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Archive 1

Needs clarification

As Prof. Shweder explains, syphilis is not always the raging killer most of us think it is. First of all, it is only in the early stages of the disease, when sores appear on the body, that it is contagious. This was the only stage at which arsenic had any effect at all. After that, syphilis goes into a latent state, in which there are no symptoms, and the patient is not infectious. Untreated syphilis can then go on the tertiary stage and destroy vital organs like the heart and brain—this is what happened to famous victims like Nietzsche—but for perhaps 80 percent of syphilitics, the disease stays latent, as if they never had it. The longer the disease is latent, the longer it is likely to stay that way. It is, in Professor Shweder’s terms, “self-limiting or self-correcting.”

“If untreated, syphilis then lapses into a latent stage during which the disease is no longer contagious and no symptoms are present. Many people who are not treated will suffer no further consequences of the disease.”

It was this latent stage that health authorities wanted to investigate in 1932. Consequently, when they examined 410 syphilitic blacks for possible inclusion in the study, they found many were in the early, infectious stage, and rejected them as candidates. They turned over no fewer than 178 for the standard arsenic treatment, and kept 140 for the study. They then checked up on these men at rather lengthy intervals—in 1938, 1948, 1952, and 1963—giving them full physical examinations, and treating them for any disease other than syphilis.

[http://www.amren.com/news/news04/02/03/tuskegee.html] citing [1] death metal maniac (talk) 13:25, 15 April 2009 (UTC)

Inaccuracy?

The first part claims that the experiment began in 1932. Later on it states that funding was nearly cut off in 1929. Both can't be true. The Oslo study of 1928 is mentioned in the next paragraph, perhaps the bit about the Great Depression is related to it?

It isn't true. The study that lost its funding in 1929 was a separate study called the Rosenwald Study, as it was funded by the Julius Rosenwald Fund. The purpose of this study was to find the prevalence of syphilis in Macon County, and to explore the possibility of mass treatment. Although the funding was cut they managed to report that the rate of syphilis was unusually high in Macon County, specifically in the town of Tuskegee. They also found out that mass treatment is possible. The author of the report on the Rosenwald Study then proposed another study to observe syphilis in untreated black men. He saw Tuskegee as a perfect opportunity because not only was there an unusually high number of syphilis cases, 99 percent of them were untreated. He played it off as a "study in nature" because he felt that, due to nearly all of the cases being untreated, these individuals would never seek treatment, never acknowledging that treatment simply wasn't offered to them in the first place. Thus, the Tuskegee Syphilis Study was born.

The Oslo Study was mentioned because it was a previous study that already showed that syphilis, even in its latent stage, has a 30 percent chance of killing the person infected. And it was also decided that syphilis was transmittable in its latent state. The Oslo study also found that arsenic treatment reduced this risk of further sickness to 5 percent, which includes the toxicity of the arsenic treatment as risk. That is another inaccuracy in the article. There was a therapeutic treatment for syphilis at the time, which despite having its own dangers was considered the best bet at the time. So why was the Tuskegee Study even necessary if we had a treatment, it was found that mass treatment is effective, and we have already studied syphilis in untreated cases? The answer is that the Oslo study was done on white people, and at the time it was believed that black people were biologically different and that syphilis behaves differently in them. This is the case and point of the argument that racism was the foundation of the entire study, and can not be ignored. Clinton even included in his apology that the Tuskegee Study was blatantly racist. The whole article excludes this idea, and the "Study Details" are vague and completely discarded anything that points to racism. —Preceding unsigned comment added by Bcatah11 (talk • contribs) 09:55, 26 March 2009 (UTC)

With respect to:

File:Tuskegeegroup.jpg
Some of the Tuskegee Study Group clinicians. Dr. Reginald D. James (third to right), a black physician involved with public health work in Macon County, was not directly involved in the study. Nurse Rivers is on the left.

the implication is that two of the subjects of the photograph (who happen to be of a particular ethnicity) have legitimate excuses for appearing in the photograph. One can only assume the others are guilty until proven innocent. A more NPOV description of the participants, would be useful. —Preceding unsigned comment added by 24.23.124.21 (talk) 02:55, 15 April 2009 (UTC)

When making changes to this article, one should keep in mind that the Tuskegee Experiment is very often misunderstood. Many believe wrongly that the study involved black men being injected with syphilis. An effort should be made to make it clear to an unfamiliar reader that the men were selected because they already suffered from syphilis.

Also, this experiment has often been interpreted in the context of racism. However, it should be made clear that instead, it exemplifies a breakdown in medical ethics. The men were not selected because of their race, but because they were already suffering from the disease.

Lastly, there should be an effort to clarify that the intent of the project was to study the viability of non-treatment because contemporary treatments were believed to be doing more harm than good. —Preceding unsigned comment added by 194.46.235.5 (talk) 00:22, 4 May 2008 (UTC)

