-Written Assignment Unit -7

"University of the people" Department of Health Sciences

HS 4812 - Bioethics
Instructor: Steven Wilson
3/01/2024

Introduction
The Tuskegee Syphilis Experiment is one of the most notorious examples of unethical

medical research in modern times. This study, which began in 1932, involved the U.S. Public

Health Service studying the natural course of untreated syphilis in African American men in

rural Alabama. The participants were not informed of the nature of the study or its potential

risks, and they were not given the opportunity to give informed consent. The study continued

for 40 years, during which time many of the participants died from syphilis or related

complications. This paper will analyze the Tuskegee Study and its ethical implications based

on the guidelines provided in the Belmont Report. (Infoplease Staff, 2017)

Informed Consent

One of the basic principles of ethical research involving human subjects is the requirement

for informed consent. In the Tuskegee Study, participants were not informed of the nature of

the study, nor were they given the opportunity to provide informed consent. If the researchers

had obtained informed consent from the participants, it would not have removed all questions

about whether the study was ethical. Informed consent is necessary but not sufficient for

ethical research. Researchers have a responsibility to ensure that the risks and benefits of the

study are explained clearly to participants and that they have the freedom to withdraw from

the study at any time. (NCPH, 1979)

Eunice Rivers' Justification

Eunice Rivers, the African American nurse who played a vital role in the Tuskegee Study,

justified her support for the project by stating that the attention given to the men was more

than they would have received otherwise. However, this justification is not valid. The study

involved withholding treatment from participants who had a potentially deadly disease, which

is a violation of the principle of beneficence. Ms. Rivers should have considered the impact

of the study on the participants and their families, as well as the ethical implications of the
study, before supporting it. If I were in her place, I would have considered the principles of

respect for persons, beneficence, and justice, and the potential impact of the study on the

participants and their families. (Infoplease Staff, 2017)

Failure to Conform to the Belmont Report

The Tuskegee Study failed to conform to each of the three criteria proposed by the Belmont

Report. Respect for persons involves treating individuals as autonomous agents who have the

right to make their own decisions. The participants in the Tuskegee Study were not given the

opportunity to make an informed decision about their participation, and their autonomy was

violated. The principle of beneficence involves protecting individuals from harm and

ensuring that the risks of the study are minimized. The participants in the Tuskegee Study

were not given adequate treatment for their disease, which resulted in many deaths and

serious health consequences. The principle of justice involves ensuring that the benefits and

burdens of the study are distributed fairly. The participants in the Tuskegee Study were

mostly poor African American men who were not given the same standard of care as other

patients. (NCPH, 1979)

Justification by Healthcare Professionals

The healthcare professionals of that time justified conducting the Tuskegee Study on African

American men because they believed that syphilis affected African Americans differently

than other populations. They believed that the study would provide valuable information

about the natural course of the disease in African Americans. However, this justification was

based on racial stereotypes and is not valid. The Tuskegee Study was a clear violation of the

principles of respect for persons, beneficence, and justice. (Jones, 1981(

Consequences for Society

The Tuskegee Study had serious consequences for society. It undermined trust in medical

research and healthcare providers, especially among African Americans. It highlighted the

need for ethical guidelines for human subject research and led to the creation of the National

Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.

The study also had a significant impact on the lives of the participants and their families,

many of whom suffered. (Jones, 1981)

Eunice Rivers, the African American nurse who played a vital role in the study, has justified

her support for the project on account of the fact that the attention that she and the other

medical staff gave to the men was more than a non-enrolled, poor, Macon County resident

was likely to receive. In her view, the men would have had no access to medical care if not

for the study, and their participation ensured that they received some medical care. However,

her justification does not hold up to ethical scrutiny. It is true that the medical care provided

to the men was better than what they would have received otherwise, but this does not justify

the deception, harm, and exploitation to which they were subjected. (Infoplease Staff, 2017)

If I were in her place, I would consider several factors important to reach a conclusion about

supporting or opposing the research. First, I would evaluate the research design and its

potential benefits and risks. I would also examine the ethical considerations of informed

consent, confidentiality, and the potential for harm to the participants. Additionally, I would

consider the social context and the history of medical exploitation of African Americans,

which should have raised red flags about the study's ethical implications. Overall, I would

conclude that the study was unethical and would refuse to participate in it.

The Tuskegee Study fails to conform to each of the three criteria proposed by the Belmont

Report for evaluating human subject research.

a. Respect for Persons: The study violated the principle of respect for persons by denying the

participants informed consent. The researchers deceived the men by telling them that they

were being treated for "bad blood," a term that had no medical meaning, instead of syphilis.

By not informing the participants about the true nature of the study, the researchers denied

them the opportunity to make an informed decision about whether to participate.

Additionally, the researchers did not obtain consent from the participants' spouses or family

members, which further violated the principle of respect for persons. (NCPH, 1979)

b. Beneficence: The study also violated the principle of beneficence by exposing the

participants to harm without any potential benefit. The researchers knew that they were

withholding treatment from the participants and that the men were suffering from a deadly

disease. By not providing the participants with proper treatment, the researchers caused

significant harm to the participants' health and well-being. (NCPH, 1979)

c. Justice: The study also violated the principle of justice by selecting a vulnerable

population, African American men, and exploiting them for research purposes. The

researchers targeted poor, illiterate, and marginalized men who had limited access to

healthcare and education. The researchers chose these men because they believed that the

men would be compliant and easy to control. The researchers did not provide the participants

with adequate compensation or medical care, which further violated the principle of justice.

(NCPH, 1979)

The healthcare professionals of that time provided several justifications for conducting

experiments on these African American men and their families. One of the justifications was

that the men were already infected with syphilis and that the study could provide valuable

information about the course of the disease. Another justification was that the study could

provide insight into the development of new treatments for syphilis. Additionally, some
healthcare professionals believed that the study could help reduce the spread of syphilis by

identifying infected individuals and providing them with treatment.

Conclusion

The consequences for our society from this unethical project have been significant. The

Tuskegee Study is widely considered one of the most egregious examples of medical research

abuse in history. The study undermined the trust between the medical profession and African

American communities and reinforced suspicions of medical exploitation and neglect. The

study also contributed to the development of new ethical guidelines and regulations for

human subject research, such as the Belmont Report, which established the principles of

informed consent, respect for persons, beneficence, and justice. These guidelines have helped

prevent similar.

Word Count: 1331

References:

Infoplease Staff. (2017, February 11). The Tuskegee syphilis experiment. Infoplease.

https://www.infoplease.com/history/black-history/the-tuskegee-syphilis-experiment

Jones, J. H. (1981, June 21). The New York Times. Retrieved March 15, 2023, from

https://archive.nytimes.com/www.nytimes.com/books/98/12/06/specials/jones-blood.html

National Commission for the Protection of Human Subjects of Biomedical and Behavioral

Research. (1979). The Belmont Report: Ethical principles and guidelines for the protection of

human subjects of research. US Department of Health, Education, and Welfare.

https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/

index.html