Tuskegee re-examined

My own interest in learning more about the Tuskegee syphilis study began with a dinner conversation with a friend, who is a doctor. Earlier that day I had received a communication from the head of an IRB committee indicating that 'Tuskegee' was reason enough to have all research questions and procedures at the University of Chicago screened and approved by an IRB. Although I knew relatively little about the details of the Tuskegee Study, I had somehow acquired the impression that many decades ago during the days of unregulated medical science the US Public Health Service had actually infected black men with syphilis. This is a not uncommon belief among black and white Americans who have heard of 'Tuskegee'.

But my friend told me: 'Nobody was given syphilis in the study.' All the participants (black sharecroppers in Macon County, Alabama in 1932) already had syphilis, 'but they were not treated for the disease'. I then asked him how syphilis was treated in 1932 when the study started. 'There were some horrible, painful, expensive long-term treatments around but I don't think they really worked', he said - 'there was no effective therapy at the time'. 'Had there been an IRB system in place in 1932, applying the medical research norms of those times, would the IRB have approved the project?', I asked. 'I am not sure, but they might have', he said. I began to suspect that there was both less and more to 'Tuskegee' and the political role it now plays in popular consciousness than has met the public eye.

So I began to read the now standard literature on the topic, as well as some of the scientific reports by members of the Tuskegee project, a sociological study of Macon County conducted in the early 1930s, and websites of various kinds (1). Eventually I discovered a Thucydides-like historical account of the medical belief system that informed the research (2). And the more I read, the more suspicious I became about the standard horror-story.

I would recommend reading the rest, though it is dense.

My own feeling is that there were serious ethical problems with the Tuskegee syphilis study. People would go to jail were it done in 2003. But it was not done in 2003. By any reasonable account, I think, the interpretation that the black population was being used as medical guinea pigs cannot be sustained.