What Happened at Tuskegee?

Nwamaka Agbasi
The Appalling Tuskegee syphilis experiment Attachment
The Appalling Tuskegee syphilis experiment
The video case involved the Tuskegee Syphilis study that was initiated by the United States Public Health Services (USPHS) in Tuskegee, Macon County, Alabama. According to Alson et al (2019), the Tuskegee Syphilis study began in 1932 with approximately 600 poor and mostly illiterate black men, two-thirds of whom had syphilis and lasted for four decades, during which time standard treatment for syphilis evolved from relatively ineffective arsenic-containing compounds to mostly effective penicillin. The enormous ethical issues of this study have changed how research purposes are carried out on humans.
The first ethical issue violated is the right to autonomy. According to Butts and Rich (2020), autonomy is the right of an individual to make their own decisions and determination. In this scenario, the Tuskegee African American men never did not know what the study was for and never consented to be used as guinea pigs for the effects of syphilis on the human body. The ethical principle of non-maleficence was disregarded. Non-maleficence is the ethical obligation a healthcare professional to do no harm (Unger et al, 2020). The video case showed that the doctors withheld research purposes from the participants knowing that these participants might die from syphilis or infect their partners. In addition, the doctors refused to offer penicillin treatment to the study participants even though it was readily available. The racial discrimination was eminent as only African American men who we mostly illiterate and from poor backgrounds were recruited for the study. The ethical principle of Justice was undermined because neither the doctors nor the healthcare organizations were held legally accountable and participant
The affected parties included the African American men from low-income backgrounds who were mostly illiterates, their wives, and children. According to Laws (2018), the events at Tuskegee has shown that minority patients are susceptible to peripheral trauma from racially or ethnically targeted events in the broader society, and the Tuskegee Study of Untreated Syphilis is a case study that offers a window into the negative effects of such targeted exploitation on health. The Tuskegee study repercussions resulted in generational fear and distrust in health care establishment and medical institutions by the African American community. This has caused ripple effect in which African American males are the least likely to schedule routine annual physicals or medical checkups (Alson et al, 2019). As an episode in the history of medical exploitation, Tuskegee stands in a class of its own on the fact of its persistent, government-sanctioned dehumanization that deemed its Black male subjects more valuable dead than alive (Laws, 2018). The Tuskegee Syphilis study shined a spotlight on how researchers use human subjects and hence the creation of National Human investigation Board (IRBs) which oversees research that uses humans (Robinson,2021).
Racially biased subject selection, lack of transparency, experimental exploitation and the absence of informed consent and autonomy are some of the research ethical norms involved in this case. Resolving ethical issues involves creating an environment of trust. According to Laws (2018), legislation is in place that helps to create an environment of trust that assures that people receive adequate healthcare despite their racial or economic background. The implementation of informed consents prior to any procedure or research initiative plays an important role of maintaining transparency and gives the opportunity for patients or human subjects to ask any relevant questions that they may have.
Alsan, Wanamaker, M., & Hardeman, R. R. (2019). The Tuskegee Study of Untreated Syphilis:
A Case Study in Peripheral Trauma with Implications for Health Professionals. Journal
of General Internal Medicine: JGIM, 35(1), 322–325.
Butts, J. B., & Rich, K. L. (2020). Nursing ethics: across the curriculum and into practice (Fifth
edition.). Jones & Bartlett Learning.
Fish, Shahvisi, A., Gwaambuka, T., Tangwa, G. B., Ncayiyana, D., & Earp, B. D. (2021). New
Tuskegee? Unethical human experimentation and Western neocolonialism in the mass
circumcision of African men. Developing World Bioethics, 21(4), 211–226.
Laws. (2018). Tuskegee as Sacred Rhetoric: Focal Point for the Emergent Field of African
American Religion and Health. Journal of Religion and Health, 57(1), 408–419.
Robinson. (2021). Conflation of Tuskegee Study with FDA Fiduciary Responsibilities
Sensationally Ignores International Law. Journal of Clinical Pharmacology.
Unger, J.-P., Morales, I., De Paepe, P., & Roland, M. (2020). In defense of a single body of
clinical and public health, medical ethics. BMC Health Services Research, 20(Suppl 2),
1070–1070. https://doi.org/10.1186/s12913-020-05887-y
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Nne Felder
What Happened at Tuskegee?
