U.S. Apologizes for 'Reprehensible' 1940s Syphilis Study in Guatemala

FROM PBS.ORG

http://www.pbs.org/newshour/rundown/2010/10/us-apologizes-for-60-year-old-unethical-syphilis-study-in-guatemala.html

HEALTH -- October 1, 2010 at 6:12 PM EDT

U.S. Apologizes for 'Reprehensible' 1940s Syphilis Study in Guatemala

By: Lea Winerman

U.S. officials apologized Friday for unethical medical experiments conducted in Guatemala more than 60 years ago, in which prison inmates were deliberately infected with syphilis.
The experiments were conducted between 1946 and 1948 by Dr. John C. Cutler, a U.S. public health service doctor who was also involved in the infamous Tuskegee syphilis study in the United States.
Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius issued a joint statement apologizing for the experiments:

"The sexually transmitted disease inoculation study conducted from 1946-1948 in Guatemala was clearly unethical. 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."

The history of the Guatemala study was uncovered by Wellesley College professor Susan Reverby, a medical historian who has written two books about the Tuskegee case, in which black men with syphilis were observed -- but not treated -- by U.S. government researchers for nearly 40 years. Reverby was reading Cutler's papers in an archive at the University of Pittsburgh, looking for references to the Tuskegee study, when she came across descriptions of the experiments in Guatemala.
"So I started to read it, and I said, 'Oh my god,'" Reverby says.
In the study, the researchers were investigating whether penicillin -- which was already being used to treat syphilis -- could prevent the disease if it was administered right after someone was exposed to the bacteria.
The researchers exposed hundreds of people in Guatemala to the disease. Many were men who were prison inmates, others were residents of an army barracks and mental hospital. None of the subjects were asked for their consent. The researchers used visits with prostitutes who were infected with syphilis to expose the men to the disease (such visits were legal in Guatemala at the time). They also, Reverby writes, "used direct inoculations made from syphilis bacteria poured into the men's penises and on forearms and faces that were slightly abraded when the 'normal exposure' produced little disease."
They did treat the people with penicillin afterwards, but, Reverby writes, it's not clear whether everyone was cured, or even whether they received what would have been considered adequate treatment.
The Guatemala experiment differed from the Tuskegee case, Reverby says, because people were actually exposed to the disease and then treated, instead of being denied access to treatment for a disease that they already had, as happened in the Tuskegee case.
Even within the context of the much more lax research ethics standards of the time, Reverby says, the research "fell off the edge" of what was acceptable.
"Even within the context of history, this was something they shouldn't have been doing -- and they knew that," Reverby said. In fact, she cites a letter in which Surgeon General Thomas Parran said "You know, we couldn't do such an experiment in this country."
Reverby presented her findings at a medical history association meeting in May, and also wrote them up for publication -- they'll be published in January in the Journal of Policy History, but a pre-publication version of the four-page paper is available on Reverby's website.
The government got involved in the spring, when Reverby showed the paper to David Sencer, a retired director at the Centers for Disease Control and Prevention whom she knew from her research on the Tuskegee experiment's history. Sencer passed it on to current CDC officials, and the agency sent a syphilis specialist to examine the papers in the University of Pittsburgh archive. That specialist confirmed the accuracy of Reverby's report.
Now, the government, in addition to issuing its apology, will also convene a panel of independent experts through the National Academies of Sciences Institute of Medicine to conduct a fact-finding probe of the events in Guatemala.
And Sofia Porres, of the Guatemalan Embassy, told the Washington Post that the Guatemalan government would also investigate. "We of course are very upset about this, and we think it's a very unfortunate event," she said. "We're going to do an investigation as well to see if there are any survivors, family, etc."