May 29, 2024

US apologizes for 1940s unethical research in Guatemala

696 people infected with syphilis

President Obama on the phone to President ColomIt was bioethical bow, scrape and grovel
time on Friday in Washington DC. After learning that public health researchers
had infected about 700 Guatemalans with syphilis between 1946 and 1948, US
President Barack Obama had to telephone Guatemalan President Alvaro Colom to

The appalling
story of coercion and deception
came to light through archival research by
Professor Susan M. Reverby, of Wellesley College, near Boston. What she found
was that American public health officials wanted to know whether the new
miracle drug penicillin would prevent sexually transmitted diseases as well as
cure them. After doing some research in US prisons, they organised research
subjects in Guatemala.

Dr John C. Cutler, a PHS physician, first
chose men in the Guatemala National Penitentiary, then men in an army barracks,
and then men and women in the National Mental Health Hospital. In all, 696
subjects were infected. Permissions were gained from government authorities but
not from individuals, not an uncommon practice at the time.

Initially the doctors used prostitutes with
the disease to pass it to the prisoners (since sexual visits were allowed by
law in Guatemalan prisons). When “normal exposure” produced little disease they
did direct inoculations. These were made from syphilis bacteria poured onto the
men’s penises or on forearms and faces that were slightly abraded. In some
cases they used spinal punctures. The subjects were given penicillin after they
contracted the illness. However, whether everyone was then cured is not clear
and not everyone received what was even then considered adequate treatment.

The results were never even published.

This disturbing story has been confirmed by
the US Centers
for Disease Control
and the government has launched its own
investigations. The Obama Administration is falling over itself to apologise.
“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,” declared
Secretary of State Hillary Clinton and Health and Human Services Secretary
Kathleen Sebelius.

Even by the standards of the time, the
research was regarded as unethical. After all, only a few months before, Nazi death
camp doctors had been condemned to death and long prison terms for human
experimentation without informed consent. 

It appears that Dr Cutler, who became a
respected professor at the University of Pittsburgh with an interest in
population control, had few qualms. Others were more squeamish but they did not
stop the project. Cutler’s superior confided, “I am a bit, in fact more than a
bit, leery of the experiment with the insane people. They can not give consent,
do not know what is going on, and if some goody organization got wind of the
work, they would raise a lot of smoke.” When the US Surgeon General, Thomas
Parran, was told of the project, he commented, “You know, we couldn’t do such
an experiment in this country.” But he did not put an end to it.

Dr Reverby discovered the material in her
research on the infamous mid-century Tuskegee syphilis experiment. That left
hundreds of African-American men with late stage syphilis untreated and
deceived about their disease. Dr Cutler was a key researcher in that project as
well. Her conclusion is that “the scientific enterprise must always be watched
over, even when the intentions are good and the ‘best men’ do it.” ~ Journal of
Policy History, Jan 2011

Michael Cook
informed consent