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== Introduction and Background ==The Who was studied during the Tuskegee Syphilis Experiment, or the ?====[[File:Tuskegee Syphilis Study .jpg|thumbnail|left|250px|A U.S. public health worker drawing blood from a man as part of Untreated Syphilis the Tuskegee syphilis study in the Negro MaleMacon County, Alabama.]]In total, was a United States Public Health Service (USPHS) about 600 Black men were enrolled in this study that ran from 1932-1972. This study was less About 400 of an experimentthem had syphilis, and more the remaining 200 were the non-syphilitic control group. When a member of an observationthe control group contracted syphilis, they were moved from the control group to the experimental group. Macon County, or “study in natureAlabama,” was selected as the site for this study due to findings from an earlier 1929 study backed by the Julius Rosenwald Fund on the course “the prevalence of untreated, latent syphilis in syphilis” among Black men. This According to this study , Macon County—of which Tuskegee's city is highly controversial—and not just based on historical hindsightthe county seat—had “the highest syphilis rate of the six counties surveyed.”<ref>Allan M. Racist assumptions about Black men, Black sexualityBrandt, "Racism and Blackness in general paved Research: The Case of the way for these predominantly white scientists and social scientists to conduct their experiments without spending too much time on the moral or ethical quandaries involved—which included: misinformationTuskegee Syphilis Study, lying" The Hastings Center Report, sitting back and watching the spread of a communicable diseasevol. 8, denial of treatment when one became availableno. 6 (1978): 21-29, and even prohibiting others from providing treatment when or if these patients sought it out on their ownp. 22.</ref>

In totalthe early 20th century, about 600 Black men were enrolled in this study. About 400 of them other clinics and physicians had studied syphilistreatment options. Like mercurial ointments, and the remaining 200 some treatment options were the non-of little value, while arsenic treatment seemed to offer some relief to some syphilitic control grouppatients. WhenAdditionally, or ifthese options were only for early syphilis symptoms like inflammation. They didn’t cure syphilis, a member nor did they prevent some of the control group contracted maladies associated with latent syphilis—like insanity, cardiovascular disease, and death. If scientists could watch syphilisas it progressed untreated, they were simply moved might be able to learn from it. Furthermore, doctors in the control group to USPHS wondered whether syphilis ran its course differently in whites than Blacks. While other scientists had not argued that these experiments should prevent the treatment of disease, “the doctors who devised and directed the Tuskegee Study accepted the experimental groupmainstream assumptions regarding Blacks and venereal disease. Macon CountyThe premise that Blacks, Alabamapromiscuous, was selected as and lustful would not seek or continue treatment shaped the site for this study due to findings from an earlier 1929 study backed by . A test of untreated syphilis seemed ‘natural’ because the USPHS presumed the Julius Rosenwald Fund on “the prevalence of syphilis” among Black men. According to this study, Macon County—of which would never be treated; the city of Tuskegee is the county seat—had “the highest syphilis rate of the six counties surveyedStudy made that a self-fulfilling prophecy.”<ref>Allan M. Brandt, "Racism and Research: The Case of f the Tuskegee Syphilis Study," The Hastings Center Report, vol. 8, no. 6 (1978): 21-29, p. 2223.</ref>

In ==== The Study ====To recruit men for their study, the doctors involved in the early 20th century, other clinics and physicians had studied syphilis treatments options. Some treatment options, like mercurial ointments, experiment were of little value, while arsenic treatment seemed quick to offer some relief to some syphilitic patients. Additionally, assure their subjects that these options were only for early syphilis symptoms like inflammationnot draft physicals. They didn’t cure syphilis, nor did they prevent some Officials assumed most of the maladies associated with latent syphilis—like insanity, cardiovascular disease, subjects would test positive for syphilis and death. If scientists could watch syphilis as it progressed untreated, they might be able lamented the wasted studies necessary to learn from itlocate the small number of negative patients. FurthermoreTo coerce their subjects into participation, the doctors in told the men they were sick and needed treatment—that they offered for free (the USPHS wondered whether syphilis ran its course differently in whites than Blacks. While other scientists had not argued treatments were essentially placebos that these experiments should prevent treatment did nothing to interfere with their study of disease, “the doctors who devised and directed the Tuskegee Study accepted the mainstream assumptions regarding Blacks and venereal diseasesyphilis). The premise that Blacks, promiscuous men were also given hot meals regularly. Subjects experienced examinations and lustfulpainful spinal taps. To keep them interested, would not seek or continue treatment, shaped the study. A test also offered to cover burial expenses so that they could perform autopsies when the men died of their untreated syphilis seemed ‘natural’ because the USPHS presumed the men would never be treated; the Tuskegee Study made that a self-fulfilling prophecy.”<ref>Brandt, p. 23disease.</ref>

