Ethical Experiments

On October 1, Secretary of State Hillary R. Clinton and Secretary of Health and Human Services Kathleen G. Sebelius found themselves apologizing to the Guatemalan government for an unexpected reason: A recent report revealed that American researchers had infected approximately 700 Guatemalans with syphilis between 1946 and 1948 to study the effects of penicillin. In some cases, the taxpayer-funded National Institutes of Health paid for syphilitic prostitutes to sleep with the test subjects in prisons. Other subjects were infected by pouring bacteria into cuts on their bodies. Although the tests were both unethical and appalling, in this situation, the apology issued by Secretaries Clinton and Sebelius was the most appropriate response to the revelations of scientific misconduct.

The U.S. government certainly owed an apology to Guatemalan officials, the victims of the study, and their families, especially given the funding provided by the National Institutes of Health. Apologizing is the most effective response to these revelations, because anything more—such as reparations or indemnity payments, as suggested by Cesar Dura of the Guatemalan newspaper Prensa Libre—would be impractical. Not only would it be difficult to quantify the amount of payment deserved by the victims and their families, but measures such as reparations would fail to right the past injustices in any productive manner. Although providing money to the victims’ relatives offers some form of compensation, it does not undo the prior wrong or the emotional anguish suffered as a result of the harmful experimentation.

One cause for concern in this case is the time lapse between the act of wrongdoing and its public revelation.  While the subjects were infected with syphilis between 1946 and 1948, the unethical activities were not reported until earlier this year, when they were unearthed by Susan M. Reverby, a professor at Wellesley College. At the very least, the U.S.’s apology rights the injustice of the experiment’s concealment from public view, providing the victims and their families with the acknowledgement they have deserved for decades.

In addition, we fear that the syphilis experiment may be symptomatic of other cases of medical injustice. If this is the case, the government should immediately release information on comparable situations. For example, the very doctor who spearheaded the Guatemala experiments was also guilty of ethical violations in the famous Tuskegee syphilis tests, when he denied patients medication in order to continue his study of their disease. Between 1963 and 1966, mentally handicapped children in New York City were intentionally infected with hepatitis in order to test treatment methods; also in 1963, patients in a Brooklyn hospital were infected with cancer cells to complete a study of tumors. However horrible their history, it is encouraging that all of these incidents have finally come to light in recent years. The American government has an obligation to continue investigating similar offenses and exposing them to public examination. Responsibility does not end with the doctors who conduct these unethical tests but with the government that endorses or conceals them.