Tuskegee, Alabama is a small town. Even as recently as 2000, it only had a population of about 12,000. Even so, Tuskegee has a lot of pride in its role in African American history. It is the home of Tuskegee University, founded by Booker T. Washington in 1881 for the education of freedmen. But hand-in-hand with Tuskegee’s pride also comes the infamy of exploitation, disease, and malpractice. Here, we find the site of the Tuskegee Syphilis Experiments.
It began (like so many things do) with good intentions. The Public Health Service was trying to scientifically document the progression of syphilis, forward research for a cure, and perhaps create a treatment program for the black population. To that end they contacted the university (then called the Tuskegee Institute) and, in 1932, began their tests.
Syphilis is an old disease and a famous one. It is caused by a sexually transmitted bacterium, Treponema pallidum, a corkscrewy little thing. Sores are the most common symptom, although a vast array of other signs have been documented. The has a few nicknames, The Great Imitator (for it’s ability to confuse diagnosticians), the Great Pox (as opposed to the smallpox), and either the French disease (Italians blamed the disease on French troops) or the Italian disease (French troops blamed the disease on Italians).
The exact origin of syphilis is contested. Some believe that it is a new world disease and was actually carried back to Europe by Columbus’s crew, contracted from friendly local relations. This ideas weight is mostly due to the dearth of records pre-1492. However, other evidence suggests that syphilis was a mutation of yaws, an old-world disease caused by a similar bacterial species.
Anyways, the Tuskegee scientists recruited 600 black men for their tests, three hundred and ninety-nine of which had already contracted the disease. The scientists were pretty generous and did care about the well-being of their subjects; the men were given free medical exams, meals, and burial insurance. The problem was that nobody though to tell the men what the experiments were for. None were told that they had syphilis or were being treated for syphilis. The scientists simply said it was “bad blood”. The men were never given the facts nor informed of the risks. Worse than that, by 1947 the antibiotic penicillin had proven itself to be a powerful cure, but, in the interest of the experiment, it was never widely used by the Tuskegee researchers. They never even told the patients it was a possibility.
These tests continued, sans informed consent, sans cure, for forty years. Forty years of unknown risks and complications. Toxic attempts at cures and painful treatments. Accidentally infected wives and newborns. Forty years of being kept in the dark by men the black community trusted to help them.
The experiments stopped in 1972 when a whistleblower brought these transgressions to light. Both the Washington Star and the New York Times ran pieces nationally exposing Tuskegee. The reaction was substantial. Positively, the Tuskegee experiments highlighted the need for informed consent, for patients to understand their treatments, as well as the latent exploitation of African American communities. Negatively, Tuskegee damaged black trust in public health care. Tuskegee is the base reason that the black demographic has traditionally been more fearful of participating in biomedical research.
A class action lawsuit was filed against the U.S. government, which ended up paying $9,000,000 as well as any past, present, or future medical bills accumulated by the affected victims. Today, Tuskegee is one of the United States’ most infamous cases of medical malpractice and an astounding example of scientific hubris. It survives as a black mark in America’s records and a well-studied example in any medical ethics textbook.