Ethics in Research Discussion: The Appalling Tuskegee Syphilis Experiment
Ethical Issues
The Tuskegee Study was in violation of fundamental bioethical norms of autonomy, which were breached. Participants were not provided with sufficient information to enable them to make independent choices. Also, it went against the fundamental bioethical norms of non-maleficence (YouTube-Today I Found Out, 2019). The participants suffered because of therapy being delayed after it was determined to be the best option for them. Furthermore, only Black Americans were recruited for the Tuskegee Study, which violated fundamental bioethical norms of justice.
Affected Parties and How Were They Were Affected
Popularly recognized as the Untreated Syphilis’ Tuskegee Study in the Black-American Male, it was the longest human experiment in the history of public health and medicine, lasting for more than a decade. One or more of the study’s participants had adverse consequences, which ranged from paralysis of their limbs as a result of a highly hazardous spinal tap technique performed by the researchers to remove fluid from the patients’ spinal cords to severe neuronal damage. Some died because of severe syphilitic sores, while others had their spouses afflicted, and many of the participants’ children were born with congenital syphilis (YouTube-Today I found out, 2019). The men in the “Tuskegee Study,” on the other hand, were refused treatment by the US government, even after penicillin became the standard therapy for syphilis in the mid-1940s, even though penicillin had become the conventional treatment for syphilis by that time. When some of the men developed severe syphilis and were blind and crazy, the physicians refused to cure them, instead opting to observe their patients until the planned “end point” – an autopsy – was reached. To guarantee that their families would consent to this last process, the government provided burial insurance, which would bear the expenses of a coffin and a cemetery at a maximum of fifty dollars (Frazier, 2020).
Relevant Ethical Principles/Research Ethical Norms Involved In the Case
There are a number of ethical standards that should be followed while doing research with human beings. Furthermore, health organizations have come to the conclusion that it is necessary to develop ethical standards of conduct for use in evaluating research initiatives that include human participants. It is necessary to provide an explanation of the ethical standards for biomedical/clinical research with the aim of identifying the moral principles that were abused in the Tuskegee Study to determine the ethical standards that were violated. Ethics professors, researchers, and medical practitioners all agree that informed consent is a critical component of any study project involving human subjects that must be conducted in accordance with ethical standards. Although informed permission is required for ethical clinical research, according to Frazier (2020) and Smolin (2011), informed consent alone is not adequate. The authors suggest seven indispensable criteria as the foundation for a cohesive framework for evaluating the ethics of clinical research studies to account for the insufficiency of informed consent in clinical research investigations. Their stance is based on the rationales of key regulations, declarations, and other publications that are significant to the study on human beings, including the Declaration of Helsinki. The seven fundamental principles are as follows:
•The research should be valuable in that it should contribute to the advancement of health knowledge by providing information on how to deal with the disease under investigation.
•Scientific validity: The study must be scientifically sound in order to be considered legitimate.
•Ethical Subject Selection should be done with scientific goals in mind rather than concern about vulnerability. (4) A favorable risk-benefit ratio must be achieved in research, with risks being reduced and benefits being increased.
•Independent Review-individuals who are not connected with the study must review it on a regular basis (YouTube-Today I Found Out, 2019).
•Informed consent— In keeping with Frazier (2020), potential participants should be made aware of the study and their permission should be obtained before participating.
•It is necessary to respect and defend the rights of study participants in their capacity as autonomous individuals.
How the Ethical Issues Could Be Resolved
Anxiety over medical practice has the potential to have catastrophic consequences. For example, it has the potential to prevent new research projects from being initiated that might aid in the prevention of disease outbreaks from occurring. It is necessary to avoid the start of another research in the same vein as the Tuskegee experiment from taking place (YouTube-Today I Found Out, 2019). When developing international and regional guidelines for ethical biomedical research, it is important to keep in mind the fact that health professionals should act in accordance with such principles as objective moral in such a way that their research intentions and actions can be universalized (Frazier, 2020). Furthermore, at the current time, the greatest obstacle to ethical medical practice and research is not the absence of standards, but rather the failure to adhere strictly to the norms that are already in place. Because of this, consequences for breaking the standards should be included into the guidelines themselves, so that any healthcare professional who breaks the rules will be subject to disciplinary action.
Frazier, C. (2020). It’s more than just news: Print media, the Tuskegee syphilis study and collective memory among African Americans. Journal of Historical Sociology, 33(3), 280-296.
Smolin, D. M. (2011). The Tuskegee syphilis experiment, social change, and the future of bioethics. Faulkner L. Rev., 3, 229.
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