Tuskegee syphilis study

Tuskegee syphilis study, U.S. Public Health Service (PHS) study conducted from 1932 to 1972 in Macon county, Alabama, in which hundreds of Black men with syphilis were not adequately informed of their diagnosis and were denied effective treatment. The study became one of the most notorious examples of unethical human-subject research in American history and contributed to major reforms governing medical research and clinical trials.

The project was designed to observe the effects of untreated syphilis. Conducted by the PHS with the cooperation of the Tuskegee Institute (later Tuskegee University), it enrolled 600 Black men, most of them impoverished sharecroppers. Of participants, 399 had syphilis and 201 did not. For those infected, rather than being informed of their condition, participants were told that they suffered from “bad blood,” a local term used to refer to various illnesses. They also were not told that the disease could be transmitted through sexual intercourse.

Treatment was initially part of the study, and some patients were administered arsenic, bismuth, and mercury, which at the time were the most effective agents available to clear infection. But after the original study failed to produce any useful data, it was decided to follow the subjects until their deaths, and all treatment was halted. Even when penicillin, which is effective against the causative bacterium, became available in the mid-1940s, rather than provide the drug and end the experiment, researchers continued observing the men with syphilis and took steps to prevent them from obtaining treatment elsewhere. The study continued for decades as participants suffered serious complications; some died, and wives and children were also infected.

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The study drew national attention in July 1972, when Associated Press reporter Jean Heller exposed its unethical practices in a story published on the front page of the Washington Star. Heller learned of the study through information provided by Peter Buxtun, a former PHS employee who had repeatedly raised ethical objections to the research. Public outrage prompted federal officials to halt the study that year.

Survivors and families of participants filed a class-action lawsuit against the federal government, which resulted in a $10 million settlement in 1974. That same year the U.S. Congress passed the National Research Act, requiring institutional review boards to approve all studies involving human subjects. In 1997 U.S. Pres. Bill Clinton formally apologized to the study’s survivors on behalf of the federal government. (See Sidebar: Presidential Apology for the Study at Tuskegee).

The Tuskegee study remains a landmark case in the history of medical ethics, illustrating the consequences of racism, deception, lack of informed consent, and the failure to protect individuals who participate in medical research.