Tuskegee Experiment

Tuskegee Experiment
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Abstract
The Tuskegee Experiment is perhaps one of the most contentious medical studies of the 20th century. The research began in 1932 in Macon County, Alabama. The United States Public Health Service (USPHS), alongside the Tuskegee Institute, commenced a program to document and acquire a cure for syphilis among males from the African American population. Initially, the study involved a sample population of 600 black men, 399 of whom had syphilis CITATION Cen17 l 2057 (Centers for Disease Control and Prevention, 2017). It is vital to note that the majority of the sample population included poor and illiterate individuals. While the research was projected to last for only six months, it went on for four decades. The current paper employs a case study approach to assess the Tuskegee Experiment, revealing violations of the four major healthcare principles by the USPHS. Moreover, the paper finds that the researchers gave baseless justification to conduct the experiment. Finally, the paper cautions on the importance of balancing between individual rights and the common good in medical experimentation.
Keywords: Tuskegee Experiment, healthcare principles, syphilis, individual rights, the common good.
Tuskegee Experiment
The Tuskegee Experiment began in 1932 and was marred by gross ethical violation such as misinformation and deception. The researchers did not divulge the study’s objective to those involved. Instead, they described it as a treatment for “bad blood” a local term associated with diseases such as anemia and syphilis CITATION Cen17 l 2057 (Centers for Disease Control and Prevention, 2017).

