Editing Syphilis (section)

===Tuskegee and Guatemala studies===
{{see also|Tuskegee syphilis experiment|Guatemala syphilis experiment}}
[[File:Stop syphilis LCCN98509573.jpg|thumb|left|A [[Work Projects Administration]] poster about syphilis c. 1940|alt=]]
The "Tuskegee Study of Untreated Syphilis in the Negro Male" was an infamous, unethical and racist [[clinical study]] conducted between 1932 and 1972 by the [[U.S. Public Health Service]].<ref name=Brandt>{{cite journal |last=Brandt |first=Allan M. |title=Racism and Research: The Case of the Tuskegee Syphilis Study |url=http://nrs.harvard.edu/urn-3:HUL.InstRepos:3372911 |url-status=live |journal=The Hastings Center Report |volume=8 |issue=6 |pages=21–29 |date=December 1978 |access-date=9 December 2020 |jstor=3561468 |pmid=721302 |doi=10.2307/3561468 |s2cid=215820823 |archive-url=https://web.archive.org/web/20210118011339/https://dash.harvard.edu/handle/1/3372911 |archive-date=18 January 2021|url-access=subscription }}</ref><ref name="timeline">{{cite web |url=https://www.cdc.gov/tuskegee/timeline.htm |title=Tuskegee Study – Timeline |work=NCHHSTP |publisher=CDC |date=25 June 2008 |access-date=4 December 2008 |archive-date=3 September 2011 |archive-url=https://web.archive.org/web/20110903161044/http://www.cdc.gov/tuskegee/timeline.htm |url-status=live}}</ref> Whereas the purpose of this study was to observe the [[Natural history of disease|natural history]] of untreated syphilis; the African-American men in the study were told they were receiving free treatment for "bad blood" from the United States government.<ref>{{Cite book|title=Examining Tuskegee : the infamous syphilis study and its legacy|author=Reverby, Susan M.|date=2009|publisher=University of North Carolina Press|isbn=9780807833100|location=Chapel Hill|oclc=496114416}}</ref>

The Public Health Service started working on this study in 1932 in collaboration with [[Tuskegee University]], a [[historically black college]] in Alabama. Researchers enrolled 600 poor, African American [[sharecroppers]] from [[Macon County, Alabama|Macon County]], [[Alabama]] in the study. Of these men, 399 had contracted syphilis before the study began, and 201 did not have the disease.<ref name="timeline"/> Medical care, hot meals and free burial insurance were given to those who participated. The men were told that the study would last six months, but in the end, it continued for 40 years.<ref name="timeline" /> After funding for treatment was lost, the study was continued without informing the men that they were only being studied and would not be treated. Facing insufficient participation, the Macon County Health Department nevertheless wrote to subjects to offer them a "last chance" to get a special "treatment", which was not a treatment at all, but a spinal tap administered exclusively for diagnostic purposes.<ref name="Brandt" /> None of the men infected were ever told that they had the disease, and none were treated with [[penicillin]] even after the antibiotic had been proven to successfully treat syphilis. According to the [[Centers for Disease Control]], the men were told they were being treated for "bad blood"—a colloquialism describing various conditions such as fatigue, [[anemia]] and syphilis—which was a leading cause of death among southern African American men.<ref name="timeline"/>

The 40-year study became a textbook example of criminally negligent [[medical ethics]] because researchers had knowingly withheld treatment with [[penicillin]] and because the subjects had been misled concerning the purposes of the study. The revelation in 1972 of these study failures by a [[whistleblower]], [[Peter Buxtun]], led to major changes in U.S. law and regulation on the protection of participants in clinical studies. Now studies require [[informed consent]],<ref name="hhs.gov">{{cite web |title=Code of Federal Regulations Title 45 Part 46 Protections of Human Subjects 46.1.1(i) |url=https://www.hhs.gov/ohrp/policy/ohrpregulations.pdf |url-status=live |publisher=[[U.S. Department of Health and Human Services]] |date=15 January 2009 |access-date=22 February 2010 |archive-url=https://web.archive.org/web/20160328191725/http://www.hhs.gov/ohrp/policy/ohrpregulations.pdf |archive-date=28 March 2016}}</ref> communication of [[diagnosis]], and accurate reporting of test results.<ref>{{cite web |title=Final Report of the Tuskegee Syphilis Study Legacy Committee |url=http://exhibits.hsl.virginia.edu/badblood/report/ |url-status=dead |publisher=University of Virginia |date=May 1996 |access-date=5 August 2019 |archive-url=https://web.archive.org/web/20170705123612/http://exhibits.hsl.virginia.edu/badblood/report |archive-date=5 July 2017}}</ref>

