Syphilis Risk Management

Anand Sundaram Professor George Bishop USE2307: HIV/AIDS – From Microbes to Nations 6th February, 2015 Book Review: The Invisible Cure by Helen Epstein Helen Epstein’s book “The Invisible Cure: Africa, The West and the Fight Against AIDS” is a powerful account of the AIDS epidemic that has hit hardest in Africa. Epstein is a scientist-turned-writer who merges 15 years of personal observations with scientific reasoning to explain the spread of HIV/AIDS in the continent. She explains why the battle against the disease has been so challenging in Africa in spite of the investment of large amounts of effort and money. Giving the example of Uganda, Epstein argues that the solution may not align with what the proverbial Western World envisions, and that it must come from the Africans themselves.

This experiment, conducted by the U.S. Public Health Service, was intent to study the natural progression of syphilis in African American male population. The study participants voluntarily participated in the study but the researchers did not properly inform the participants on the availability of treatment or the risks of the disease if untreated. To make the matter worse, the participants were deliberately led to believe that they were receiving treatment from the Public Health Service for free, while the actual treatment was being withheld to achieve the purpose of the research. In today’s point of view, it is surprising that even the federal agency did not respect the dignity of human rights for the sake of research. In Henrietta’s era, even the federal agency did not follow the proper informed consent procedure, and a prestigious institution like John’s Hopkins did not have any regulations or office such as Institutional Review Boards (IRBs) to govern their research protocols to protect human subjects and their rights.

However, diseases began to impact populations more than previously imaginable. For example, syphilis became dangerous

The final stage, also known as "late" syphilis, begins 3 or more years after infection. About 40 percent of the infected progress to this stage. At this stage, the person may no longer be contagious, but the bacteria have multiplied and spread throughout the body, damaging the majority of the major organs and nerves within the body. A few years before the Tuskegee Experiment, there was another syphilis experiment that was conducted on the white population to see the long-term effects as well, but because of many people's views syphilis affected African Americans differently than Whites; the theory was that syphilis affected are different in every way, especially their blood, which led researchers to focus on African Americans to see if the disease affected blacks differently than whites. For over 40 years, this experiment was had infected over dozens of African American men had gone untreated, those who were used for the experiment were told that they had ‘bad blood’, and were also not informed of the true nature of the experiment.

In the beginning of the film both doctors represented stated how syphilis was increasing among African Americans across the country and how treatment for this disease was needed. In 1932 there was no full proof treatment that worked to cure syphilis instead there were methods used such as mercury rubs to help assist with the effects of syphilis. One of the reasons attentions was being placed on syphilis was because there was a great concern that the

U.S. Public Health Service Syphilis Study at Tuskegee In 1932 an experiment was initiated by the United States Public Health Service (USPHS) to record the natural history of untreated, latent syphilis in African American men. The study took place in Macon County, Alabama; it involved 399 syphilitic men as well as 201 healthy, uninfected men to serve as the controlled group. This experiment which was “originally scheduled … to last six months.” as stated by Dr. Taliaferro Clark, Chief of the USPHS Venereal Disease Division, stretched out until 1972.

Even worse, they unknowingly carried the syphilis bacteria back to Europe, where it would spread to other Old World

Biologist Irwin Sherman (2007) lists venereal syphilis as one of the twelve diseases that changed the world. Within five years of arrival to Europe the disease was an

In this case, the question of this experiment was, “Does the prevalence of syphilis have the same effect on African American and whites?” Syphilis was said to be a “black” disease. In order to see if this question was true, a special type of person was needed, “the poor African American male”. The men who were chosen to participate in this experiment were very poor, had little to no education, worked on cotton fields, and had become accustom to their living conditions such as racism and lack of health care, and made it their lifestyle. Fred Grey (1998, p. 36) stated “I am sure that only a handful of the 600 participants… had ever been treated by a physician.

The Tuskegee study of Untreated Syphilis began in 1932, mainly designed to determine the history of untreated latent syphilis on 600 African American men in Tuskegee, Alabama. 201 out of 600 men were non-syphilitic just unknowingly involved in the study as a control group This study is known to be “the most infamous biomedical research study in the U.S history”. Most of these men had never visited a doctor and they had no idea what illness they had. All of the men agreed to be a participant thinking they were being treated for “bad blood” and plus they were given free medical care and meals.

For 40 years, many African Americans in Alabama that were infected with syphilis were left untreated as part of an experiment to determine how “different” syphilis affected blacks. This was an orchestrated even by the United States Public Health Service, and other organizations; whose job is to protect the public. Syphilis is a highly contagious infection spread by sexual contact. If untreated, it can cause bone and dental deformations, deafness, blindness, heart disease and deterioration of the central nervous system. The participants, mostly made of poor, uneducated black men, were lured into the program with false pretenses, not advising of the infections they carried (Heller).

In addition to this misinformation, patients were not provided with a way out of the study, effectively dooming them to a life without treatment for the disease. This, of course, contradicts the principles of non-maleficence, as the patients were made to suffer with their ailment throughout the study, even though they could have been easily treated. Although Penicillin was the standard treatment for syphilis by the mid-1940s, participants’ in the Tuskegee Study were denied access to it (Walker, C. (2009). The study infringes on the principle of justice in major aspects.

The only benefit that may have occurred out of this study was proving that African Americans react no differently to syphilis then

The study would ultimately prove that everyone, no matter the color of their skin, is equal when it comes to the disease of syphilis. The intention behind manipulating the men was not for the greater good of society, but instead was for the greater good of Dr. Brodus and Miss Evers. Although the actions of Dr. Brodus and Miss Evers prove to be unethical, I also find the actions to be unprofessional. Miss Evers should have informed the men of the severity of the disease, as well as how the disease is passed from one individual to another. They failed to inform their patients of many of the risks that came along with the disease.

This study was referred to as the “Tuskegee Study of Untreated Syphilis