conscious effort to stop the program once it started.

A 1969 CDC study of 276 treated and untreated syphilis patients who participated in the Tuskegee Study found that seven died as a direct result of syphilis. Another 154 died of heart disease.

CDC officials say they cannot determine at this deadline how many of the heart disease deaths were caused by syphilis or how many additional deaths may be linked to the disease.

However, an American Medical Association study several years ago determined that untreated syphilis reduced life expectancy by 17 percent in black men ages 25 to 50, compared to the Tuskegee study subjects. There is a definite explanation.

Don Prince, another official in the CDC’s Division of Neurology, said the Tuskegee study provided some information about syphilis, particularly that the morbidity and mortality rates among untreated syphilis patients were so high. Not as much as previously thought.

Like Dr. Miller, Prince said he thinks the study should have stopped with penicillin treatment for participants after World War II.

“I don’t know why the decision was made not to close the program in 1946,” Prince said. “When I first came here and found out about it, I was pleasantly surprised. It really surprised me.”

At the beginning of 1972, according to CDC data, 74 untreated syphilitics were still alive. All of these were men who did not suffer the potentially fatal side effects that accompany the disease, Dr. Miller said.

Prince said some of them had received penicillin and antibiotics for other nutritional reasons over the years, but none had been treated for syphilis. Now, both men agree, it’s too late.

Dr. Miller said recent reviews of the Tuskegee study by the CDC show that treatment for survivors is now medically questionable. Their average age is 74 and widespread penicillin therapy, with potential side effects, is considered a great risk to individuals, especially those whose syphilis is now inactive.

However, Dr. Miller added that there was a point in time when survivors could be treated with at least some degree of success.

“The most important ethical issue about this experiment arises in the postwar period, after the end of World War II when penicillin became widely available.

“I know that some were treated with penicillin for other diseases and then dropped from the program because the drug had some positive effect on the underlying disease (the fever). Looking back on it now, any reason Can’t see how they couldn’t have been treated at that time.

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