== The Study ==In order to recruit men for their studyBy 1936, some of the doctors involved in first findings from this study were shared with the experiment were quick to assure their subjects that these were not draft physicalsAmerican Medical Association. Officials assumed most In 1936, “only 16 percent of the subjects would test positive for syphilis and lamented the wasted studies that would be necessary gave no sign of morbidity as opposed to locate 61 percent of the small number of patients who were negativecontrols. To coerce their subjects into participationTen years later, the doctors told the men they were sick and needed treatment—that they offered for free (the treatments were essentially placebos that did nothing to interfere with ” their study of syphilis). The men were also given hot meals regularly. Subjects experienced examinations and painful spinal tapsfound that the experimental group’s life expectancy was reduced by 20 percent. To keep interestBy 1955, the study also offered to cover burial expenses so that they could perform autopsies when concluded, “that slightly more than 30 percent of the men test group autopsied had died directly from advanced syphilitic lesions of their untreated diseaseeither the cardiovascular or central nervous system.”<ref>Brandt, p. 25.</ref>

== The Controversies: ==The very premise of this study was to see how a dangerous disease progressed in a group of test subjects the doctors and scientists described as “ignorant and easily influenced.” Dr. Raymond Vonderlehr, who was directly in charge of the study in Tuskegee once stated, “Naturally, it is not my intention to let it be generally known that the main object of the present activities is the bringing of the men to necropsy.”<ref>Brandt, p. 25.</ref> Given these explicit desires to see a disease run its fatal course, the scientists at the helm had little interest in providing treatment once it became available—and it did. By the 1950s, penicillin was regularly and effectively used to treat syphilis in patients, but USPHS made no effort or attempt attempted to administer penicillin to its patients. Not only that, USPHS went out of their way to ensure that their subjects were unable to get treatment elsewhere.  In 1934, Vonderlehr advised individual physicians in the area not to not treat the men in their study. USPHS advised a mobile VD unit not to not treat their subjects when they came to Tuskegee in the 1940s, and when the men were drafted in the Army in 1941, USPHS “supplied the draft board with a list of 256 names they desired to have excluded from treatment, and the board complied.”<ref>Brandt, p. 26.</ref>  The test subjects were already participating in a study, and may not have felt the need to seek treatment elsewhere—believing they were already getting treatment from USPHS doctors. In the 1950s and 1960s, the USPHS voted to continue with the experiment. It was only when When Jean Heller broke the story for the Associated Press on July 25, 1972 that , the public became aware of this study. Even when the story broke, USPHS doctors were still collecting data.

In response to public outcry, the US department Department of Health, Education, and Welfare (HEW) began an investigation. The primary ethical concerns were whether subjects were given proper informed consent, and whether penicillin should have been administered when it was recognized as a suitable treatment for syphilis. The dozens of men who died after that time were then preventable deaths, and the infection of wives, sexual partners, and children could have been prevented as well. While HEW believed the men participated of their own free will, the experiment was “ethically unjustified” because the doctors lied to their test subjects. Despite the clear ethical violations, other physicians were defending this study as late as 1974. Many of these defenses relied, too, on racial assumptions about the Black test subjects and their supposed unwillingness to seek medical treatment of their own. <ref>Brandt, p. 27.</ref> Thankfully, Heller’s expose brought this study to an end, but it is possible that this experiment taught us about racist medical discourse than it did about latent syphilis in Black men.

According to While HEW believed the Centers for Disease Control and Prevention (CDC)men participated of their own free will, "in the summer of 1973, a class-action lawsuit experiment was filed on behalf of “ethically unjustified” because the study participants and doctors lied to their familiestest subjects. In Despite the clear ethical violations, other physicians were defending this study as late as 1974, a $10 million out-of-court settlement was reached. As part Many of the settlementthese defenses relied, too, on racial assumptions about the U.S. government promised Black test subjects and their supposed unwillingness to give lifetime seek medical benefits and burial services to all living participantstreatment of their own."<ref>The Tuskegee TimelineBrandt, Centers for Disease Control and Prevention, https://www.cdc.gov/tuskegee/timelinep.htm27.</ref> These benefits were expanded in 1975Thankfully, and 1995 Heller’s expose brought this study to include wives or widows and children, respectivelyan end. Though all the participants and their spouses are now deceasedStill, there are still a handful of their offspring who are still covered by these settlementsit is possible that this experiment taught us about racist medical discourse than it did about latent syphilis in Black men.

== References ==According to the Centers for Disease Control and Prevention (CDC), "in the summer of 1973, a class-action lawsuit was filed on behalf of the study participants and their families. In 1974, a $10 million out-of-court settlement was reached. As part of the settlement, the U.S. government promised to give lifetime medical benefits and burial services to all living participants."<ref>The Tuskegee Timeline, Centers for Disease Control and Prevention, https://www.cdc.gov/tuskegee/timeline.htm.<references /ref>These benefits were expanded in 1975 and 1995 to include wives or widows and children, respectively. Though all the participants and their spouses are now deceased, there is still a handful of their offspring still covered by these settlements.

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