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International News Title: The Moral of the U.S. Syphilis Experiments in Guatemala Read this account of the experiments carried out in the 1940s by "scientists" from a "civilized" nation in another country that was under its influence: The initial experiments involve the study of sex workers intentionally infected with Treponema pallidum [photo, left] as the source of infection for male inmates. At that time, the sex workers were admitted into the prisons. When the rate of male-female transmission proved low, the research approach changed to direct inoculation of inmates and patients in the psychiatric hospital. Most of the experiments involved subcutaneous injection of T. pallidum or exposure of the penile foreskin to infectious material. The majority of research subjects were treated with penicillin, although the available research records don't document therapy or the completion of therapy for all participants; some received only partial treatment. One research subject, a patient with a history of severe epilepsy, died of "status epilepticus" during treatment with penicillin. Although additional deaths occurred during the study in the psychiatric hospital, they were probably related to high rates of previous illnesses like tuberculosis. The researchers provided some items of institutional support, such as anti-convulsants and refrigerators for storing vaccines; and offered cigarettes as an incentive for to the research subjects. The records provide no indication that the individuals have understood that they are participating in research. The majority of the experiments on gonorrhea and cancer were carried out on soldiers. While the initial studies involved sexual contact between soldiers and sex workers who had been infected with gonorrhea; subsequent participants were infected with intraurethral inoculations with Neisseria gonorrhea and cutaneous inoculations with Haemophilus ducreyi, which were then treated with penicillin and sulfa drugs, respectively. Ethical violations in this study include the following: (1) the participants were members of vulnerable populations, including people with mental illnesses and the institutionalized, prisoners and soldiers (who were incapable of giving valid informed consent); (2) subjects were intentionally infected with pathogens that could cause severe illnesses; and (3) lies were told in order to carry out the experiments. The correspondence between the researchers and their superiors also recognizes the unethical nature of their work. A letter written in 1948 states: "I am a bit, in fact more than a bit, leery of the experiment with the insane people. They cannot give their consent, do not know what is going on, and if some goody organization got wind of the work, they would raise a lot of smoke." The study was never published. For many people, the first impulse would be to conclude that these experiments were conducted by Nazis in Poland, but that is not the case. The author of the letter I just quoted was R.C. Arnold, the supervisor of the physician John Cutler, who carried out the experiments in Guatemala between 1946 and 1948. This was, therefore, the end of World War II, and coincided with the exposure of the horrors at German concentration camps and the work of butchers like Josef Mengele. Arnold and Cutler worked for the U.S. Public Health Service. The documents relating to this barbaric research were discovered by Susan Reverby of Wellesley College in the U.S. She was looking for documents from another inhumane experiment with syphilis, this one on North American soil (Tuskegee), but found the Arnold letter and other overwhelming documentation on the Guatemalan case. Reverby's discovery is available on the Internet, and the above report was translated from the article of recognition - almost an apology - written by Thomas R. Frieden and Francis S. Collins, directors of the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), respectively, both in the U.S. The commentary was published in the Journal of the American Medical Association (JAMA). I don't write about this to demonize the Americans, although it's always useful to qualify our admiration for the high standards of medical research bodies in the U.S. I do it to put my finger on a more painful wound, which appears to have scarred over, but which hides an abscess that remains untouched: the long history of evil, or the unsettling fact that moral and ethical standards vary over time. After all, despite the discomfort of the writer, there were more than a few people in that decade who would perhaps have considered the harmful research on people who are "objectively" inferior as legitimate, such as those - prostitutes, the insane and criminals, and above all, in a Banana Republic. It seems inconceivable today. But I never tire of remembering that my paternal grandmother, Dona Sinhá, who was born in 1885, had a Black mammy. We don't know if she was a slave. The effects of slavery in Brazil aren't as remote as ideologues of the nonexistence of racism among us would have you believe. In the middle of the 20th century, eugenics was still current doctrine in medicine, and not just in the U.S., Germany or Brazil. http://worldmeets.us/ http://worldmeets.us/folha000036.shtml#ixzz12YudGhxq
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