Between 1946 and 1948, American doctors led by the U.S. PHS physician John Charles Cutler deliberately infected Guatemalan soldiers, prostitutes and prisoners with syphilis. In order to study the effects of penicillin in counteracting syphilis, doctors paid infected prostitutes to spread the disease by having intercourse with prisoners and sometimes by directly inoculating Guatemalans through spinal taps with the bacterium. Dr. Reverby estimated that around 1,500 healthy Guatemalans were infected in this way. While penicillin was given to most patients, only 26% of the subjects received the full therapy, which led to many deaths amongst the subjects.
The brutality of these experiments is unquestionable and its bioethics violation beyond dispute, but we can learn more by addressing further questions.
1) John Charles Cutler defended his experiments saying that the subjects were treated in the end. Although we know that the treatment was not adequately completed, if all subjects were cured of the disease after the penicillin treatment, does that justify infecting uninformed subjects?
2) Can the suffering of a few people be justified, and such flagrant violations of bioethics condoned to allow for research that would benefit the greater community? For example, if someone were to develop a potential cure for cancer, could the sacrifice of a few individuals be justified to promote research that would ultimately cure countless people?
3) What are some factors underpinning the execution of these experiments? Rather than condemning American doctors as depraved and immoral, what contextual elements enabled their justification of these "ethically impossible" experiments? Was it Racism? Foreign subjects? Medical imperialism?
4) President Obama made a formal apology to Guatemalan president Colom regarding this matter. How should the subjects be compensated?
For further reading, please refer to the report, "'Ethically Impossible' STD Research in Guatemala from 1946 to 1948," by the Presidential Commission for the Study of Bioethical Issues - http://bioethics.gov/cms/sites/default/
- Kevin Kang