Tuskegee Experiment

Tuskegee “Experiment” is a well known, ugly and appallingly long chapter in the American history. For 40 years,The US. government medical researchers followed the effects of syphilis in more than 600 black Alabamians, without ever treating them or providing them with adequate medical information.

Now we learn of another medical “experiment”  one involving, incredibly, the same government researcher that was if possible even worse: Almost 700 men and women in a Guatemala mental hospital was deliberately infected with syphilis or gonorrhea between 1946 and 1948, in a study of possible preventive effects in penicillin. The tests produced no useful conclusions, and were hidden away.

The project was funded by the National Institutes of Health and led by Dr. John Cutler, who at the time was still involved in the Tuskegee study who lasted from 1932 until 1972. Susan Reverby, a historian at Wellesley College, discovered the records of the Guatemala project while studying Cutler’s papers on Tuskegee.

Indication that such a vulnerable population was abused so badly by the name of science prompted Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sibelius to issue a statement expressing outrage “that such reprehensible research could have occurred under the guise of public health.” A personal apology from US.President Barack Obama to Guatemalan President Alvaro Colom followed shortly thereafter.

Reverby’s research uncovered evidence that the NIH had permission from Guatemalan officials to do a study, but did not inform the subjects  a detail that has no bearing on the moral responsibility of the U.S. government for such a loathsome project.

Dr.John C. Cutler (The US researcher) whose horrific experiments in sexually transmitted disease syphilis in Guatemala in 1946-48 became public on Friday had also worked on a related assignment in India. Just a year after forced to wind down the Guatemala experiment, Dr John Cutler led a World Health Organization (WHO) programme in India.

Pradesh, to check the efficacy of newly found wonder drug penicillin en masse treatment of syphilis. He published the findings of the Himachal programme  conducted in Ghund, 45 kilometers from Shimla in a report in 1951 titled Mass treatment of Syphilis in an Indian province.

However, it's a report , Dr.cutler never published that has brought him the kind of infamy usually reserved for the ruthless doctors and researchers of Nazi-run concentration camps. Cutler died in February 2003.

Prof.Susan M Reverby, from Wembley College discovered the unpublished papers recently setting off events ending with the US apologizing to Guatemala on Friday.

US.President Barack Obama called  to Alvaro Colom to (Guatemala's president )“ express his deep regrets and ... extend an apology to all those affected”.

In an experiment funded by US health authorities, Dr.Cutler's team infected inmates of a state-run prison and mentally ill patients in Guatemala with syphilis and other sexually transmitted diseases.

“The purpose of the study was to test the effectiveness of penicillin, which was relatively new at the time,” said Francis Collins, director, National Institutes of Health.

Prof.Susan Reverby stumbled upon Cutler's Guatemala's experiment while writing a book on a project in which African - American men suffering from syphilis were monitored by health authorities over 40 years, but never treated. Dr.Cutler was involved in this study.

Himachal project started a year after Guatemala was wound down by  Dr.John Cutler's public health bosses. The Himachal project was tame in comparison. It was based on voluntary participation rustled up through district officials and propaganda work and there was no use of force or deception at any stage.

Only, the intention was never to cure individuals suffering from syphilis in that area, chosen for the high incidence of the disease there, but to control the illness “to reduce the reservoir and transmission”.

Every willing Syphilis positive individual was given one shot of moderate dose penicillin — just one, in contrast to one shot every day for a week as was then prescribed in richer countries such as the US. “The dosage used was low,” Dr.Cutler admitted in his report, adding, 

“but it must be remembered that programmes for other countries with particular problems, 

Republic of Guatemala issued a polite request for full disclosure on how United States scientists deliberately infected hundreds of people here with sexually transmitted diseases from 1946-1948.

"All of the data has been requested officially, but it is still at the university where they found the archives," President Alvaro Colom said of the cases of 1,500 Guatemalans, who were used unwittingly in test that some locals have likened to Nazi's experiments.

In a phone talk with Guatemala President  on Friday, US President Barack Obama expressed his deep regret for the experiment conducted by US public health researchers six decades ago and apologized "to all those affected."

The study, which was never published, came to light this year after Wellesley College Prof.Susan Reverby stumbled upon archived documents outlining the 1940s experiment led by controversial US public health DR.John Cutler.

His fellow researchers enrolled people in Guatemala, including mental patients, for the study, which aimed to find out if penicillin, relatively new in the 1940s, could be used to prevent sexually transmitted diseases.

