The Tuskegee Syphilis Study

The Tuskegee Syphilis Study

Introduction

The Tuskegee study is a historical study that involved Negro males in 1932. The study got conducted to try and justify a syphilis treatment program for blacks. Although the study was supposed to benefit the people, the individuals used in the research were mistreated and harmed.

Furthermore, they were not given any consent during the study. This paper tries to analyze the Tuskegee Study and identifies several questions raised by the Tuskegee study. Furthermore, it looks at how the study failed when it comes to ethical issues.

Ethical questions on the study

The Tuskegee study raised a lot of ethical issues and has become a case study when looking at ethics in health care researches. Looking at it in terms of the Blanchard-Peale three-step model, it poses several questions on whether the legality of the study, its fairness, and how people feel when they look at it. Furthermore, the study helps researchers to opt for better medical procedures when researching humans and proves that there is a need to safeguard the well fair of human participants of research.

Is it legal?

Using the model of the Blanchard-Peale, the Tuskegee study raised three ethical issues. Foremost, it is whether the survey was legal or not. Using the model, if the review is not legal, then it gets considered unethical. As a result, the researcher should not continue with the analysis because the research got rendered ethical. In the Tuskegee study, there were 600 black men in the study where 399 of them had syphilis, and 201 did not have the disease (Anekwe, 2015). In the research, the men were not fully informed and got informed they were getting medication for bad blood. Although they agreed to get tested and treated, research showed that there wasn’t evidence on whether the men had gotten informed about the study or its primary purpose.

Furthermore, they were misled and never given the facts necessary to show informed consent. Besides that, the men never got adequate medication for the disease even after a drug of choice for syphilis was out.  Furthermore, the participant was not allowed to quit the study. All this proved that the investigation had many irregularities and thus making it unethical. Hence, based on the three steps of ethics models, the study would get considered as not legal.

Is it fair?

The second step in the three steps ethic models asks whether the actions involved in a study are fair or not. It also asks whether other people outside the research or education sees’ the decision made whether they are honest and honorable. Furthermore, it looks at whether the people affected get treated with respect or without consideration. And whether people are getting an advantage or not. In the Tuskegee study, one would consider the study as not to be fair to all the participants. Foremost, it’s because they never got accurate information about the study since they got informed that they were getting tested for bad blood, which was not the case.

Furthermore, it was not fair for the participant to be given drugs like aspirin and placebos when there was a drug like penicillin that cloud fully cure them (Alsan et al, 2018). Besides that, researchers conducting the research asked local physicians not to treat the participants, an action that was not fair to the participant. Furthermore, the men did not get adequate care, which leads to their death and others going blind and becoming insane. As an outsider, the men never got treated with consideration, and the process was not honest. Thus, all these activities raised the question of the process of not being fair to the participant.

How does it make one feel?

The third step on the ethics model looks at how one feels regarding the study at question after looking at the activities involved in a process. It also analysis the two-step on whether an event was legal or not and on whether it was fair to the people involved. In the third step, people’s views get considered, and on the Tuskegee study, people felt that the survey was unfair both to the participant and their families. Furthermore, it brought more repercussions to them since it exposed them to more illness, like becoming blind going insane and even death.

Belmont Report.

Belmont report gives principles regarding health care research and ethics. Its vital purpose ensures the protection of participants and subjects in a research study. The report provides three principles that research should ensure there is respect for persons in the study; there are justice and beneficence. The Tuskegee study failed in implementing the three policies of the Belmont principle concerning its subjects.

How the Tuskegee study fails to conform to beneficence

Foremost, the Tuskegee study failed when it comes to beneficence. Beneficence emphasizes that there should be no harm done to the subjects, and risks subjected to the participants should get minimized at all costs. When people look at the Tuskegee study, participants got exposed to more harm during the research. Foremost, the researcher instructed the local physicians not to treat the men involved in the study. Besides, researchers did not provide adequate care to the men so that they could track the disease’s progress. Besides that, after a committee gets established to review the study, it did not stop the research but continued with it intending to track participants until they had died (Sacks, 2017). All these activities proved that the subjects got exposed to more harm during the research, and there was no consideration to minimize any risks that come with the study. Besides, researchers opted to continue with the survey and not offer a cure to the men, which shows that the study failed to conform to the beneficence principle of the Belmont.

