With the study of syphilis and other infectious diseases also comes the rise of studying ethical issues that may occur when studying infectious diseases. Ethical issues such as the disclosure of information and privacy issues, the protection and study of humans and animals with the infectious disease, and the administration of cures and vaccines when available. Additionally, gaining informed consent and the responsibility of the experimenters to supply aid to the local population are other ethical issues that must be addressed (Grady et al., 2001). An example of a study that failed to tend to ethical issues such as the aforementioned is The Tuskegee Study of Untreated Syphilis in the African American Male. The Tuskegee study failed to obtain informed consent, used black physicians local to Tuskegee to lure local, black participants to conduct the experiment, used poor, uneducated, vulnerable black participants, failed to educate the participants about the infectious disease, and failed to treat many of the participants, despite having the cure- penicillin- before the end of the experiment (Stephen & Sandra, 1991). Instead, the study deceived participants by giving them “treatments” that were actually spinal taps to receive more samples on the effects of syphilis. Furthermore, experimenters never educated the participants of the infectious disease they had, instead calling it “bad blood” as a term to replace syphilis and further deceive participants of the truth. The target sample population of Macon County, Alabama provided an uneducated population that ensured participants would not understand many of the necessary rights they had nor the treatments they should have received. Using black physicians helped recruit black participants who were disadvantaged, and the few benefits offered enticement to the poor population (Heintzelman, 2003). The Tuskegee study was rationalized because of precious studies regarding syphilis in black populations in 1928 and demonstration projects from 1929 to 1931 in Virginia, Georgia, North Carolina, Alabama, and Tennessee. Additionally, the scientific inquiry for cardiovascular and neurological effects of syphilis on blacks was large after the contrary findings of syphilis on whites from Dr. Bruusgaard in 1929. Conflict among findings, as well as the reduction in resources placed Macon County as the primary study population with limited resources to conduct the experiment (Stephen & Sandra, 1991).
The effects of this study, as well as other studies such as the Guatemala syphilis study, resonate deeply among target populations and the scientific community. Studies such as these have lasting effects on the trust of certain populations and races in local and state governments, as well as local effects on families, social and cultural relationships, and the health of states and communities. During the Guatemala study, patients were demanded to have sex with infected men and women. Sex workers were employed to commit egregious acts with inmates, soldiers, and civilians, while scientists knew the effects and encouraged the spread of the infectious disease among the community. Syphilis was spread to hundreds of Guatemalans and continues to spread today and infect children and grandchildren (Walter, 2012). Poor, uneducated populations are still target to attacks from experimenters. Local populations may not trust hospitals, healthcare, or the government due to these studies. Many blacks in Macon County still do not trust hospitals because of the Tuskegee experiment- which hinders HIV education efforts in Black communities (Stephen & Sandra, 1991). These studies offered devastating effects on local populations and inform us on pertinent ethical issues that must be addressed when dealing with the study of infectious diseases.
References:
Grady, C., Ramjee G., Pape J.W., et al. Ethical and Legal Issues in Infectious Disease Research and Control. Emerging Infectious Diseases. 2001;7(7):534.
Heintzelman, C.A.. The Tuskegee Syphilis Study and Its implications for the 21st Century. Social Worker. 2003: 10(4).
Stephen, B.T. & Sandra, C.G.. The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community. American Journal of Public Health. 1991; 81(11): 1498-1505.
Walter, M.. First, Do Harm. Nature. 2012; 482: 148-152.