The Tuskegee Syphilis Study is the most well-known US case of unethical medical treatment. As described in the Tuskegee study film, 400 African-American men were offered “free treatment” for a disease vaguely termed “bad blood”. Officially, the experiment began for the purpose of finding out whether syphilis in African-Americans was the same and/or had the same series of symptoms and effects as that in Caucasians. However, patients were never told the actual sickness or offered consistent treatment, even after informed consent became required in experimental research. Instead, patients were given fake tonics and pills as “treatment” and subjected to routine medical exams as their health slowly worsened from the effects of syphilis. The continual deception and withholding proper medical treatment from patients without their knowledge are what makes the Tuskegee study so unethical. In the video, physician Dr. Culter attempts to rationalize it by saying that the result of the research would save so many African-American lives as to be worth the subjects’ lives. It was later discovered that Dr. Culter was involved in a similar experiment affecting (according to a current Encyclopedia Britannica online article by Kara Rogers) over 1,000 Guatemalans. Prisoners, soldiers, and sex workers were purposely infected with STDs to test potential alternatives for the widely-used penicillin without their informed consent.

After public outrage over experiments such as the Tuskegee Syphilis Study, the responsible organizations often try to financially reimburse the survivors and families of the deceased. Cultural effects of such experiments, however, are not easily forgotten. In 2016, research about an outbreak of tuberculosis in Alabama led New York Times author Alan Blinder to conclude that residual mistrust from the Tuskegee Syphilis Study was to blame for the people’s unwillingness to seek medical help. His article “Outbreak is Fueled by Mistrust in Alabama” describes the people of Marion, Alabama as being close-lipped about their sickness, while blaming the same authorities for not working to contain and prevent the sickness earlier. Therefore, unethical experiments such as the Tuskegee study affect more than just the current victims and their families. They also create lasting cultures of medical distrust, a source of complications for future attempts to contain or treat disease.

In general, ethical issues surrounding infectious diseases exist also on a personal level. For example, recent news of “anti-vax” support raises the question of whether it is ethical to require each individual to be vaccinated (regardless of their personal preference) for the safety of the larger population. Additionally, historical requirements for quarantine of recently arrived immigrants were questionable, since they assumed that immigrants were already infected and/or likely to spread infectious disease. Minority groups are often viewed as targets for experiments such as the Tuskegee Syphilis Study (discussed in class), most likely because of the expectation that they accustomed to taking orders without full explanation and will follow doctors’ instructions without question. Another example of this, described in the article “The Rationalization of Unethical Research” by Charlotte Paul in 2015, was women in New Zealand used in a study about the development of cervical cancer. The doctor in charge of the experiment received permission to leave carcinoma in situ (CIS) untreated in the women, but never informed the women that their lack of treatment was unusual.

The modern difficulty of doing research in developing countries is that it can be difficult for doctors to communicate the information for informed consent, leaving themselves open to an accusation of unethical practices. Even in the US, good intentions cannot outweigh unethical actions. A final example is the SIU professor William Halford’s attempts (described in a 2017 StatNews article by Marisa Taylor) to create an effective herpes vaccine. He wanted to test the vaccine in 2013 and resorted to a series of hotel-room tests on volunteers who were unaware that the formula was experimental. His good intentions meant nothing against the unethical nature of his actions. Similarly, the Nazi doctors’ beliefs that their experiments would be worth the suffering of patients for future knowledge and health of many did not earn them any leniency when faced with the Nuremburg Trials.

HR: References as listed in text, class discussion, Microsoft Word for spelling/grammar check