Tuskegee syphilis study timeline
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The Tuskegee Syphilis Study:
A Hard Lesson Learned
The Tuskegee Syphilis Study, carried out in Macon County, Alabama, from 1932 to 1972, is an example of medical research gone wrong. The United States Public Health Service, in trying to learn more about syphilis and justify treatment programs for blacks, withheld adequate treatment from a group of poor black men who had the disease, causing needless pain and suffering for the men and their loved ones.
In the wake of the Tuskegee Study and other studies, government took a closer look at research involving human subjects and made changes to prevent the moral breaches that occurred in Tuskegee from happening again.
The Study Begins
In 1932, the Public Health Service, working with the Tuskegee Institute, began a study in Macon County, Alabama, to record the natural history of syphilis in hopes of justifying treatment programs for blacks. It was called the "Tuskegee Study of Untreated Syphilis in the Negro Male".
The study involved 600 black men—399 with syphilis and 201 who did not have the disease. Researchers told the men they were being treated for "bad blood," a local term used to describe several ailments, including syphilis, anemia, and fatigue. In truth, they did not receive the proper treatment needed to cure their illness. In exchange for taking part in the study, the men received free medical exams, free meals, and burial insurance. Although originally projected to last 6 months, the study actually went on for 40 years.
What Went Wrong?
In July 1972, a front-page New York Times story about the Tuskegee Study caused a public outcry that led the Assistant Secretary for Health and Scientific Affairs to appoint an Ad Hoc Advisory Panel to review the study. The panel had nine members from the fields of medicine, law, religion, labor, education, health administration, and public affairs.
The panel found that the men had agreed freely to be examined and treated. However, there was no evidence that researchers had informed them of the study or its real purpose. In fact, the men had been misled and had not been given all the facts required to provide informed consent.
The men were never given adequate treatment for their disease. Even when penicillin became the drug of choice for syphilis in 1947, researchers did not offer it to the subjects. The advisory panel found nothing to show that subjects were ever given the choice of quitting the study, even when this new, highly effective treatment became widely used.
The Study Ends and Reparation Begins
The advisory panel concluded that the Tuskegee Study was "ethically unjustified"—the knowledge gained was sparse when compared with the risks the study posed for its subjects. In October 1972, the panel advised stopping the study at once. A month later, the Assistant Secretary for Health and Scientific Affairs announced the end of the Tuskegee Study.
In the summer of 1973, a class-action lawsuit filed by the National Association for the Advancement of Colored People (NAACP) ended in a settlement that gave more than $9 million to the study participants. As part of the settlement, the U.S. government promised to give free medical and burial services to all living participants. The Tuskegee Health Benefit Program was established to provide these services. It also gave health services for wives, widows, and children who had been infected because of the study. The Centers for Disease Control and Prevention was given responsibility for the program, where it remains today in the National Center for HIV, STD, and TB Prevention.
1895 Booker T. Washington at the Atlanta Cotton Exposition, outlines his dream for Black economic development and gains support of northerner philanthropist including Julius Rosenwald (founder of Sears).
1900 Tuskegee experiment gains widespread support. Rosenwald Fund provides monies to develop schools, factories, businesses, and agriculture.
1915 Booker T. Washington Dies, Robert Motin continues work.
1926 Health is seen as inhibiting development and major health initiative is started. Syphilis is seen as major health problem. Prevalence of 35 percent observed in reproductive age population.
1929 Aggressive treatment approach initiated with Mercury and Bismith. Cure rate is less than 30 percent, treatment requires months and side effects are toxic, sometimes fatal.
1929 “Wall Street Crash” Economic Depression begins.
1931 Rosenwald Fund cuts support to development projects Clark and Vondelehr decides to follow men left untreated due to lack of funds to show need for treatment program.
1932 Follow-up effort organized into study of 399 men with syphilis and 201 without. The men would be given periodic physical assessments and told they were being treated. Motin agrees to support study if “ Tuskegee gets its full share of the credit” and Black professionals are involved (Dr. Dibble and Nurse Rivers are assigned to study).
1934 First papers suggest health effects of untreated syphilis.
1936 Major paper published... Study criticized because it is not known if men are being treated. Local physicians asked to assist and asked not to treat men. It was also decided to follow the men until death.
1940 Efforts made to hinder men from getting treatment by military draft effort.
1945 Penicillin accepted as treatment of choice for syphilis.
1947 US PHS establishes “Rapid Treatment Centers” to treat Syphilis, men in study not treated, but syphilis declines.
1962 Since 1947, 127 Black medical students are rotated through unit doing the study.
1968 Concern raised about ethics of study by Peter Bauxum and others.
1969 CDC reaffirms need for study and gains local medical societies support (AMA and NMA chapters officially support continuation of study).
1970 First news articles condemns studies.
1971 Congress holds hearings and law suit initiated.
1972 Study ends and participants compensated with cash and continued medical treatment.
1997 May 16th President Clinton Apologizes on behalf of the Nation.