You're right that it exemplifies the breakdown of medical ethics, but racism is the foundation of this breakdown. It is impossible to know whether the men were selected because of their skin color or not, but all participants were black. No whites were selected. The possible reasons are: 1) whites weren't considered or 2) whites in the area didn't have syphilis. In the former case, racism is evident. In the latter case, it is implicit since economic inequality must account for it.
The major ethical breach, however, is continuing the study after 1947 when a humane treatment with penicillin became available. Thus, I must disagree that "there should be an effort to clarify that the intent of the project was to study the viability of non-treatment because contemporary treatments were believed to be doing more harm than good". This may or may not have been the initial intent. After 1947, it could not be the intent. Understanding the disease to publish new articles is one alternative. The research is racist because its victims' lives were not considered valuable- presumably because they were black. Great point that black men were not injected with syphilis. This was my understanding before reading the article, but not anymore. 67.174.107.159 (talk) 08:12, 1 July 2008 (UTC)
How can anyone possibly assert that it was not racism, and they were only selected because they had the disease? Do you think it was just coincidence that they chose only black males? Clearly there was a bias. One of the doctors is quoted in the article saying there was no ethical concern because they were just subjects, and not "sick people". Truly revolting. —Preceding unsigned comment added by 24.108.93.159 (talk) 02:11, 4 July 2008 (UTC)
It can be asserted that it was not racism because in the process of eliminating scientific variables, selecting men of one race would make sense. If the highest local population of men infected with siphilis were black, it would make sense to draw from the largest pool available. Using the logic in the previous post, it could be asserted that sexism was a factor in the selection of scientific subjects -- all the subjects were men. Simply put, this is not the case. Similarly, racism can not be assumed just because all of the subjects were black men. While revolting that the subjects were treated as specimens and not people, racism is not obviously in play here. —Preceding unsigned comment added by 167.244.212.6 (talk) 16:02, 16 July 2008 (UTC)
This is the problem with the segregated society of the time - looking back at it from the relative comfort of our present makes it difficult to realize the racism at play. Yes, by the previous comment logic, sexism would also have been at play, but given the male-oriented nature of the society to that point (women only got the right to vote in the U.S. 12 years before this started), and the white-first mentality of the region (this was still 25 years or so before the Civil Rights Movement was in full swing), it can't be anything but a race-based decision since they didn't view all people as equally viable (i.e., women were "too frail" to be research subjects, and black men were "expendable"). While it's possible that there weren't whites in that area who also had syphilis, it's highly improbable. That said, I don't believe that the researchers, at the start, were willing to let the subjects die - it does seem to be very likely that had their work elicited a cure, they would've administered it to all who were suffering from the disease. The real crime begins when the known cure is announced in 1947 and denied to these people (perhaps there was some misguided pride at play, that they could come up with their own cure which would be better) - whether racism was a deliberate factor at that point is debatable, but the casual racism of the time this started is unavoidable given the society of the time. Starmiter (talk) 20:54, 3 September 2008 (UTC)
This is exactly the logic used by Nazi doctors in their studies using Jews with the claim of "eliminat[ing] scientific variables." I find experiments where treatment of "the other" is inhumane hidden behind such "scientific language" hard to swallow.
Moreover, it is now possible to treat categorical variables that explain differences between latent variables (like race) within the populations, and most current studies collect data across racial groups. Were such methodologies unavailable in the 1930's? If "eliminat[ing] scientific variables" was a major issue here, then how could the researchers generalize outside the black population without either 1.) a fundamental belief that black and non-black biology are essentially equivalent or 2.) the requisite statistics to do the analysis between racial groups? Thus the inclusion of exclusively black men for "scientific reasons" seems somewhat circumspect (by the way, I am a PhD student of biomedical engineering).
On the other hand, some people claim that the study was conducted in Tuskegee was the reason for the inclusion of only black men; this argument does hold credence from a practical standpoint. However, the researchers unethical decisions in continuing this study was essentially made possible by the poor, black communities relative lack of legal recourse (this was before the 1964 Civil Rights Act) and the lower probability (from demographic studies) of having someone associated with the community with enough education to realize possible ethical transgressions. It is no accident that once the demographics and social recourse of this "research pool" began to change, the study was exposed and immediately halted. While the reasoning of experiment ease may not appear racist at first glance, it is a direct exploitation of racial inequalities enforced by our social system. In my opinion, that is an adequate DEFINITION of racism.
Unfortunately, the previous paragraph is an analysis of the climate, and has only cursory relevance to the actual particulars of this case. I guess that the only way to verify the intentions of the researchers would be to go back to the original documents. Unfortunately, since this experiment was a longitudinal study where ethical transgressions did not fully materialize until a number of years after commencement, such historical documentation would most likely take quite a bit of work to compile and collate. If anyone has done such studies, I'd appreciate your comments.Billyziege (talk) 15:44, 16 September 2008 (UTC)

Hey 194.46.235.5, How was your Klan meeting with 167.244.212.6 last night? —Preceding unsigned comment added by 124.78.15.2 (talk) 12:12, 10 June 2009 (UTC)

How is racism obvious simply because the study failed to consider non-blacks? These types of racial criteria abound today, are they all racist? The blacks in that area represented a largely coherent social group that could certainly warent study. Anyways, I agree that their should be a myths section. I came to this page to check and see if my recollection was correct in the face of such claims that the men were purposely infected, and I've seen enough parroting of these claims by jackasses in the media that I would think it notable enough to bear meantion. —Preceding unsigned comment added by 24.29.232.2 (talk) 06:09, 9 October 2009 (UTC)

older entries

Periodically, someone comes by this article and reads it and thinks, without doing any research, "This is terrible, things couldn't have really happened this way, this article must be biased and false."

I thought so myself until I started doing research. The more research I do on this study, the more horrible it looks. If this article is biased, it is probably biased in its mildness of condemning the study and those who kept it going after 1947.

Before you disagree (as some of those below have done), follow up on the references listed at the bottom of the article (especially the CDC web page), or go to the library and do your own research.

The doctors who started this study started with a false hypothesis in mind and with lies to ignorant patients. The study probably should have stopped as soon as they disproved that hypothesis, but instead continued. It should have shifted to testing penicillin when that became available, but did not. The study should definitely have stopped in 1947 when penicillin became widely available and was generally accepted as a cure for syphillis, but did not. Instead, the study was continued, and papers were published from it until the press discovered it and spread the word and congress came down hard and eventually set new laws to prevent this from ever happening again.

This study is a sad event in medical history that has only shaky justification for ever happening, even in the context of the time it started. --ssd 12:26, 29 Apr 2005 (UTC)

Time context

Dear mxpule your work on this article is great but I believe you should have included some more contextual information aout the time this study was done. I do not believe the study initiators planned to do wrong from the beginning. Back then syphilis was a terrible problem. Treatment was expensive, prolonged (a year), toxic and its efficacy unproven. The natural history of the disease was unknown. You should point out that only patients with latent syphilis were recruited for this study. It was not known if they needed treatment. They were by definition asymptomatic. You could argue that it would have been wrong to treat them with Arsenic and bismut. Without the study (up until national eradutcation programmes with penicillin) these subjects would not have got treated. As regards penicillin it is easy retrospectively, but at that point one could have argued it was wrong to give asypmtomatic subjects with a positive antibody to syphilis a new experimental drug - it could have had unknown toxicity etc etc etc. Lying to the patients was clearly wrong but back then if the investigators had gone and said "ok, you have syphilis a sexually transmitted disease blah blah..." how would the community have responded to these doctors? Lying to patients was universal then in the medical profession "doctor knows best". US and UK military experimented on their own service men with nerve gas and radiation. I believe there are probably countless examples of studies equivalent to Tuskegee (though not as prolonged) although this one is infamous because of the race component. In my mind it was not so much race but rather the arrogance of the medical profession and the time AND a class issue. So please mxpule less of the Mengele and Nazi stuff, no appeasement - this study quickly became wrong but put it into the context of the time. nitram