[[File:De ontdekking van Guaiacum als middel tegen syfilis, anoniem, Museum Plantin-Moretus, PK OPB 0186 007.jpg|thumb|299px|''Preparation and Use of Guayaco for Treating Syphilis'', after [[Stradanus]], 1590]]

Similar experiments were carried out in [[Guatemala]] from 1946 to 1948. It was done during the administration of American President [[Harry S. Truman]] and Guatemalan President [[Juan José Arévalo]] with the cooperation of some Guatemalan health ministries and officials.<ref name=CDCFactScheet>{{cite web |title=Fact Sheet on the 1946-1948 U.S. Public Health Service Sexually Transmitted Diseases (STD) Inoculation Study |url=https://www.hhs.gov/1946inoculationstudy/factsheet.html |url-status=dead |publisher=U.S. Department of Health and Human Services |date=n.d. |access-date=15 April 2013 |archive-url=https://web.archive.org/web/20130425164618/http://www.hhs.gov/1946inoculationstudy/factsheet.html |archive-date=25 April 2013}}</ref> Doctors infected soldiers, prostitutes, prisoners and [[mental patient]]s with syphilis and other [[sexually transmitted infection]]s, without the [[informed consent]] of the subjects and treated most subjects with [[antibiotic]]s. The experiment resulted in at least 83 deaths.<ref name="BBC20110829">{{cite news |url=https://www.bbc.co.uk/news/world-latin-america-14712089 |title=Guatemalans "died" in 1940s US syphilis study |date=29 August 2011 |publisher=[[BBC News]] |access-date=29 August 2011 |archive-date=1 December 2019 |archive-url=https://web.archive.org/web/20191201011231/https://www.bbc.co.uk/news/world-latin-america-14712089 |url-status=live}}</ref><ref name=PHR>{{cite journal |last=Reverby |first=Susan M. |title=Ethical Failures and History Lessons: The U.S. Public Health Service Research Studies in Tuskegee and Guatemala |journal=Public Health Reviews |date=3 June 2012 |volume=34 |issue=1 |doi=10.1007/BF03391665 |doi-access=free}}</ref> In October 2010, the U.S. formally apologized to Guatemala for the ethical violations that took place. Secretary of State [[Hillary Clinton]] and Health and Human Services Secretary [[Kathleen Sebelius]] stated "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. We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices."<ref name=NPRapology>{{cite news |first=Scott|last=Hensley|title=U.S. Apologizes For Syphilis Experiments in Guatemala |url=https://www.npr.org/blogs/health/2010/10/01/130266301/u-s-apologizes-for-medical-research-that-infected-guatemalans-with-syphilis |work=[[National Public Radio]] |date=1 October 2010 |access-date=1 October 2010|archive-url=https://web.archive.org/web/20141110013859/http://www.npr.org/blogs/health/2010/10/01/130266301/u-s-apologizes-for-medical-research-that-infected-guatemalans-with-syphilis|archive-date=10 November 2014}}</ref> The experiments were led by physician [[John Charles Cutler]] who also participated in the late stages of the Tuskegee syphilis experiment.<ref name=guardian>{{cite news|author=Chris McGreal|title=US says sorry for "outrageous and abhorrent" Guatemalan syphilis tests|url=https://www.theguardian.com/world/2010/oct/01/us-apology-guatemala-syphilis-tests|access-date=2 October 2010|work=[[The Guardian]]|quote=Conducted between 1946 and 1948, the experiments were led by John Cutler, a US health service physician who would later be part of the notorious Tuskegee syphilis study in Alabama in the 1960s.|date=1 October 2010|author-link=Chris McGreal|archive-date=14 May 2019|archive-url=https://web.archive.org/web/20190514115428/https://www.theguardian.com/world/2010/oct/01/us-apology-guatemala-syphilis-tests|url-status=live}}</ref>