How the study fails to conform to justice

The Belmont report proposes for there to be justice to any subject involved in a study. Justice consists in ensuring there is no exploitation, and there are reasonable and well-considered procedures which are administered relatively to the participants. Furthermore, justice also provides there is equality when administering medication to all the subjects. The study failed to conform to the truth in that it exploited the participant by getting discriminated from getting medication. In an instance, when several of the men tried to enlist in World War II, they got diagnosed with having syphilis and were asked to get treatment. However, the PHS researchers prevented the men from getting medication and thus, depriving them of getting cured. This act was an injustice act to them.  Another injustice subjected to the participant was the act of the researchers, preventing them from participating in a program to cure syphilis after penicillin become a standing therapy for syphilis.

Furthermore, the process of recruiting participants was unjust and unfair since people got misleading information. On one occasion, the participant got misled by being told that it was the last chance for a free treatment; thus, they should enroll. Besides, a black nurse from Macon County got employed to build trust and personal relationships with the patients (Sacks, 2017). Besides that, participants would not get funeral benefits until they had undergone an autopsy after their death. All these activities were exploitative to the men participating in the study, thus proving that the study failed to conform to justice.

How the study fails to conform to respect for the person

Respect for persons involves treating people with courtesy, respect, and allowing informed consent to the people. Furthermore, it ensures that researchers must be truthful and should not conduct deception. During the Tuskegee study research, researchers did not give full consent to the people involved. Furthermore, they never got entirely informed that they were conducting a study for syphilis, but instead, they got mislead that it was bad blood. Lack of consent to the people was one of the significant reasons that lead to the program getting terminated, and victims get compensated. Researchers wholly disregarded respect for persons and their rights and led to death and further illness to the people and their children who were born with congenital syphilis.

What would have constituted informed consent in the study?

There are several ethical issues involved in human researches when research is getting conducted. The primary moral issue to get looked into is informed consent that entails showing the people getting involved in research about all the aspects of research that might influence their decision to participate. Another concern area is the likelihood that the participant might feel lured to agree or might not get what they are deciding on. In the Tuskegee study, informed consent involved the researchers’ taking advantage of the deprived socio-economic situation whereby subjects had faced low levels of both health care and finances. Furthermore, the participants got into contact with doctors and nurse who some were familiar with as they were from the locality. The idea of using people from the local area constituted misinformed consent.

Furthermore, researches practiced deception in recruiting subjects and never explained to them that the survey got designed to detect syphilis. The term ‘bad blood’ referred to various diseases like anemia and leukemia by the doctors (Alsan et al, 2018). However, it got used for the subject, but it never got defined to them. Besides that, participants never got informed they had syphilis or what caused it and anything about its treatment. Also, they got presented with a treatment that constituted of spinal taps described as spinal shots. Also, patient welfare got overlooked, and the doctors tried to justify why they withheld penicillin for the participant.

Furthermore, physicians felt that repair of the damage would be minimal. Moreover, after the discovery of penicillin, the participants were not given a choice on whether they should continue with the study or get treated. Besides that, the PHS did not regard the impact of untreated syphilis on the wives of the married participants.

Next, physicians did not keep accurate records, and there was no known number of people who died. Also, the heath of the community was in jeopardy since the disease was contagious. If all these activities got done the other way round, whereby participants were fully informed about the research and given choices to take treatment when it was available, the situation would have been regarded as to have informed consent.  Furthermore, if the researchers used accurate information and did not deceit the participant during the recruiting period, it would have constituted informed consent.

If there was consent, could the study be considered ethical?

If informed consent got obtained from the subjects, are the questions on whether the Tuskegee study was ethical would have gotten removed, as it would have been considered ethical. And would have been by all the legal requirements and issues in the health care sector.

References

Anekwe, O. N. (2015). Artist’s Statement: Tuskegee Men. Academic Medicine, 90(5), 621.

Alsan, M., & Wanamaker, M. (2018). Tuskegee and the health of black men. The quarterly journal

            Of economics, 133(1), 407-455.

Sacks, T. K. (2017). The single case study: Understanding the life history of a Tuskegee Syphilis

            Study descendant. SAGE Publications Ltd.

White, R. M. (2019). Driving Miss Evers’ Boys to the Historical Tuskegee Study of Untreated

Syphilis. Journal of the National Medical Association, 111(4), 371-382.