Tuskegee’s real moral: The legacy of the infamous experiment argues …

While vaccinations for Black Americans have picked up in the past few weeks, they are still behind vaccination rates for whites. The reluctance of many Black citizens to get vaccinated can be traced to the mistrust of the medical establishment based on the gruesome Tuskegee study. But the lessons aren’t what we often hear in the media.

In 1932, the U.S. Public Health Service, in association with the Tuskegee Institute, initiated a research project called “The Study of Untreated Syphilis in the Negro Male.” The title itself announces the unethical nature of the research — a study dedicated to not treating a disease.

Six hundred Black males — 399 of whom were diagnosed with syphilis and a control group of 201 who did not have the disease — were recruited for the research. These poor farmers from rural Alabama were offered several perks for their participation: free hot meals, free medical exams and burial insurance. But those suffering from syphilis were not told they were being used as sacrificial lambs. The syphilis group believed they would be treated for “bad blood,” which was a euphemism for syphilis. But they were not treated, and the real purpose of the study was not disclosed: to gather data on how untreated syphilis progressed over a lifetime.

At the beginning of the study, the only effective treatment for syphilis was Salvarsan, developed by German biochemist Paul Ehrlich in 1909. It was effective for some but not for advanced cases. Moreover, Salvarsan was difficult to administer, the injections were extremely painful, and it had several dangerous side effects. Nevertheless, no treatments were given to the experimental Tuskegee syphilis group. To deceive them into thinking they were being treated, they were occasionally given placebos such as vitamins, aspirins and tonics.

Fifteen years into the study, penicillin was introduced in the U.S. Penicillin was developed in England in 1928 by Scottish physician and microbiologist Alexander Fleming. But it wasn’t until 1942 that the first patient in the U.S. was treated with penicillin. That patient, Ann Miller, was suffering from the deadly disease of sepsis. Although she was near death, one dose of penicillin cured her.

Subsequently, penicillin was applied to other diseases and proved effective for syphilis. The drug was initially in very short supply, but by 1943, penicillin production was ratcheted up and was widely available.

Tragically, it was never given to the Tuskeegee victims of syphilis. If the penicillin treatment had been offered to them it’s doubtful that any would have refused, since they joined the study in the belief they were being treated for the “bad blood” disease. But penicillin wasn’t offered because the researchers had no interest in curing them. Rather, they stuck to their commitment to study the “natural history of untreated syphilis” — data that would be useless now that there was a reliable cure for syphilis. With penicillin available, sufferers of syphilis would be treated and cured at diagnosis so how untreated syphilis would play out over a lifetime, which was the aim of the study, no longer had any practical medical value.

The study should have been shut down immediately. Under the changed circumstances, that the researchers chose to continue their useless research rather than treat and cure the men in the experimental group may have been an act of criminally negligent homicide, defined as “an act of recklessness or negligence causing the death of another person.”

Not until 1972, after the Associated Press published a story about the experiment’s draconian breach of ethics, was the study finally halted. But it was not soon enough for the consequences of withholding penicillin treatment: 128 participants died of syphilis or related complications, 40 wives were infected, and 19 children were born with congenital syphilis.

The nation was so shocked by the abuses of the Tuskegee study that in 1974, the National Research Act was passed to ensure the highest ethical standards for human research. The act required that human research supported by the Department of Health Education and Welfare (DHEW) must be reviewed by a Board to verify that studies meet strict ethical standards. Since then, additional legislation has been enacted to protect volunteers in all biomedical and behavioral research. Today, oversight of research is so extensive that the abuses of the Tuskegee tragedy are unlikely to ever be repeated.

How does this history inform how Black Americans should relate to COVID-19 and the coronavirus vaccines?

Keep in mind that the horror of the Tuskegee experiment was the lie participants were told about why they were selected for the study. Worse, they were not given treatment with a new proven cure for syphilis.

Amid the current pandemic, many Black people are citing the Tuskegee experiment as the reason they are rejecting a proven vaccine that can prevent them from falling victim to a deadly virus.

The distrust of medical research, once given reason to take root, cannot be expected to grow in logical directions. The Tuskegee study was about the withholding of an effective treatment while the public health strategy for the current coronavirus pandemic is about offering free effective prevention to everyone.

The facts scream out: Get your arm to a vaccination facility as fast as possible.

Starr is professor emeritus at CUNY, Brooklyn College.

Originally Published: August 19, 2021 at 5:00 AM EDT