Sure, if one limits it ONLY to the period of the Great Depression and before penicillin, it is only extremely unethical in retrospect (pre-informed consent, etc.) and is only MOSTLY unethical in its own time (come on, medical ethics was not completely foreign an idea). But the fact that it continued so long after the invention of a treatment, and even after the exposure of the sorts of experiments by Mengele and the Nazis, shows both a tremendous lack of ethical boundaries and a tremendous lack of consideration for the patients in question. You cannot bracket it off neatly -- if they had stopped immediately, then we could say, "well, they were just trying to do good, but they didn't have any other options." The fact that they didn't do that at all seems to cast considerable doubt as to how noble their motives were, in my opinion. Anyway -- the Mengele/Nuremberg comparisons are made all the time in the medical literature, so it isn't as if this is an unheard of comparison, though so attribution of quotes would be more ideal for an encyclopedia article (I will try to help with that). In any event, the article is actually significantly low in moralizing, comparatively speaking. --Fastfission 12:33, 26 Apr 2005 (UTC)

I'm really sorry guys but you have absolutely failed to point out the pivotal fact in this whole study - bear with me:

Syphilis was untreatable when the study began. The disease goes from primary to secondary phases to a long latent phase and finally to a terrible tertiary phase where the bacillus infects the brain, eyes, heart, bone marrow etc etc to lead to a slow and terrible death. It was a truly horrible disease regarded with the same loathing as say cancer is today.

As early as 1947, penicillin was standard treatment, was highly effective and essentially now I would say there are very very few physicians in the West who have seen a case of tertiary syphilis. The pivotal point of Tuskegee is that in 1947 the study should have closed. The study participants who had syphilis should have been given penicillin and that would have been the end of it.

Instead the physicians running the study put their own intellectual curiosity of watching the natural history of the disease progress above the lives and well-being of their subjects. To put it another way, the physicians running the study cared so little for the study subjects, who where poor, illiterate and black that they preferred to let them suffer and die so they could get scientific data (that incidentally would be largely useless since syphilis had been cured). mxpule

Syphilis was somewhat treatable when the study began. That's why the study was started in the first place. Also, it was known that the men could pass on the disease to thier wives and children: I'm supporting the idea that the study was unethical when first concieved, although 1947 was indeed a turning point. Also, in Macom county, Syphilis was not neccesariy a veneral disease, it had reached endemic proportions and was being transmitted in other ways. Anybody want me to include more on the health situation in Macom county at the time, I read a primary source about it. (don't have refrence this second)--Notenderwiggin 02:05, 23 February 2006 (UTC)

Inaccurate?

What part of Tuskegee syphilis study did you find factually inaccurate? You didn't list anything in particular on the discussion page. --ssd

See the "spiked-online" article at the bottom for an account of the factual errors in this article. -- VV 03:08, 6 Apr 2004 (UTC)
Which facts in the article do you think are inaccurate? Could you be more specific as to what in the external link contradicts statements in the article? Wmahan. 20:42, 2004 Apr 25 (UTC)

I have now read the "spiked-online" article. It is fairly rambling, but does raise some good points. However, most of the medical references in the article are just wrong, and probably are using 1930's data rather than modern understanding of syphilis. (Mostly, it says that people "self cure". This is wrong. The disease commonly has 10 year dormant phases, and even in those phases causes many symptoms including neurological damage that are difficult to diagnose and recognize.) In addition, there is nothing in the article that disagrees with the wikipedia article. They even admit that medical treatment was withheld, and try to justify it in several ways (several believable to a point). I believe the wikipedia article is fairly balanced in that it fully states all sides of any possible controversy. I am going to remove the "disputed" tag. If you think the article is unbalanced, I suggest you add material to balance it out. --ssd 05:04, 11 May 2004 (UTC)

Well, there are still discrepancies. For instance, the spiked article says there were 140 patients, not 400. Saying they were "allowed" to progress is deceptive in that it implies there was some viable alternative (arsenic treatment not necessarily viable), but in fact those who were treatable were in fact treated and removed from the study. Being "allowed to sicken and die" is particularly emotive and inaccurate in this light. Furthermore, there are neutrality issues, such as failing to mention the study was motivated by a desire to help blacks, among whom syphilis was rampant. I'd like to start rewriting it myself, but I feel I want to be more thoroughly informed before I do. But while it has all these inaccuracies there should be a dispute notice. -- VV 06:30, 11 May 2004 (UTC)
Ahh, finally something substantial to fix! I don't think there is any dispute that the study started with good intentions and with 400 participants. The article here fails to mention how many participants stayed in the study. It did end bad, however. In my mind, the only real controvrsey is if the study was continued after '47 due to incompetance or unethical intentions. I think combinding the first and last paragraphs and adding these details would be well on the way to fixing this article. --ssd 12:53, 11 May 2004 (UTC)
The "spiked" article I consider to be uncredible, as it contains many medical misunderstandings and/or obsolete syphilis data. It is a tertiary or worse source. I have gone to a secondary source and added more accurate material. The study DID include 400 people. Many of them died of syphilis--that's why there's so few left. They were not just allowed to die...they waited for them to die so they could do autopsies on them and look for syphilis damage. The study may have been motovated by beneficial desires, but the study should have stopped after 1947, and instead it was continued, and proper medial treatment was blocked from the involuentary participants whenever possible. Are there any other items in this article you think are disputed, or should I continue doing research and add more material? Next item I would look for would probably be the specific symptoms victims of this study suffered from as a result of their non-treatment. (now added) --ssd 22:19, 11 May 2004 (UTC)
You've clearly done some excellent work on this article. There are parts that still make me uncomfortable, in particular the "allowed to sicken and die" part, which I think should be clarified; perhaps that they were "not provided with treatment by those carrying out the study"? Also, isn't it true that many of them never had any further sickness issues, much less succumbing? Well, in any case, I'll remove the factual notice, since it's so much better and this seems to be one of your goals. -- VV 22:41, 11 May 2004 (UTC)
Actually, Ive only begun to skim the material I found. The more I read it, the more horrible this whole issue sounds. I had previously thought that perhaps the doctors involved just didn't know about syphilis, but it sounds like they did know, and were out to prove it. Patients that they thought had been "asymptomatic" they did autopsies on, and found syphilitic leisions that had been causing much discomfort and illness. Even so, they still prevented others still alive from getting treatment. No, they didn't merely "not provide" treatment. They blocked treatment, and they did watch them sicken and die, if not worse. Yes, many of them died of syphilis while in the study. No, they were not really asymptomatic--perhaps their problems were just not attributed to syphilis. There are many reports as to what exactly the study found, and if you like, I'll try to summarize those. Also, the article on syphilis could use a better list of symptoms. When I find a comprehensive one, I'll update that article for sure. The more I look at this particular study, the worse it looks; I hadn't realized exactly how far from ethical this study had strayed. --ssd 00:32, 12 May 2004 (UTC)
As an update--the CDC page lists quite a few details. Not only were the participants of the study watched, but also they watched the spread of the disease to family members. One perhaps good thing that did come out of the study is a better understanding of exactly how damaging syphilis is. Unfortunately, they should have had plenty enough information about that by 1947. Peers reading the research papers coming out of this study were criticizing the ethics of this study as early as 1936. --ssd 06:33, 22 May 2004 (UTC)

