The study of untreated syphilis in the negro male.
OBJECTIVE
The participation of minorities in clinical studies is the subject of much discussion and has even become the subject of Federal law. The project known as the Tuskegee Syphilis Study and officially titled "The Tuskegee Study of Untreated Syphilis in the Negro Male," is one of the great debacles of American medicine and a national shame. Despite the fact that its existence is well known, many do not know the historical facts of the study nor the context of the study. My purpose here is to recount the facts of the study and its historical context.


METHODS
The history recounted here is taken from documents gathered during a U.S. Senate investigation of the study, original papers located in National Library of Medicine, and books about the trial.


RESULTS
The trial began in 1931 as a survey of the natural history of untreated tertiary syphilis in Black men. This study enrolled 399 men with syphilis and 201 uninfected men to serve as controls. All were at least 25 years old at enrollment. The men were told they were in a study, but never educated about the implications. Later, men were not informed that there was a treatment for effective treatment for their disease--a treatment that was being withheld from them. This trial continued till 1972.


CONCLUSIONS
Many of the issues that led to the study and caused it to continue for 40 years still exist. The lessons of the Public Health Study of Untreated Syphilis in the Untreated Negro include the dangers of paternalism, arrogance, blind loyalty, and misuse of science. "Those who do not appreciate history are condemned to repeat it" (Alfred North Whitehead).
Brawley
O W
OW
Office of Special Populations Research, National Cancer Institute, Bethesda, MD 20892, USA.
D000407:Alabama; D044383:Black People / Q000266:history*; D002985:Clinical Protocols; D002986:Clinical Trials as Topic / Q000266:history*; D004992:Ethics, Medical / Q000266:history; D049673:History, 20th Century; D006801:Humans; D008297:Male; D010406:Penicillins / Q000266:history / Q000627:therapeutic use; D011287:Prejudice; D016079:Refusal to Treat; D012107:Research Design; D013587:Syphilis / Q000188:drug therapy / Q000208:ethnology / Q000266:history*; D014481:United States; D014492:United States Public Health Service / Q000266:history; D001741:Black or African American
D010406:Penicillins