Dr.John Cutler, was also involved in a highly disputed study known as the TuskegeeExperiment in which hundreds of African American men with syphilis were observed but given no treatment for 40 years, between 1932 and 1972.

Guatemala President, who has formed a panel to investigate, said it was "important for Guatemala as a nation to get the investigation done as soon as possible."

At least one client died during the experiments, while it is not clear whether the death was from the tests or from an underlying medical problem.

A Wellesley College historian discovered the U.S. government-funded experiment that ran from 1946 to 1948. Apparently, it aimed to test whether penicillin, then relatively new, could prevent infection with sexually transmitted diseases. The study came up with no useful information and was hidden for decades.

 

Dr. John Cutler, a government researcher which led the Guatemala project, also was involved in the infamous Tuskegee experiment, in which from 1932 to 1972 scientists tracked 600 black men in Alabama, who unknowingly had syphilis and the scientists did not offer them treatment.

"We are outraged that such reprehensible research could have occurred under the guise of public health," Secretary of State Hillary Rodham Clinton and Health and Human Services Secretary Kathleen Sebelius said of the Guatemalan project.

The white house spokesman Robert Gibbs said President Barack Obama plans to call Guatemalan president Alvaro Colon.

Strict regulations today make clear that it is unethical to experiment on people without their consent. However, such regulations didn't exist in the 1940s. Forty similar deliberate-infection studies were conducted in the United States during that period, Collins said.

With Guatemala's permission, 696 men and women were exposed to syphilis or gonorrhea from prostitutes or deliberate inoculation, Wellesley College medical historian Susan Reverby reported. It's not clear. How many were infected or treated with penicillin successfully?

Every uncovered Cutler's records while researching the Tuskegee experiment for a book.

U.S. government ordered two independent investigations.

The United States issued an unusual apology yesterday to Guatemala for conducting experiments in the 1940s in which doctors infected prisoners and mentally ill patients with syphilis and other sexually transmitted diseases.

US.President Barack Obama apologised in a telephone call to Guatemalan President Alvaro Colom. ''This is tragic and the United States by all means apologises to all those who were impacted by this,'' White House press secretary Robert Gibbs said.

The experiments, conducted by a doctor who was later involved in the infamous Tuskegee syphilis study in Alabama, involved 696 men and women who were drafted into studies aimed at determining the effectiveness of penicillin.

''The sexually transmitted disease inoculation study conducted from 1946 to 1948 in Guatemala was clearly unethical,'' Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius said in a joint statement.

''Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health.''

Susan Reverby, a professor at Wellesley College in Massachusetts, discovered the experiment while investigating the Tuskegee experiment. In the experiment, perhaps the most notorious medical experiment in US history, hundreds of African-American men with syphilis were left untreated in order to study the disease for 40 years.

Prof. Susan Reverby  was reading papers in archives from Dr.John Cutler, a doctor with the federal government's Public Health Service who would later be involved in the Tuskegee experiment. The documents detailed the Guatemalan studies.

''I almost fell out of my chair when I started reading this,'' Professor Reverby said. ''Can you imagine? I couldn't believe it.''

The study was sponsored by the Public Health Service, the National Institutes of Health and the Pan American Health Sanitary Bureau (now the World Health Organisation's Pan American Health Organisation) and the Guatemalan government.

It came when doctors were trying to assess whether giving men penicillin right after sex would prevent infections.

Dr.John Cutler and colleagues decided to study men in Guatemalan prisons because prisoners in that country were allowed to have sexual visits. ''The doctors used prostitutes with the disease to pass it to the prisoners,'' Professor Reverby wrote in a synopsis of the experiments.

Because so few men were getting infected, the researchers then attempted ''direct inoculations made from syphilis bacteria poured into the men's penises and on forearms and faces that were slightly abraded, or in a few cases through spinal punctures'', Professor Reverby wrote.

They conducted similar experiments involving gonorrhoea, and on soldiers and on men and women in the National Mental Health Hospital.

Thomas Parran, then US surgeon general, clearly knew the experiment was unethical, Professor Reverby said.

''You know, we couldn't do such an experiment in this country,'' he said, according to her synopsis.

President Barack Obama issued a public apology to the country of Guatemala. The apology was delivered to Guatemalan President Alvaro Colom and hundreds of Guatemalan citizens for research experiments that had been conducted by American health officials during the 1940s.

During the time period,The US health officials had claimed to be testing remedies for diseases on the Guatemalan control group. Instead, however, the medical officials were actually infecting sex trade workers with sexually transmitted diseases first before convincing them to have unprotected sex with prison inmates. The doctors later used penicillin on the patients in varying doses to test for the effectiveness of the drug against diseases.