Ironically, much of the medical information in the spiked-online article is directly contradicted by this study's own reports. I don't think the authors of the article have done even cursory research on the actual conclusions of the study. --ssd 00:46, 12 Nov 2004 (UTC)

Sweden's Oslo?

Sweden's Oslo Study? This surely must be a mistake. Oslo is the capital of Norway. Or am I missing something?

You appear to be right. The name there is disruptive to the sentence flow anyway, and does not add any information. All references to the study I can find call it "The Oslo Study". None refer to it as Sweden's Oslo Study or Norway's Oslo Study or even The Oslo Study in Sweden/Norway, so I am going to just remove it. --ssd 15:36, 30 December 2005 (UTC)
          • Sorry, that was my mistake. here's a reference to that study (not the original paper):

Acta Derm Venereol. 1955;35(Suppl 34):3-368; Annex I-LVI. The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material. GJESTLAND T. PMID: 13301322 [PubMed - OLDMEDLINE for Pre1966] I'll try and stick it in User:mxpule 31st Dec 2005.

Spiked online

For reference to this discussion:

Richard A Shweder, "Tuskegee Re-examined," Spiked online (2004).[2]

"removing spiked online reference; it is a POV racisism denial source; if you want it added back, I'll add a list of mistakes in that article"User:ssd.

  • Possibly...except spiked online does tend to write articles like "devil's advocates" just to stir things up - their "style". I don't think spiked is generally considered a racism denial source here in the UK. I would probably include reference in the interest of balanceUser:mxpule 2nd Jan 2006.
  • I share mxpule's impression that spiked's controversial essays tend to be printed in the spirit of provoking critical thought. The author of the article suggested that it was possible that there had been a shortage of critical thinking behind the mainstream interpretation. ssd, please post your list of factual errors in the spiked article, so that we may determine if it makes some salvageable points. Thanks --Niku 05:07, 3 January 2006 (UTC)

I think all the "salvageable points" in the spiked online article were added to the article already, most shortly after the spiked online article reference appeared here. All of the points added were added from secondary (i.e., more accurate) sources. Below is my list of discrepancies between the verified facts in the wikipedia article as of this writing, and the spiked article. --ssd 07:43, 8 January 2006 (UTC)

Thanks ssd. I am working on a detailed reply. In the meanwhile, I added to the references a second publication by Dr. Susan Reverby, a "historian of nursing and medicine and professor of Women's Studies". This one is full text online.[3] It makes some points that are similar to the spiked article, it is also well referenced, and we can perhaps be somewhat confident in its credibility, since it is the 1998 winner of the Award for Excellence in Medical Communication, granted by the American Writers Association. I encourage persons watching this debate to read both the Reverby article and the Spiked article.
  • Spiked implies that there have not been impartial debates. I'll ignore this point, it's just inflamatory, not factual.
  • Spiked says the study was conducted "openly and without secrecy". I think the victims of the study would not agree with that -- they were definately not told.
  • He says "Nobody was given syphilis in the study." I think the 40 wives and 19 children would not agree with that.
  • I will not address the racism issues, as it is indeterminite in my eye if they were exploiting the subjects' race, poverty, or ignorance, or all three. Someone would have to read through the original reports (which I don't have access to) and attempt to read the tone of the reports to see if there was any racisim. However, the discussion of the letter included in the wikipedia article does look pretty racist to me.
  • He states "the vast majority of people who have untreated syphilis either remain asymptomatic all of their lives or else spontaneously recover from the disease." This is blatently false, and early reports in the Tuskegee study itself contradict this statement. They knew it was very wrong after doing the first autopsy in the study. This statement alone tells me that the author has never read (or did not understand) any of the material surrounding the study, including the study's own conclusions. It is difficult for me to read beyond this, as the article has lost all credibility in my eyes at this point. He stresses this incorrect statement several times, and uses this to justify the continuation of the study even after 1947, so nearly all the rest of his conclusions are wrong from this one misunderstanding alone. Nobody spontaneously recovers from syphilis, and it causes chronic painful body wide symptoms for those in the latent stages.
  • He uses Eunice Rivers's support of the study as justification for it. What he does not say is that she was untrained in medicine, or only trained as part of the study, and was duped into believing in it by those running the study. She had no outside training that would give her perspective on the rightness or wrongness of the study.
  • He uses the excuse that "a baseline against which to evaluate the effectiveness of any therapy" was needed. However, by 1947, no such baseline was needed, and the study was never used to test the effectiveness of penicillin, which it should have if this was actually a goal of the study.
  • He talks quite a bit about full disclosure and informed consent not existing at the time of the study. Do you think this justifies the deceptive nature of exhibits like the letter in the wikipedia article?
  • He implies that because some of the victims of the study escaped and got treatment, that the rest were not kept in the dark. My research left me with the impression that the people who got treated had moved out of the area, and were no longer under the control of the study. To be fair, the author claims ignorance on this point.

