Racism and Research: The Case of the Tuskegee Syphilis Study The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Brandt, Allan M. 1978. "Racism and research: The case of the Tuskegee Syphilis study." The Hastings Center Report 8(6): 21-29. Published Version http://www.jstor.org/stable/3561468 Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:3372911 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA THE EXPERIMENTAND HEW'S ETHICALREVIEW I Racism and Research: The Case of the Tuskegee Syphilis Study by ALLAN M. BRANDT ale for Americanracism.3 Essentially primitive peoples, it was argued,could not be assimilatedinto a complex, white In 1932 the U.S. PublicHealth Service (USPHS) initiated civilization.Scientists speculated that in the strugglefor sur- an experimentin MaconCounty, Alabama, to determinethe vival the Negro in Americawas doomed.Particularly prone naturalcourse of untreated,latent syphilis in black males. to disease, vice, and crime, black Americanscould not be The test comprised400 syphiliticmen, as well as 200 unin- helpedby educationor philanthropy.Social Darwinistsana- fectedmen who servedas controls.The firstpublished report lyzed census data to predict the virtual extinction of the of the studyappeared in 1936 with subsequentpapers issued Negro in the twentiethcentury, for they believed the Negro every four to six years, throughthe 1960s. When penicillin race in Americawas in the throes of a degenerativeevolu- becamewidely availableby the early 1950s as the preferred tionaryprocess.4 treatmentfor syphilis,the men did not receive therapy.In The medical professionsupported these findingsof late fact on severaloccasions, the USPHSactually sought to pre- nineteenth-and earlytwentieth-century anthropologists, eth- vent treatment.Moreover, a committeeat the federallyop- nologists, and biologists. Physiciansstudying the effects of eratedCenter for Disease Controldecided in 1969 that the emancipationon health concluded almost universallythat study shouldbe continued.Only in 1972, when accountsof freedom had caused the mental, moral, and physical dete- the studyfirst appeared in the nationalpress, did the Depart- riorationof the black population.5They substantiatedthis ment of Health,Education and Welfarehalt the experiment. argumentby citing examplesin the comparativeanatomy of At that time seventy-fourof the test subjectswere still alive; the black and white races. As Dr. W. T. Englishwrote: "A at least twenty-eight,but perhapsmore than 100, had died careful inspectionreveals the body of the negro a mass of directlyfrom advancedsyphilitic lesions.1 In August 1972, minordefects and imperfectionsfrom the crown of the head HEW appointedan investigatorypanel which issued a report to the soles of the feet.. .." Cranial structures, wide nasal the followingyear. The panel found the studyto have been apertures,receding chins, projectingjaws, all typed the Ne- "ethically unjustified,"and argued that penicillin should gro as the lowest species in the Darwinianhierarchy.7 have been providedto the men.2 Interestin racialdifferences centered on the sexualnature This articleattempts to place the TuskegeeStudy in a his- of blacks.The Negro, doctorsexplained, possessed an exces- toricalcontext and to assess its ethicalimplications. Despite sive sexual desire,which threatenedthe very foundationsof the mediaattention which the studyreceived, the HEWFinal white society. As one physiciannoted in the Journalof the Report, and the criticismexpressed by several professional American Medical Association, "The negro springs from a organizations,the experimenthas been largely misunder- southernrace, and as such his sexual appetiteis strong;all stood. The mostbasic questionsof how the studywas under- of his environmentsstimulate this appetite,and as a general taken in the firstplace and why it continuedfor forty years rule his emotional type of religion certainly does not de- were never addressedby the HEW investigation.Moreover, crease it."8 Doctors reported a complete lack of morality on the panel misconstruedthe natureof the experiment,failing the part of blacks: to consult documentsavailable at the National important Virtue in the negro race is like angels' visits-few and far Archiveswhich bear significantlyon its ethical assessment. between.In a of sixteen I have never examined the in which values are practice years Only by examining specific ways a virgin negro over fourteen years of age.9 engagedin scientificresearch can the study be understood. A particularlyominous feature of this overzealoussexuality, doctors was the blackmales' desire for whitewomen. Racismand