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In 1932 the U.S. government promised 399 African American men free treatment for Bad Blood, a euphemism for syphilis, which was epidemic in Macon County, Alabama. All of the men were residents of Macon County; all were poor and uneducated, and none of them received the promised treatment. The men became unwitting participants in a government sanctioned medical investigation, "The Tuskegee Study of Untreated Syphilis in the Negro Male", which lasted 4 decades and had nothing to do with treatment. No new drugs were tested; the efficacy of old treatment modalities was neither confirmed nor refuted, and when a definitive treatment for syphilis became available in 1942, it was withheld (Jones, 1992).
A Prospective Study
For a few months, the men received exceedingly low, nontherapeutic doses of mercurial ointment and bismuth, which were the somewhat effective, but quite toxic treatments of the day; however, funding never materialized to pay for extended treatment. Instead ofcalling a halt to the study, U.S. Public Health Service investigators decided to salvage their work by compiling data on spontaneous evolution of syphilis and its effects on African American males. The scientific objective was to compare the pathological manifestations of untreated syphilis documented at Tuskegee with findings of an earlier study conducted in Olso, Norway, but there was a big difference: The Olso study had been a retrospective investigation in which researchers pieced together information from syphilitic white males who had remained untreated for a long time prior to the study's start in 1928 (Benedek, 1978; Jones, 1992).
Ethical Misconduct
According to current human protections guidelines, ethical considerations in the Tuskegee Study were limited from the beginning, and they rapidly deteriorated. Participants were uninformed, and deception was used throughout. One survivor noted, "I don't know what they used us...