What Is The Tuskegee Syphilis Study?

Museum, Tuskegee Institute National Historic Site
Museum, Tuskegee Institute National Historic Site, Tuskegee University, Tuskegee, Alabama, USA. Panoramic Images/Getty Images

Question: What Is The Tuskegee Syphilis Study or The Tuskegee Incident?

Answer: A shameful moment in U.S. scientific history. 

The Tuskegee Incident  is more correctly known as the "Tuskegee Study of Untreated Syphilis in the Negro Male." It was designed to investigate the long-term side effects of untreated syphilis. It followed a group of 600 poor African-American men in Alabama,. Of those men, 399  had tested positive for syphilis and the rest did not.

The group of men were followed for over 40 years.

When the cohort study first began, there was no treatment for syphilis. But even when one was developed, it was not provided to participants. In fact, in the course of the study, scientists actively denied treatment to these men.. This had devastating effects on the health of not only the men but their families. This is why the study is best known as "The Tuskegee Incident." It was one of the most blatant examples of violation of scientific ethics seen in the United States in the last century.

The study had reasonable goals. Researchers wanted to understand the effects of untreated syphilis on whole body health. The problem is that the study was performed in an ethically unjustifiable way. For almost 30 years after penicillin became the accepted treatment for syphilis in 1945, the men in the Tuskegee study were actively denied treatment. Worse, treatment was not only denied by the study doctors.

It was also denied by physicians in their own communities who had been requested to withhold treatment from the study participants. The request was made so that scientists could continue to follow the course of the disease. Why the request was followed.... Perhaps the doctors didn't feel they had another choice.

 

The study started in 1932 and was ended in 1972. In 1974, the men involved in the study won a class-action lawsuit against the government that gave them lifetime health care benefits. However, it was not until 1997 that these men and their families received a formal apology. That apology came from now former President Clinton on behalf of the nation.

One of the results of the Tuskegee incident is that many African Americans are now understandably reluctant to participate in research studies. There is still a great deal of lingering mistrust of the scientific and medical communities. In fact, some people believe this is one reason why African American communities have lower overall engagement with healthcare systems. This contributes to widely recognized health disparities and poor health outcomes in these communities. 

Unfortunately, to fix these issues requires rebuilding trust. That's something not easily done. There remains a legacy of racism in the United States that is difficult to overcome.

The Black Lives Matter movement may be focused on police brutality. However, the slogan could be used to advocate within medical communities as well. It has been shown time and time again. Black lives are not treated the same way by doctors as White Lives. The shame of Tuskegee can not be overcome until that changes. All people deserve evidence based, high quality medical care. Their treatment should not vary based on the color of their skin. 

Sources:

Brandon DT, Isaac LA, LaVeist TA. The legacy of Tuskegee and trust in medical  care: is Tuskegee responsible for race differences in mistrust of medical care? J Natl Med Assoc. 2005 Jul;97(7):951-6.

Mays VM. The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton's Apology. Ethics Behav. 2012 Nov 1;22(6):411-418.

Rencher WC, Wolf LE. Redressing past wrongs: changing the common rule to increase minority voices in research. Am J Public Health. 2013 Dec;103(12):2136-40. doi: 10.2105/AJPH.2013.301356. 

U.S. Public Health Service Syphilis Study at Tuskegee. Accessed at http://www.cdc.gov/nchstp/od/tuskegee/index.html on 5/28/07.

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