President’s Corner: The Tuskegee Study on Syphilis

Black History in America is celebrated every year in the month of February to honor the significant contributions Black Americans have made to the building and developing of this country.  The scientific section of this Advisory focuses on the recent rise in primary and secondary syphilis in the United States. Therefore, a review of the “Tuskegee Study of Untreated Syphilis in the Negro Male” seemed fitting.  The chronology of the study is as follows.1,2,3

 In 1932, the US Public Health Service with the Tuskegee Institute began the study.

  • The study initially involved 600 black men: 399 with syphilis; 201 without syphilis.
  • For participating they received free medical exams, free meals, and burial insurance.
  • The study lasted 40 years instead of 6 months as initially told.
  • In 1972, an Associated Press Story caused a public outcry. The Asst. Secretary of Health and Scientific Affairs appointed an Ad Hoc Advisory Panel to review the study.
  • Results found: There was no evidence the researchers had informed the men of the study’s real purpose, nor given them all the facts, nor were patients ever given treatment for their disease, even after 1947, when penicillin became the treatment of choice for syphilis. In Oct. 1972, the study was declared “ethically unjustified” and stopped at once.   Findings also declared the harsh reality is “the knowledge gained was sparse when compared with the risk the study posed for its subjects.”
  • In 1974, a $10 million out-of-court settlement was reached, which provided lifetime medical benefits and burial services. Later, the wives, widows and offspring of the research subjects also became eligible for benefits. On May 16, 1997, President Clinton apologized on behalf of the Nation. In January 2004, the last study participant died. In January 2009, the last widow died. In 2006, Tuskegee University National Center for Bioethics in Research and Health Care held its formal opening.
  • In 2007, the CDC hosted “Commemorating and Transforming the Legacy of the US Public Health Service Syphilis Study at Tuskegee University National Center for Bioethics in Research and Health Care.

A former civil rights advocate said, “We cannot rewrite history, but we can right history.”  So what can we learn from this experiment to right history?  First, consider every human being is valuable. Second, we have an ethical responsibility to each other to treat others as we want to be treated.  The issue of informed consent is paramount, so the person has the true choice to decide whether to participate. Third, the focus on prevention, testing and treatment of sexually transmitted diseases has to be magnified and ethically carried out. The current emphasis and funding by the United States Government for condom education and distribution is ethically wrong when peer reviewed studies have demonstrated the limitations of condoms for STI prevention.  To the contrary, not enough money or emphasis is spent for preventive measures and education on sexual risk avoidance and building healthy relationships.

I wonder 40 years from now, how will history tell this story?

1).Tuskegee Study-Timeline-CDC-NCHHSTP. Retrieved Jan 21, 2015

2).Gray, Fred D. The Tuskegee Syphilis Study.  Montgomery: New South Books. 1998. www.tuskegee.edu/biothics.

3).Allan M. Brandt, 1978. Racism and Research: The Case of the Tuskegee Syphilis Study. The Hastings Center Report. 8(6)21-29.

Freda M. Bush, M.D.Freda McKissic Bush, MD – President/CEO
Freda McKissic Bush, M.D is a Fellow in the ACOG and a practicing OB-GYN. She is CEO of The Medical Institute for Sexual Health and has co-authored two books with Founder Joe S. McIlhaney, MD, HOOKED, and Girls UNCOVERED. Dr. Bush is a Clinical Instructor in the Departments of OB-GYN and Family Medicine at the University of Mississippi Medical Center and served on the Presidential Advisory Council on HIV/AIDS. Married to Lee Bush they have 4 adult children and 8 grandchildren.