Protection from Harm:
The Tuskeegee Syphilis Study


In 1928, the director of medical service for the Julius Rosenwald
Fund, a Chicago-based philanthropy, approached representatives of
the U.S. Public Health Service (PHS) to discuss ways to improve
the health of African Americans in the South. At the time, the PHS
had just completed a study of the prevalence of syphilis among
over 2,000 black employees of the Delta Pine and Land Company of
Mississippi. About 25% of the sample had tested positive for
syphilis. The PHS and the Rosenwald fund collaborated in treating
these individuals. This collaboration led to an expansion of the
treatment program to five counties in the southern U.S.: Albemarle
County, Virginia; Tipton Counrty, Tennessee; Pitt County, North
Carolina; Glynn County, Georgia; and Macon County Alabama. As the
testing for the program was implemented, it was found that between
35% and 40% of all age groups in Macon County tested positive for
syphilis (Jones, 1981).

Before the treatment phase of the project could be implemented,
the Great Depression began. The Rosenwald Fund's resources were
particularly hard hit. Without the financial support of the
Rosenwald Fund, the PHS did not have the resources to carryout the
treatment program.

At the same time, there was a debate occurring among health
researchers about possible racial differences in the effects of
syphilis. Dr. Taliaferro Clark of the PHS suggested that the
treatment project could be partially salvaged by conducting a
prospective study on the effects of untreated syphilis on living
subjects.

Early on in the project, the PHS enlisted the support of the
Tuskeegee Institute. Since the Tuskeegee Institute had a history
of service to local African Americans, its participation insured a
smooth execution of the experiment. In return, Tuskeegee Institute
received money, training for its interns, and employment for its
nurses. In addition, the PHS recruited black church leaders,
community leaders, and plantation owners to encourage
participation.

The fact that African Americans had almost no access to medical
care resulted in an increased willingness on the part of African
American men to participate in the study. For many study
participants, the examination by the PHS physician was the first
medical examination they had ever undergone. In addition to free
medical examinations, food and transportation were supplied to
participants. Burial stipends were used to get permission from
family members to perform autopsies on study participants (Jones,
1981).

While the study participants received medical examinations, none
were told that they were infected with syphilis. They were either
not treated or were treated at a level that was judged by PHS
researchers to be insufficient to cure the disease.

During World War II, about 50 of the study subjects were ordered
by their draft boards to undergo treatment for syphilis. The PHS
requested that the draft boards exclude study subjects from the
requirement for treatment. The draft boards agreed to exclude the
men.

In 1943, the PHS began to administer penicillin to patients with
syphilis. Study subjects were excluded from the treatment.

Beginning in 1952, the PHS began utilizing local health
departments to track study participants who had left Macon County.
Until the termination of the study in the 1970s, local health
departments worked with the PHS to keep the study subjects from
receiving treatment.

The project was finally brought to a stop 1972 when Peter Buxton
told the story of the Tuskeegee Study to an Associated Press
reporter. Buxton was a venereal disease interviewer and
investigator for the PHS who had been attempting to raise the
issue within the PHS since 1966. Despite his protestations, the
"experiment" was still being carried out when the story appeared
on the front pages of newspapers around the country (Jones, 1981).

Congressional subcommittee meetings were held in early 1973 by
Senator Edward Kennedy. These resulted in a complete rewrite of
the Health, Education, and Welfare regulations on working with
human subjects. In the same year a $1.8 billion class action suit
was filed in U.S. District Court on behalf of the study subjects.
In December of 1974, the U.S. government paid $10 million in an
out of court settlement.

The Tuskeegee Syphilis Study remains one of the most outrageous
examples of disregard of basic ethical principles of conduct (not
to mention violation of standards for ethical research). In 1976,
historian James Jones (1981) interviewed John Heller, director of
the Venereal Diseases unit of the PHS from 1943 to 1948. Among
Heller's remarks were the following: "The men's status did not
warrant ethical debate. They were subjects, not patients; clinical
material, not sick people" (p. 179).

The suspicion and fear generated by the Tuskeegee Syphilis Study
are evident today. Community workers report mistrust of public
health institutions within the African American community. Alpha
Thomas of the Dallas Urban League testified before the National
Commission on AIDS: "So many African American people I work with
do not trust hospitals or any of the other community health care
service providers because of that Tuskeegee Experiment" (National
Commission on AIDS, 1990).

The Southern Christian Leadership Conference (SCLC), one of the
country's major civil rights organizations, has been providing
AIDS awareness education through a program called RACE (Reducing
AIDS through Community Education). In 1990, the SCLC conducted a
survey among 1056 African American Church members in five cities.
They found that 34% of the respondents believed that AIDS was an
artificial virus, 35% believed that AIDS is a form of genocide,
and 44% believed that the government is not telling the truth
about AIDS.


The materials for this page were largely derived from --
Jones, J. (1981). Bad blood: The Tuskeegee syphilis experiment: A
tragedy of race and medicine. NY: The Free Press.