The only point in the article I will accept is that medical treatment of syphilis was ineffective and dangerous in 1932. This barely justifies the study after 1936, and not at all after 1947.

The tone of the article seems to imply that we over reacted to the study, and that reviews of medical experiments are not needed. I think the history of dangerous studies since 1972 show that this is not the case, and that we do need high standards to prevent exploitation of patients. Even today, there are controversies surrounding under-reporting of deaths in drug tests. This tells me that abuses are continuing, despite the "over reaction" to Tuskegee. --ssd 08:57, 8 January 2006 (UTC)

I agree that the spiked article tone is off - but as I said before this is intentional in that this publication adopts a (Devil's advocate). On the otherhand, the tone of this wikipedia article is completely correct - the study is seen in its historical context. Perhaps readers can understand how a mixture of scientific single-mindedness and racial contempt led to this study going on for so long. It would be too one-dimensional to portray the investigators as Mengele type sadists secretly experimenting away - it wasn more complex than that. Regards to your last comment - as someone who has put an IND through the FDA I belive in the US and EU safeguards are more than adequate to protect patients from investigators. Ethical problems areas now are two fold - (1) Infiltration of FDA and regulatory bodies by big Pharma, lobbyists etc and (2) Dangerous new therapies will inevitably be tried and refined in the developing world e.g. korea, China and South America. user:mxpule Feb 2006.

I agree that current safeguards are sufficent; however, I suspect that a few with weak ethics in the industry and within FDA may not always be following those safeguards as much as they should. There have been too many dangerous drugs put on the market in the US in the last 5-10 years that had to be recalled later. My point is that we can not afford to relax our vigilance on this, and that people who claim the current measures are over reaction or unnecessary are either corrupt themselves or are wearing rose colored glasses and are ignorant of the dangers. --ssd

Not a secret study

The study was not kept secret, as is implied by this article. Seventeen scientific articles were continuously and openly published during the 40-year time period. One article's title read, for example, "The Tuskegee Study of Untreated Syphilis: The Thirtieth Year of Observation." Quite right. It would be nice if someone had time to burn or had this as a part of a thesis or something to include references to these papersuser:mxpule

I wrote a paper on this. I'll try to dig it up. I agree that we need more on the papers, they were published in leading journals --Notenderwiggin 02:06, 23 February 2006 (UTC)

I don't think any attempt was made to keep the study secret from the medical community. It would be interesting to see more references to the papers that were published. The real purpose of the study was, however, largely kept from those participating in it. --ssd 12:54, 10 March 2006 (UTC)

Citations Needed

This is a fine article in many ways. There are a few POV issues here and there but generally its quit good. The biggest drawback is the absence of citations. It's really not sufficient to simply list references at the end. Important statements, claims and especially direct quotations need a footnote. I'm sure the material exists but someone more familiar with it could apply the cites. See WP:CITE. Also, does anyone know what became of the survivors and their families? JodyB 21:20, 16 April 2007 (UTC)

I added references are at the bottom, put there before the citation extension was added. Someone has converted one of them to a citation, but the first reference could be added to other places. Much of the hard information (population numbers, dates, etc.) can be found on the CDC web page if you want to confirm them. I think the aftermath section of the article covers what happened to the study victims and their families adequately. --ssd 22:26, 17 April 2007 (UTC)

For the sentence: "Instead, the Tuskegee scientists continued the study without treating any participants and withholding penicillin and information about it from the patients. In addition, scientists prevented participants from accessing syphilis treatment programs available to others in the area." It says citation needed. I believe I found one: http://www.infoplease.com/ipa/A0762136.html. I obtained that via Snopes: snopes.com » Archived Forums » Medical Archive » Tuskegee Experiment. David Tornheim (talk) 04:16, 7 July 2011 (UTC) 04:16, 7 July 2011 (UTC)

I looked again. It appears the source is already cited later in the article: Bad Blood. I may just add it, since it is properly cited elsewhere.David Tornheim (talk) 04:33, 7 July 2011 (UTC) 04:33, 7 July 2011 (UTC)

Confused

"Dr. Paxton Belcher-Timme, Dr. Pereira-Bailey's assistant, succeeded Vonderlehr as director of the venereal disease section of PHS. Heller's leadership coincided with the years when penicillin was introduced in other PHS clinics as routine treatment for syphilis, and when the Nuremberg Code was formulated (to protect the rights of research subjects). The study was brought to public attention in 1972; Heller defended the ethics of the study."

I'm confused. This is the first reference to "Heller" in the article. What's going on in this paragraph? —Mhari* 21:24, 22 April 2007 (UTC)


Page Move

Admittedly a bold move, but we must be NPOV. The title of the previous page "Tuskegee Syphilis Study" is inaccurate and a whitewash of the shameful history of the P.H.S. (Public Health Service). We need to clean up errors in Wikipedia where we see them, and this was a blaring mistake. --ProtectWomen 00:39, 17 May 2007 (UTC)

I agree with your move including the title and the inclusion of the word "Negro." Historically, that was the name of the study and you (or someone) tagged it appropriately. It was a bold move and I might kindly suggest that you at least let others have some discussion in moving a page. Again, however, I do agree with the move. JodyB talk 01:42, 17 May 2007 (UTC)
Thank you JodyB. This was my first (& hopefully last) page move ever. I'm still wet behind the ears and didn't think about the discussion first. But you are right, I apologize. If there is a next time I will discuss it first. Otherwise this one was a no-brainer. Personally, I find the word "Negro" very offensive, but that's what the true name of the study was- that is the historical context. Perhaps someone had good intentions by censoring this word when they created the article, but Wikipedia is not censored.--ProtectWomen 07:23, 17 May 2007 (UTC)
Not a problem. Its just that communicating keeps down the tension sometimes and as you probably know, there are some folks who just love to fuss! You'll come across other articles that need to be moved and you should be bold. Just keep it in mind. Like you that word is terribly offensive today although what you usually hear is another derivative that is very caustic to most. In the period prior to the 60s, the word in the article was considered appropriate, albeit by the white-set standards of the day, and was often used in scientific journals. In any case, it's an historical record and should be kept. Have a great day! JodyB talk 13:12, 17 May 2007 (UTC)