Chief medical researcher for the experiment, Dr.John Cutler, had also played a key role in the Tuskegee experiment in the US, a similar drug effectiveness experiment that took place in Tuskegee, Alabama a few short years before. In the Tuskegee experiment, men with symptoms of fatigue as well as those already infected with syphilis came forward for expected treatment. The men were all African-American and were baited with promises of 

“special medical treatment” that included free medical exams, free meals, and free burial. 

Tuskegee experiment continued until 1972, nearly thirty years after it had been publicly published and announced that penicillin was the new standard treatment for syphilis. Those participating in the Tuskegee experiment who weren’t previously aware of having the disease were never told. They were also never treated for the sometimes fatal disease.

The US has since monetarily compensated surviving family members of the Tuskegee experiment.

President Barrack Obama offered “profound apologies” while Secretary of State Hillary Clinton called the act against Guatemala, “reprehensible”.

The US. President Barack Obama personally apologised on Friday to his Guatemalan counterpart for a US-led study conducted in the 1940s, in which hundreds of people in  Latin American state were deliberately infected with sexually-transmitted diseases.

In a phone conversation with Guatemalan President "Alvaro Colom", The Predsident expressed his deep regret for the experiment conducted by US public health researchers in Guatemala between 1946 and 1948, and apologised "to all those affected".

Barack Obama also vowed that all human medical studies conducted today will be held to exacting US and international legal and ethical standards.

"This is shocking, it's tragic, it's reprehensible," White House spokesman Robert Gibbs told reporters, adding to apologies and outrage voiced by the president, Secretary of State Hillary Clinton, Health Secretary Kathleen Sebelius and other US officials.

In an impromptu news conference in Guatemala on Friday, Colom denounced the study as "a crime against humanity", and said he had learned of the gruesome years-long experiment in the phone call from Clinton.

Hilary Clinton had phoned Colom on Thursday to express her personal outrage and deep regret over the "reprehensible research".

"What happened all those years ago is a crime against humanity and the government reserves the right to lodge a formal legal complaint over it," Colom said.

But almost immediately, he backed off his tough talk, saying: "We are aware that this is not the policy of the United States... this happened so long ago."

Clinton and Sebelius said in a joint statement on Friday that the study was "clearly unethical" and apologised to all those who had been affected by it.

Francis Collins, director of the National Institutes of Health (NIH), the US government body that funded the study, called it "deeply disturbing" and "an appalling example in a dark chapter in the history of medicine".

Senator Robert Menendez, a member of the congressional Hispanic caucus, called the experiments in Guatemala one of the "darkest moments" in US history.

"No innocent fellow human should be treated as a lab rat, no matter your nationality," Menendez said.

The study, which was never published, came to light this year after Wellesley College professor Susan Reverby stumbled upon archived documents outlining the 1940s experiment led by controversial US public health doctor John Cutler.

Cutler and his fellow researchers enrolled people in Guatemala, including mental patients, for the study, which aimed to find out if penicillin, relatively new in the 1940s, could be used to prevent sexually transmitted diseases.

"There is no evidence study participants gave informed consent, and in fact... the subjects were often deceived about what was being done to them," Collins told reporters as he outlined the experiment's most flagrant ethics violations.

The US doctor behind the Guatemala study, Cutler, was also involved in a highly controversial study known as the Tuskegee Experiment in which hundreds of African American men with late-stage syphilis were observed given no remedial treatment for 40 years, between 1932 and 1972.

Initially, the researchers infected female commercial sex workers with gonorrhea or syphilis, and then allowed them to have unprotected sex with soldiers or prison inmates.

"When few of these men became infected, the research approach changed to direct inoculation of soldiers, prisoners and mental hospital patients," background documents on the study show.

A total of some 1500 people took part in the study. At least one patient died during the experiments, although it is not clear whether the death was from the tests or from an underlying medical problem.

The US surgeon general in the 1940s, Thomas Parran, appeared to have been aware of the experiment, as were "components" of the Guatemalan government at the time, said Collins.

The Pan American Health Organisation, whose predecessor, the Pan American Sanitary Bureau, received grant money from the NIH for the study, expressed its "deep regrets for past ethics violations" and vowed to cooperate with investigators as they dig out specifics of the study.

Independent experts under the umbrella of the US Institute of Medicine will conduct a fact-finding probe of the Guatemala study, and the US Presidential Commission for the Study of Bioethical Issues will convene international experts to review standards surrounding human medical research, Collins said.