Ethics in research, particularly biomedical research, has been a reoccurring issue since its inception and is closely examined in current studies. This topic is particularly examined due to the unethical conditions in which numerous studies have taken place, major examples being the Tuskegee Syphilis Experiment and the Guatemala Syphilis Studies. During these experiments, several ethical protocols were broken in the name of science. The horrific outcomes still influence us today.
In dealing with infectious diseases, several ethical issues come into play. First, the disease must be understood. In order to fully understand an infectious disease, research must be conducted by infecting living things. One ethical question that arises from this is: can humans be test subjects? Mice and other mammals are routinely substituted for human subjects, but do not always closely reflect the disease mechanism found in humans. This is one ethical consideration when studying infectious diseases.
Another ethical issue includes testing treatment options. Most drugs have detrimental side effects. What happens if the side effects are worse than the disease? What if the treatment kills the subject before the disease does? In addition, every scientific study requires a control group. This inherently means some people in the study do not get treated, even though they have the disease. Is this right? These are some ethical considerations regarding testing treatment.
Finally, if research is complete on a particular infectious disease and treatments are approved, treatments are sold commercially. This involves pharmaceutical companies in competition with one another to make money. What if the price for treatment is so high only a select few can afford it? Also, supplies are not infinite. What happens if stock runs out? Who gets treated? There are many ethical issues associated with infectious diseases, in general.
Two studies stick out as examples of unethical medical scientific studies. These include the Tuskegee Syphilis Experiment and the Guatemala Syphilis Studies. Both were rationalized in their own way.
The Tuskegee Syphilis Experiment was mainly rationalized through discriminatory ways. Scientists believed that Macon County, Alabama was an ideal location do run their experiment. The majority of the population did not have much education, syphilis was prevalent, and it was believed that the population often engaged in sexual activity. Not to mention, the majority of the population was African American. Scientists wanted to better understand the pathology of untreated syphilis and also wanted to see if African Americans had a different type of syphilis than whites. They also wanted to be better able to treat syphilis based on the results of this study.
As the study continued, researchers continued to justify its existence. Scientists wanted to see the conclusion of this experiment. They argued that they were getting valuable data about untreated syphilis. Towards the end of the study, researchers believed that too much damage had been done to the subjects that treatment would be ineffective.
The Guatemala Syphilis Studies were similar in rationalization. At the time of the study, there was a large push in the United States to get rid of STDs, especially in the military. To do this, researchers wanted to better understand how gonorrhea, syphilis, and chancroid affected the body. In their studies, research subjects included prisoners, Guatemalan soldiers, and prostitutes. These people were not valued. In addition, there was much political turmoil in Guatemala, so the government did not object to the American studies. Finally, some of the participants of the study were treated in the end. These are a few ways the Guatemala Syphilis Studies were justified.
There are many examples of how the Tuskegee Syphilis Study, in particular, was unethical. First, the study was discriminatory. The only participants selected were African American men. Second, researchers did not fully disclose their plan to the participants. Subjects were under the impression that they were being treated for “bad blood.” The researchers did not even clearly define what “bad blood” truly meant. Third, the study was not stopped once it was confirmed that the study was causing harm. Researchers kept the study going in order to see the full effects of untreated syphilis. Finally, the study was not stopped once an effective treatment was found. Penicillin was a new antibiotic at the time and was found to be effective against syphilis. Despite this treatment option, subjects were actively denied treatment for the purpose of the study.
The unethical practices of the Tuskegee Syphilis Experiment still effect perception of medical research and physicians today. There is an overall distrust of research scientists among the African American community largely due to the Tuskegee Syphilis Experiment. According to a study by Shavers et al. (2000), 51% of African Americans versus 17% of whites in Detroit did not trust research scientists after 81% of African Americans and 28% of whites said they knew about the Tuskegee Syphilis Experiment. In addition, 49% of African Americans versus 17% of whites said they would not volunteer for a medical study.
In addition to a distrust of scientists, there also exists a distrust of physicians. A study by Katz et al. (2008) found that this distrust was particularly prevalent in Macon County, Alabama and mostly in men. More than likely as a result of this distrust, there was a tuberculosis outbreak in Marion, Alabama in 2014.
Unethical studies, such as the Tuskegee Syphilis Experiment and the Guatemala Syphilis Studies, have greatly impacted both science and society today. From new ethical standards required and reviewed for scientific research to a culture of distrust, these studies still affect us today. These were horrific historical events in science that have led to current change in bioethics.
Help Received: Tuskegee Syphilis Experiment video from class, class discussion, Guatemala experiment article (Matthew Walter) from Canvas, Knowledge of the Tuskegee Study and its Impact on the Willingness to Participate in Medical Research Studies article on Canvas, In Rural Alabama, a Longtime Mistrust of Medicine Fuels a Tuberculosis Outbreak article from Canvas, Did Infamous Tuskegee Study Cause Lasting Mistrust of Doctors Among Blacks article from Canvas, http://media.urbantabloid.com/wp-content/uploads/2014/11/The-Tuskegee-Syphilis-Experiment.jpg for image 1, https://allthatsinteresting.com/wordpress/wp-content/uploads/2017/10/human-experiments-guatemala-lineup.jpg for image 2, Spellcheck