Article formating

I have eliminated the bolding on the AKA's of the study which appeared in the opening sentence. The Wikipedia MOS guideline suggests bolding for the actual article title only. See this discussion of lead sections. JodyB talk 00:57, 28 May 2007 (UTC)

hmmm, i had the idea that names of redirects into the article should also be bolded, so that readers expecting to reach the 'Foo' page know immediately that they've not reached the 'Bar' page by mistake. Doldrums 08:33, 28 May 2007 (UTC)

Herxheimer reaction

I understand "Miss Evers' Boys" is a fictionalized account of the study, but in the play the doctors withhold Penicillin (at least in part) due to unclear effects of the Herxheimer reaction. This is a real and applicable condition, and if true, this contradicts that the "Tuskegee scientists withheld penicillin and information about penicillin, purely to continue to study how the disease spreads and kills". Could an alternative motive in the early period of the study have been fear of the Herxheimer reaction? Perhaps a further paragraph is in order, upon further research? 152.7.15.87 19:27, 13 September 2007 (UTC)

Fiction has no place whatsoever in this article. However if you can establish verifiable and reliable sourcing for such a theory fine. Be careful to find solid material as original research is not allowed. Also, in the future, please put your comments at the bottom of the page. It helps in reading a chronology. Thanks! --JodyB yak, yak, yak 22:04, 13 September 2007 (UTC)

Something an average reader like me is likely to want to know is:

Was there an attempt to prosecute the doctors and other perpetrators? Was prosecution considered and decided against? (I presume, or hope, that there was some law against it, if not the article should say so if we can find out.) Also, did the medical licensing people in government discipline any of the doctors? Thanks, Rich (talk) 06:43, 8 January 2008 (UTC)

At the time the study was started, there were no laws against what they did. The study was forcibly ended by an act of congress, which was shortly followed by laws that did make such studies illegal. Since our constitution bans retroactive laws, the doctors could not possibly be prosecuted for something that was not illegal (merely unethical) when they did it. Also, I think due to the length of the study, at the end most of the doctors were near retirement anyway, but I"m not sure without checking. --ssd (talk) 23:42, 2 October 2008 (UTC)
I agree with Richard, as an average reader, I also want to know about any other intent of prosecution.
In general laws are not retroactive, but there are several ways to commit a crime like this. One being an active part. For example a murder using a weapon kills his victim. A murder may also kill by omitting to do something to keep alive his victim. For example not feeding a baby until (s)he die. This was a crime by omission of the known treatment aggravated with racism.
Its hard to believe, that kind of crime by omission were not punished by 1932. During the study life laws changed, that implied to stop this crime. It is important to know this issues. This information must be included.

What is the status of laws and regulations today?

Among real scientists it is considered unethical to leave without treatment the control group. Different treatments should be administered to patients, measuring the effectiveness of each treatment. Does anybody knows if it is still considered legal to leave without treatment the control group patients? Although this happened in the USA, it is important to know the status of this kind of laws in other countries like the mentioned in this article.

In now days of genomes era, it is unscientific to classify medical results just by the color of skin. Does anybody knows how is this issue regulated by the government agencies involved in health issues? This is also a subject to include in the article.

Unfortunately, this was just one of many illegal and criminal experiments with humans. All the pages about similar cases should include a list of links to all this kind of experiments along the world.

Footage of apology

Anyone know where I can find some footage of the apology?--Moonlight Mile (talk) 22:42, 14 February 2008 (UTC)

There may be something on the CDC website devoted to the study. I believe it is referenced in the article. --ssd (talk) 23:43, 2 October 2008 (UTC)

Some mention of the apology for the Tuskegee experiment by Bill Clinton should be mentioned here. Also, if applicable, the effects and ramifications, if any, of that apology.--Beezer137 (talk) 06:47, 11 March 2008 (UTC)

Effects on vaccination rates among African-Americans

To this day, I still see lower rates of vaccination in African-American children, and at least on three separate occasions, the parents (all educated and literate) have mentioned the Tuskegee experiment as one of their reasons. Also, one one of these occasions, the family explained that syphilis was injected into unwilling subjects. Of course, this is wrong, but this misunderstanding regarding the Tuskegee experiment is common, and causes further distrust in vaccines. The recent moratorium (2004 or 2005) on vaccines called by Louis Farrakhan for the Nation of Islam is an example of this suspicion which was based, in part, on the Tuskegee experiment. Does anyone know of any study that determines the effect of the Tuskegee experiment on vaccination rates, besides just anecdotal studies?--Beezer137 (talk) 06:47, 11 March 2008 (UTC)

Nice to see Frank Zappa getting the last word.

Almost literally. It's the last section of real text, before "References." I concur that this is a really good and balanced treatment of the issue, but it is slightly quirky. —Preceding unsigned comment added by 75.2.144.110 (talk) 16:17, 30 March 2008 (UTC)

Racism

This article frequently gives the false impression that the Tuskeegee Experiment is an example of racism. Clearly this is not the case. The experiment was a breakdown in medical ethics and moral practices in medical research. The men were left untreated not because they were black, but because the medical researchers wanted to study the disease.

The study wasn't racist? Dr. J.E. Moore, the leading venereal disease doctor in the nation in 1932 wrote in a textbook that syphilis must be treated. This was based on the Oslo Study that yielded the conclusion that syphilis carried severe lifelong effects or was fatal in 30 percent of its cases. He had this to say about the idea of a Tuskegee Study...

... Moore, who had written so persuasively in favor of treating latent syphilis,

suggested that existing knowledge did not apply to Negroes. Although he had called the Oslo Study "a never-to-be-repeated human experiment," he served as an expert consultant to the Tuskegee Study 6 "I think that such a study as you have contemplated would be of immense value. It will be necessary of course in the consideration of the results to evaluate the special factors introduced by a selection of the material from negro males. Syphilis in the negro is in

many respects almost a different disease from syphilis in the white."

