The Tuskegee Syphilis Study followed 399 African-American males for 40 years to see how syphilis progressed. Researchers in the Tuskegee Syphilis Study took great lengths to keep participants uninformed of life-saving penicillin treatments for syphilis (Jones, 1993). The Tuskegee Syphilis Study's dishonest and manipulative character prompted public outrage and legislative action to defend human rights and avoid future unethical actions in human subject research. Its ramifications shaped the American Psychological Association's Ethical Code of Conduct (2002) and the present level of care demanded of researchers.
The Tuskegee Syphilis
The Tuskegee Syphilis Study is infamous and controversial. In 1932, the US Public Health Service and the Tuskegee Institute began 40-year research to determine racial disparities in syphilis development. Syphilis is a sexually transmitted illness that causes deformities, dementia, paralysis, and sometimes death (Center for Disease Control [CDC], 2012). The Tuskegee Institute studied 600 African-American males from Macon County, Alabama, 399 with untreated latent syphilis (Reverby, 2001).
People with "bad blood," a phrase used to characterize many ailments in the black community at the time, were compelled to participate in the study. Participants were also fed regularly, had free transportation to and from the clinic, and received funeral stipends for their families (Carmack, Bates, & Harter, 2008). Moreover, researchers engaged African-American doctors and nurses to gain and keep participants' trust (Corbie-Smith, 1999).
Generations of researchers who worked on the Tuskegee Syphilis Study justified their work on scientific grounds and the need to study the disease's biological evolution. That researcher could never replicate the data or collect a large sample of untreated patients justified any ethical concerns (Rothman, 1982). Researchers' justifications for mistreating patients highlight the significance of setting ethical boundaries.
Recognizing past mistakes in therapy and research helps shape future patient care decisions. Other unethical research methods in our country's medical and psychiatric past, such as eugenics and the mistreatment of mentally ill patients in asylums, shaped the ethical expectations presently demanded of all health care workers. The Tuskegee Syphilis Study's ethical infractions prompted the addition of numerous principles listed in the APA Code of Ethics concerning patient care, therapeutic practice, and research methods.
Ethical Issues
General Rules
The Tuskegee Syphilis Study breached the General Principles of Beneficence and No maleficence, Fidelity and Responsibility, Integrity, Justice, and Respect for Human Rights and Dignity defined in the American Psychological Association Ethical Code of Conduct 2002. The researchers participating in the Tuskegee Syphilis Study damaged its subjects and their families who had to care for them as their health deteriorated due to the illness development. Furthermore, researchers failed to explain syphilis transmission and preventative methods, causing harm to people who had sexual connections and children with untreated participants (Corbie-Smith, 1999; Jones, 1993).
Human Rights and Dignity is concerned with preserving human rights and overall patient wellbeing (APA, 2002). The Tuskegee Syphilis Study violated many human rights and exploited a community vulnerable to a potentially deadly illness. For example, researchers gave participants funeral stipends and hot meals, which hampered their capacity to make educated judgments about participation in the study (Carmack, Bates, & Harter, 2008; Corbie-Smith, 1999). Furthermore, societal biases towards African-Americans may have impacted the study's initial and on-going reasoning (Bhopal, 1997).
Given Consent
The American Psychological Association's guidelines apply to all health care clinicians who assess, treat, or research patients. Participants must understand the study's aim, dangers, and duration to make informed choices about their involvement (APA, 2002). The APA Code of Conduct did not include all standards, research guidelines, and protocols during the Tuskegee Syphilis Study. However, the Tuskegee Syphilis Study emphasizes informed consent and how it affects modern patient care standards.
Research Fraud
Participants in a study that might "cause bodily injury or serious mental distress" cannot be deceived, according to the APA Ethical Code (p. 11). The Tuskegee Institute's negative impacts broke this criterion in several ways. When participants had "bad blood," researchers provided them therapy and incentives to keep participating. The study's doctors never revealed the patients' accurate diagnoses. In the words of Charles Pollard, a Tuskegee subject, "they never mentioned syphilis to me, not once" (Jones, 1993, p. 278).
R&D Implications
The Tuskegee Syphilis Study's unethical activities influenced legislation, politics, and social policy, exploiting research techniques. After the public outcry over the Tuskegee Syphilis Study, Congress created the National Research Act in 1974 to prevent future unethical research methods (Rencher & Wolf, 2013).
Misconceptions about the Tuskegee Syphilis Study, which imply researchers purposely injected patients with syphilis to track the disease's course, may further contribute to minorities' distrust of researchers and health care professionals (Freimuth et al., 2001; Shaver, Lynch, & Burmeister, 2000). Furthermore, parental influence and socialization may have indirectly influenced more recent generations uninformed of the discredited history of scientific research methodologies (Poythress, Epstein, Stiles, & Edens, 2011). Cultural perceptions of research may foster aversion to research and distrust of health care practitioners.
Conclusion
The Tuskegee Syphilis Study continues to impact APA code updates, patient care standards, human rights legislation, and health care workers' societal viewpoints. Despite the end of the Tuskegee Syphilis Study in 1973 and strong government constraints, blacks remain underrepresented in research. The absence of involvement reduces the generalizability, validity, and usefulness of study results. To promote change, researchers and health care professionals must dispel myths about the Tuskegee Syphilis Study, acknowledge the evolution of ethical norms through time, and stress the need to represent minorities in research accurately.
Author: Edward Carey
Profile: English Litterature & Essay Writing Analyst
Designation: Professor At Texas University