MedicalOpinion argued, "A perversionfrom which most races are exempt,"wrote A brief reviewof the prevailingscientific thought regard- Dr. English,"prompts the negro'sinclination towards white ing race and heredityin the earlytwentieth century is funda- women,whereas other races inclinetowards females of their mental for an understandingof the TuskegeeStudy. By the own."10Though English estimatedthe "graymatter of the turn of the century,Darwinism had provideda new ration- negro brain"to be at least a thousandyears behindthat of the white races, his genital organswere overdeveloped.As Dr. WilliamLee Howardnoted: ALLAN M. BRANDT is a doctoralcandidate in the Department of History, Columbia University. He is presently writing a The attacks on defenseless white women are evidences of social history of venereal disease in the United States. Mr. racial instinctsthat are about as amenableto ethical culture Brandt was a student intern at The Hastings Center in 1977. as is the inherentodor of the race .... When education will The HastingsCenter 21 I I reduce the size of the negro'spenis as well as bring about the possibilities for mass treatment. The USPHS found Macon sensitivenessof the terminalfibers which exist in the Cauca- County, Alabama, in which the town of Tuskegee is located, sian, then will it also be able to prevent the African's birth- to have the highest syphilis rate of the six counties surveyed. right to sexual madness and excess." The Rosenwald Study concluded that mass treatment could be One southern medical "Castration Instead successfully implemented among rural blacks.19Although journal proposed it is doubtful that the funds would have been allo- of Lynching," as retribution for black sexual crimes. "An necessary cated even in the best economic conditions, after the econ- impressive trial by a ghost-like kuklux klan [sic] and a 'ghost' or to the would make omy collapsed in 1929, the findings were ignored. It is, how- physician surgeon perform operation ironic that the to it an event the would never noted the edi- ever, Tuskegee Study came be based on 'patient' forget," of Rosenwald torial.12 findings the Study that demonstrated the pos- sibilities of treatment. to these lust and un- mass According physicians, immorality, Three in Dr. Taliaferro Chief of stable families, and reversion to barbaric tendencies made years later, 1932, Clark, the USPHS Venereal blacks to venereal diseases. One doctor esti- Disease Division and author of the especially prone Rosenwald mated that over 50 of all over the of Study report, decided that conditions in Macon percent Negroes age merited were free of disease as County renewed attention. Clark believed the high twenty-five syphilitic.13 Virtually of offered an "unusual for slaves, were now overwhelmed it, to in- prevalence syphilis opportunity" they by according observation. From its the USPHS the formed medical opinion. Moreover, doctors believed that inception, regarded Tuskegee Study as a classic in nature,"* rather than treatment for venereal disease among blacks was impossible, "study an experiment.20As long as was so in Ma- particularly because in its latent stage the symptoms of syph- syphilis prevalent con and most of the blacks went untreated life, ilis become quiescent. As Dr. Thomas W. Murrell wrote: throughout it seemed only natural to Clark that it would be valuable to They come for treatment at the beginning and at the end. observe the consequences. He described it as a "ready-made When there are visible manifestationsor when harried by situation."21Surgeon General H. S. Cumming wrote to R. R. pain, they readily come, for as a race they are not averse to Moton, Director of the Tuskegee Institute: but tell them not, look well and feel well, physic; though they The recent control demonstrationcarried out in Ma- that are still diseased. Here rates science a syphilis they ignorance con with the financialassistance of the Julius Rosen- fool... 14 County, wald Fund, revealed the presence of an unusually high rate Even the best educated black, according to Murrell, could in this county and, what is more remarkable,the fact that 99 not be convinced to seek treatment for syphilis.15Venereal per cent of this group was entirely without previous treat- disease, according to some doctors, threatened the future of ment. This combination,together with the expected coopera- the race. The medical profession attributed the low birth rate tion of your hospital, offers an unparalleledopportunity for among blacks to the high prevalence of venereal disease carryingon this piece of scientific research which probably which caused stillbirths