[1] —Preceding unsigned comment added by Bcatah11 (talk • contribs) 10:15, 26 March 2009 (UTC)

The article should be edited to remove the false charges of racism in order to clarify the issues surrounding this incident.

One example is the paragrapgh that states: "Infamous examples of real racism in the past such as Tuskegee Syphilis Study (1932-1972) have injured the level of trust in the black community towards public health efforts." —Preceding unsigned comment added by 194.46.175.124 (talk) 00:59, 27 April 2008 (UTC)

I do not think the charges are false. It would be very easy to prove that there were no racist intentions If someone could show the same study done on White men or that any white men were included in this study. The fact that this is not an illness found only in blacks( no matter how wide spread the claims) but one contracted by all races, yet only blacks were studied in this manner leads many to believe racism did play a part. To prove that racism had nothing at all to do with why these African American men were used as "lab rats" you would have to prove this was a normal happenening by including examples of the same or similar study done on Whites by this same or any other government sanctioned group19:27, 15 May 2008 (UTC)~~.!Sandipanda (talk) 19:00, 15 May 2008 (UTC)
Sandipanda, I don't think that is necessary. Just look where the study took place: Tuskegee, Alabama, which even today is still 95% African-American. And according to another part of the article, the Tuskegee Institute participated and loaned medical facilities for the study. And, it has also been reported that African Americans today still have the highest STD rates[2].
It seems logical to me that if I were doing a study today in Tuskegee using 400 people, at least 380 of them would be black. And considering it was started in the 1930s when there was a huge economic gap between blacks and whites, there was a much greater chance that a poor black person would have syphilis than a rich white person. CH52584 (talk) 13:16, 3 June 2008 (UTC)

The study could have been done anywhere in the world. The organisers entitled it "Negro Male" and chose to locate it in Alabama for reasons that scholars and politicians can debate. As long as reliable sources address the racism charges in a meaningful and substantial way (pro or con) then it can remain in. --Hroðulf (or Hrothulf) (Talk) 10:03, 27 September 2008 (UTC)

As I said above, it is unclear if the study exploited racism or illiteracy. Personally, I see either as equally bad. If by "anywhere in the world" you mean "anywhere an illiterate minority population existed" I agree. If you mean "it could have happened in a rich white neighborhood with a high literacy level" I'd have to disagree. It didn't happen anywhere in the world. It happened where it did. Attempts to claim this study is not racist is just attempts at denial. There is no evidence there was no racism, and quite a bit of evidence there was. --ssd (talk) 23:49, 2 October 2008 (UTC)
Remember, what appears in the article is not supposed to be our opinions, but third-party reliable scholarly/journalistic sources. I think there have been analysts/scholars/commentators who have addressed racial issues of the study and how it was run. It is difficult to know all the factors at the time, but continuation past 1947 appears to be the most damning aspect in terms of overall medical ethics.--Parkwells (talk) 16:44, 17 March 2009 (UTC)
It is a racist experiment. Even for the time in which it was conceived - It is always easy to recruit poor illiterate people, and no-one cares about them - in the lines of "at least they are being useful, once in their life" or "yah, I know it's unethical, but it's for the advancement of science and the health of mankind"... Maybe the experiment could have gone on longer if the subject were Native Americans. It would not have gone on after 1945 if the subject was the Jewish Male. Maybe the experiment was not conceived outright as a "racist" one, but at least some time after 1950 it should be clear that the experiment has to be aborted - all the premises under which the experiment started were not valid, the disease became curable etc. etc. Instead, to satisfy some weird scientific curiosity, the researchers - hiding behind some pretext - decided to go on. Remember "The road to Auschwitz was paved with indifference." 80.38.94.139 (talk) 13:21, 14 July 2009 (UTC)CH (July 14, 2009)


  • I do not agree with the interpretation that it only became unethical in 47. It was unethical from the start, since it was known roughly what the late effects would be, and it was certainly known to be sexually transmissible, and there was a fairly effective though unpleasant therapeutic option. Enough people avoided the therapy that it would have been possible at the start--but not after 47-- to recruit a group of people who would agree to a study where they all got rewards, but only half got medicine. But this too would have been unethical also, give the sexual transmission. A real ethical question, if you nowadays wanted to do such a study, and you could enforce condom usage, and you used educated informed people, and could give a reward so high that people not living in dire poverty would do it & then would it be ethical. ? DGG (talk) 19:24, 6 August 2009 (UTC)

References

  1. ^ http://www.sociology101.net/readings/Racism-And-Research.pdf
  2. ^ http://www.wrongdiagnosis.com/news/blacks_still_face_highest_prevalence_of_std_s.htm

Question

I'm totally new at posting, so please forgive me if I'm posting in the wrong spot (and let me know what's preferable). I read the comments & didn't see this, but I apologize if it's already been mentioned.

My question is about the statement early on that most of the men in the study were illiterate. Later in the article, you quote one doctor praising another doctor's ability to frame things in letters to the study subjects. Later still, you mention the flyers mailed to those participants advertising the spinal tap.

Maybe a word or two resolving this would help (or qualifying the idea of what's meant by "illiterate" here, whether it refers to low-level literacy, etc). A word or two qualifying it would make the references to written communication feel less of a contradiction (slight, but distracting).


I was curious also if anyone knows more about how access to treatment was prevented. How did they prevent these men from joining the military or receiving treatment? Did they use intimidation, threaten legal consequences, etc? I was curious if someone knows more about the techniques used to control these people and their access to treatment for so long. —Preceding unsigned comment added by Granitebiceps (talk • contribs) 16:59, 11 August 2009 (UTC)

Article title

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was move. Jafeluv (talk) 01:54, 29 August 2009 (UTC)

Tuskegee Study of Untreated Syphilis in the Negro Male → Tuskegee syphilis experiment — The current title seems unnecessarily long and specific. I see above (on the talk page) that a move occurred from a simpler title a while ago, the rationale being that "...we must be NPOV. The title ... 'Tuskegee Syphilis Study' is inaccurate and a whitewash of the shameful history of the P.H.S. (Public Health Service). We need to clean up errors in Wikipedia where we see them, and this was a blaring mistake."