Even so, at the time of the research’s completion in 1972, none of the participants had received the proper treatment for syphilis, even with the advent of penicillin in 1947 CITATION Cen17 l 2057 (Centers for Disease Control and Prevention, 2017). The current paper reviews, in brief, the medical and ethical catastrophe that was the Tuskegee Experiment. Herein, the discussions will focus on identifying the health care principles that were violated in the study and how the researchers justified their methods. Subsequently, an evaluation of the delicate balance between individual and common good and how researchers used this argument to defend their actions will follow.
Violated Health Care Principles in Tuskegee Experiment
The majority of available medical procedures have their merits and demerits. Moreover, the decision to employ a specific medical procedure requires the patient’s input. Nevertheless, there are instances when practitioners are required to make difficult decisions when faced with complicated patient situations. Healthcare principles provide guidelines to come up with sober and beneficial decisions. This section of the paper reviews the health care principles that were violated by the Tuskegee Experiment.
Autonomy
Summers (2009) describes autonomy as self-rule. The author notes that in a medical setting, autonomy is dictated by two conditions, competence and lack of coercion and persuasion. As such, the patient should be informed of the proposed medical procedure and allowed to decide whether to participate in it. Summers (2009) notes that in the case that practitioners make a medical decision for a patient, even though such a resolution may be regarded as beneficial, without their consent, they would have violated the patient’s autonomy. In the case of the medical study in Tuskegee, the researchers deliberately misinformed the study’s targeted population. Instead of notifying the black male population of the study’s objective and expected outcomes, they purposefully deceived them into thinking that they receiving treatment for bad blood. Moreover, the researchers did not inform their subjects of the treatment method and whether it had any side effects.
Additionally, one could argue that although the men in the Tuskegee Experiment had agreed freely to participate in the study, they had been persuaded by the thought of free meals and medical checkups and burial insurance CITATION Cen17 l 2057 (Centers for Disease Control and Prevention, 2017). As mentioned earlier, the vast majority of the subjects in the Tuskegee experiment were poor. As such, they would be more accepting to take part in the study for the “rewards.”
Beneficence
Beneficence dictates that all medical practitioners should do everything in their powers to ensure the patient benefits in all situations. According to Summers (2009), beneficence also incorporates altruism. The author argues that medical practitioners are morally obligated to be selfless in helping others. Nevertheless, the researcher conducting the Tuskegee Experiment seem not to bear their subjects well-being in mind. According to the CDC (2017), the researchers continued to administer ineffective treatment, primarily mercurial ointments, and bismuth, even with the advent of penicillin in 1947. The employed treatment at the time had minimal success rates and adverse effects that were in some instances fatal. It is imperative to note that by 1947, penicillin had become widely accepted as a potent treatment for syphilis CITATION Cen17 l 2057 (Centers for Disease Control and Prevention, 2017). This incidence goes on to show that the researchers did not have the patient’s interest when conducting their study.
Nonmaleficence
Nonmaleficence is perhaps the most widely acknowledged healthcare principle that emphasizes ensuring no harm is done to the patient. Summers (2009) accentuates that in the context of the medical profession, harm is not only confined to the physical, but also in the manner in which patients are treated. The author points out that negligence and violation of autonomy are a form of harm. Transposing these definitions onto the events of the Tuskegee Experiment, it is clear that the researcher did little to nothing, in minimizing harm to their subjects.
On the one hand, the researchers violated the autonomy of the sample population when they failed to inform them of the study’s objective. Additionally, not only was the employed treatment ineffective but also highly toxic. Brandt (1978) points out that the mercurial ointments used had no therapeutic value while arsenic and bismuth injections were associated with toxicity and fatalities. It is essential to underscore that the researchers continued to administer these ineffective and toxic therapies up until discontinuation of the research in 1972. On the other hand, they neglected to educate their subjects on disease progression and transmission CITATION Cor99 l 2057 (Corbie-Smith, 1999). These led to the death of more than 100 participants from syphilis and its complications.
Justice
Justice as a health care principle dictates that there should be fairness in all medical decisions. Summers (2009) categorizes justice in two that is distributive and procedural. Procedural justice stresses on equality and following due process. This injustice was evident in the Tuskegee Experiment as the researchers failed to provide fair treatment. They deceived the subjects and failed in their duty to offer preemptive education. Distributive justice focuses on fairness in decision-making to ensure equal division of benefits and burdens CITATION Sum09 l 2057 (Summers, 2009). Nonetheless, there were gross distributive injustices during the Tuskegee Experiment. Perhaps the greatest of all was the decision not to administer penicillin as a treatment for syphilis. This choice saw the continual administration of ineffective and dangerous treatments for 40 years and resulted in deaths.
Justification for Tuskegee Experiment
The justification for the Tuskegee Experiment is deeply rooted in racism. According to Brandt (1978), Darwinism introduced a new perspective on American racism. The racists viewed that primitive (black) civilizations could not be assimilated into more complex (white) ones. This view was also supported by the medical profession, who argued that in their struggle for freedom, the black population had become mentally, morally and physically inferior. This inferiority was associated with the high rates of venereal diseases among blacks. Some doctors believed that such ailments would wipe out the black race hence the need for a study to establish the prospects of mass treatment CITATION Bra78 l 2057 (Brandt, 1978). Macon County in Alabama was found to have the highest rate of syphilis infection and was chosen to be the base for the proposed study. Brandt (1978) notes that chief of the USPHS at the time Doctor Clark believed that the high prevalence of syphilis in Tuskegee presented a rare prospect for observation. The USPHS regarded this as a study in nature CITATION Bra78 l 2057 (Brandt, 1978).
Individual Rights versus Common Good
In their simplest definitions, individual rights emphasize on the freedom and sovereignty of the individual, while common good focuses on improving benefits to the society CITATION Ric13 l 2057 (Rich, 2013). In medical experimentation, it is imperative to strike a balance between these two schools of thought. Researchers ought to come up with a methodology that infringes on neither individual nor common good. Nevertheless, as discussed above, the main aim of the Tuskegee Experiment was to establish the possibilities of mass treatment CITATION Bra78 l 2057 (Brandt, 1978). As such, the researchers focus more on the common good and in the process, encroach on the individual rights of their participants. This infringement is clearly seen in the disregard for autonomy by the study conductors. Their deliberate decision not to inform the subjects of the study’s objectives, projected outcomes or possible effects undermines their freedom and sovereignty. Conversely, the researchers, through racism, justify their need for experimenting on the black population to counter what they believe is a threat to this race. In the film Miss Evers’ Boys, Nurse Evers argues that although some patients were damaged by the study, their impairments are vindicated by the benefits gained for African American communities CITATION Jos97 l 2057 (Sargent, 1997).
Conclusion
The Tuskegee Experiment remains one of the most ghastly medical studies of all time. Nevertheless, the ethical concerns raised by that research continue to shape the manner in which medical experimentations are carried to-date. The paper has given a brief overview of how researchers blatantly disregarded the four major healthcare principles while carrying out the study. Moreover, the paper has revealed the unscientific basis with which the medical profession used to warrant the horrendous experiment. Finally, the paper emphasizes the need for balance between individual rights and common good to ensure medical experimentations are fair.

References
BIBLIOGRAPHY Brandt, A. M. (1978). Racism and research: The case of the Tuskegee Syphilis study. Hastings Center Report, 8(6), 21-29.
Centers for Disease Control and Prevention. (2017, August 30). The Tuskegee Timeline. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/tuskegee/timeline.htm
Corbie-Smith, G. (1999). The Continuing Legacy of the Tuskegee SyphiIis Study: Considerations for CI in ical Investigation. The American Journal of the Medical Sciences, 317(1), 1-7.
Rich, K. L. (2013). Introduction to Bioethics and Ethical Decision Making. In J. B. Butts, & K. L. Rich, Nursing Ethics: Across the Curriculum and into Practice (3rd ed., pp. 31-66). Burlington, MA: Jones and Bartlet Learning.
Sargent, J. (Director). (1997). Miss Ever’s Boys [Motion Picture].
Summers, J. (2009). Principles of Healthcare Ethics. In E. E. Morrison (Ed.), Health Care Ethics: Critical Issues for the 21st Century (pp. 47-58). Sudbury, MA: Jones and Bartlett Publishers LLC.