Blood, Sweat, and Tears: The Tuskegee Experiment and the Era of AIDS
Kirp, David L., Tikkun
Last winter, as controversy swirled over the (nomination of Dr. Henry Foster as U.S. Surgeon General, opponents produced a bombshell allegation: In 1969, when Foster was a medical professor at Alabama's Tuskegee Institute and vice president of the Macon County medical society, he learned about and did not protest the continuation of a protracted study of untreated syphilis in 99 Black men--a study later known and reviled as "the Tuskegee experiment."
What did Foster know and when did he know it The medical society's president recalled that, during a 1969 meeting at which U.S. Public Health Service officials briefed the group, Foster sat two or three chairs away. Foster himself remembered things differently--he insisted he was not aware of the Tuskegee experiment until it became national news in 1972, when he reacted with "outrage."
In this barrage of charge and counter-charge, one central fact went unnoticed: Until the Tuskegee story broke in 1972, no one of any stature ever challenged the experiment in its forty-year history, despite the fact that the existence of the project was well known--indeed, articles in leading medical journals regularly updated the study's findings. Furthermore, as James Jones observes in Bad Blood, the definitive account of the Tuskegee study, that fateful 1969 meeting followed on the heels of a high-level review of the experiment, undertaken by the federal Centers for Disease Control, which concluded that, on scientific grounds, the research should continue.
Research was one thing, though, common perception something entirely different. When confronted with the possibility of "wild journalistic misinterpretations," the Centers for Disease Control (CDC) decided that it would be "good public relations" to garner the support of the local medical establishment. They got that backing and much more. A CDC official noted wonderingly that the doctors "actually agreed that if they had a list of the individuals [in the study] they would not knowingly give them antibiotics," not just for syphilis but also for the wide range of infections that were routinely treated with antibiotics. The endorsement prompted the CDC to renew its search for all the original study participants still living and to continue the study until the last of them had died.
But three years later, Tuskegee became news, a medical outrage that rivaled the Nuremberg revelations about Nazi scientists. Congress investigated and passed legislation placing new strictures on the conduct of medical research. Nevertheless, this flurry of publicity and policy-making ignored the extent to which the medical and scientific establishment had endorsed the research. And the scientific establishment fled from responsibility. "Shocked and horrified" was the reaction of an assistant secretary at the Department of Health, Education and Welfare--an inadvertent adaptation of the famous line from Casablanca--and the same theme was sounded by the CDC, the Tuskegee Institute (where much of the research was carried out), and the local doctors' group. "A literal death sentence was passed on some of those people," one federal official piously declared, as if an alien authority had passed that sentence.
A generation later, Tuskegee stands as a synonym for racial genocide in our time, especially among African Americans. That's why the contention that Dr. Henry Foster was a knowing, if minor, player in this drama has such potency all these years later. Yet an exclusively racial reading of Tuskegee tells only a partial truth, for the critical lessons to be learned really have much less to do with race than is generally supposed, and much more to do with the hubris of the researchers and the power of medical hierarchy.
In the Black community, though, the reverberations of Tuskegee extend far beyond the fate of another hapless Clinton appointee. Among African Americans, the widespread perception that the experiment emblemizes Nazi science in America laid a foundation for deep distrust of the authority of public health. …