I don't think the new title creates any more sense of moral outrage than the old, even if that were a valid motivation for renaming an article. I think the truly NPOV thing to do would be to refer to the incident as it is generally known to the public and in the media, such as "Tuskegee syphilis experiment", and to disregard the compulsion to craft a title that evokes a desired emotion. Equazcion (talk) 00:56, 22 August 2009 (UTC)

  • Support — setting aside the argument that the current title is hardly neutral (which should be obvious from the "whitewash" comment that was quoted), the shorter version is also more common and so WP:UCN applies.
    — Ω (talk) 01:57, 23 August 2009 (UTC)
The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

I'm Mentioned In This Article. How Does One Make Simple Corrections To MY Story?

Dear Sirs & Mmes,

Yes, I was "the whistle blower Of Tuskegee." Yes, my pal [redacted] tried to be heard within CDC.

No, I didn't "...finally go to the press in 1970." FOR GOD'S SAKE, I HAD BEEN BOTHERING THE PRESS FOR YEARS! I also bothered senior "Lights of the Law" in my law school, and told the story to everyone who would listen - countless times. I specifically tried to tell the story to San Francisco Chronicle reporters at a social event. One of them said: "Hey pal, don't bother us on our time off. We deal with news all day!" He spurned a Pulitzer Prize nomination for "Investigative Reporting," which later went to the wrong reporter!

The nomination was wasted, because (my friend [redacted] - now Senior AP Reporter at the UN) was the first media person who listened. Unfortunately, her editor said: "Great story, but you're too junior to write it. Send Buxtun's material to any senior reporter you want." Edith ("Edie") sent it to Jean Heller. When the Pulitzer committee heard that, they gave the award to someone else.

Nor did that end my involvement. Among other things, I was present in the East Room of the White House when President Clinton made the historic apology for the study. I think I was the only non-governmental, non-media Republican there.

To the point. HOW do I send YOU material that you MAY use to supplement this and other Wiki articles about Tuskegee? I LIKE Wikipedia and use it every day.

Regards, [redacted] , Annoyed in San Francisco

P.S. HOW DOES ONE ENLARGE THIS TINY, MISERABLE TYPE ON YOUR PAGE? 63.193.244.111 (talk) 09:54, 31 August 2009 (UTC)

Hi, and welcome to Wikipedia. I'll answer assuming you are who you say you are, even though I don't know of any way to verify that, and your IP address shows your location to be Texas rather than San Fransisco (though that doesn't necessarily mean anything). Before I get started I just want to say you shouldn't post personal contact information here, as this page is viewable by anyone with an Internet connection, and you never know who might contact you, and for what purposes.
There are several Wikipedia policies that apply to this situation. One of those is WP:Conflict of interest. It's generally not a good idea to edit an article that talks about you by name, especially when your goal is to increase mention of yourself. Just how prominent a particular figure is to an event is something best left up to other editors, for the purposes of objectivity.
Next there is WP:Verifiability. While one might think a witness to an event is a source we can use directly in order to add information to an article and make it more accurate, that unfortunately isn't the case. Wikipedia's facts need to come from reliable published sources. A description of Wikipedia's standards for sourcing can be found at WP:Reliable sources.
I sympathize with your situation. It must be hard to look at article about an event you were personally involved in and see inaccuracies, particularly regarding your own involvement in that event. If you see such misinformation, it's possible the text of the article doesn't accurately reflect the source material. You can check this yourself by looking at the footnotes of the article, under the "References" and "External links" sections. If you find inconsistencies, report them here so that editors can help correct them.
The other thing you can do is bring new sources to the article. Again check WP:Reliable sources for Wikipedia's sourcing standards, and if there's a good source of information that we missed and that would help improve the accuracy of the article, by all means bring it to our attention here.
I hope I've adequately addressed your concerns. If you have any more, please don't hesitate to post here again. Oh, and the best way to enlarge the type on this page is to go to the "View" menu in your web browser and change the "Zoom" setting. :) Equazcion (talk) 10:22, 31 August 2009 (UTC)
To clarify slightly, any new information you wish to add (or wish others to add) needs to be based on published reliable sources (eg newspapers or books) - it can't just be your own experience written here. So point us to new sources we can look at and tell us what you'd like to add from those. Rd232 talk 10:50, 31 August 2009 (UTC)
PS The tiny text size happens when you start a paragraph with a space. This has been fixed for you. Rd232 talk 10:52, 31 August 2009 (UTC)

Redaction

The writer of the above text provided Wikipedia with full name and contact details. These gave rise to concerns by some users and have therefore been removed with the "oversight tool" for privacy purposes and redacted as appropriate. If the author wishes his identity to be "on permanent record" at this page for any reason I probably won't do the same a second time, but the identity isn't likely to be salient to the argument so it doesn't do much to post it either. Regards either way.

You ask: "To the point. HOW do I send YOU material that you MAY use to supplement this and other Wiki articles about Tuskegee? I LIKE Wikipedia and use it every day."

If you wish to put material on record here for any reason, feel free. But consider whether it needs your name and contact details to do so. Usually material should be cited from a "reliable source" such as a paper, book or journal; a person's own words are not usually reliable for reference material purposes, except possibly as their own statements in their own words (eg "Person X says Y").

If you do for any reason have information that's missing or important, and you feel is needed for the integrity of the article, and isn't included, I would suggest opening a brief dialog with experienced users to ask whether there's a way to verify your details they would accept, and take your own view into account as a significant view in the matter. But usually it just isn't, otherwise if we relied on hearsay not published details we'd be inundated by personal claims and views across the board and our quality would plummet.

Likewise if you have corrections, try to find "reliable sources" that show the correction, as claims unsubstantiated except by word of mouth aren't really reference quality as a norm, either (sorry!).

A good contact to speak to if discussion here doesn't help, is the OTRS team, for guidance, they often deal with similar issues and may have ideas what you can do too, although ultimately it's down to editors here.

I hope this helps somewhat. FT2 (Talk | email) 11:46, 31 August 2009 (UTC)

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