Portal de Periódicos da CAPES

Race and U.S. medical experimentation: the case of Tuskegee

2017; Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz; Volume: 33; Issue: suppl 1 Linguagem: Inglês

10.1590/0102-311x00168016

1678-4464

Joel D. Howell,

Health and Medical Research Impacts

In 1932 the county seat of Macon County, Alabama -the small town of Tuskegee -was one of the poorest towns in the United States.It was (and remains) an area marked by old plantations, sawmills, beautiful forests, and hard-scrabble living for the predominately African-American population.In 1932 they made their living as sharecroppers, picking cotton in the surrounding fields for a median income of USD 1 per day.A 1929 study found a high incidence of syphilis in the area.Ironically, that study aimed to explore possibilities for mass treatment using the ineffective treatments then available.But the depression followed and funds ran out.To understand what happened next at Tuskegee we need to consider the context.This was a time when many new scientific ideas were being developed.Scientists divided humankind into different "races".Each race was thought to have certain essential characteristics, and those racial characterizations had real, practical implications.For example, the noted American geneticist Charles Davenport opined that the influx of blood from Southeastern Europe will rapidly make the American population "darker in pigmentation, smaller in stature, more mercurial... more given to crimes of larceny, kidnapping, assault, murder, rape, and sex-immorality" 1 .A logical corollary to such racialized thinking was the notion that diseases would manifest differently in different races.Ever since the 1882 advent of the germ theory, physicians had been especially interested in understanding infectious diseases, such as syphilis.The only major study on the natural history of syphilis had been done using an almost entirely Caucasian population in Oslo, Norway.U.S. physicians wanted to know if syphilis would have a different natural history in African-Americans.One reason for their curiosity was that late syphilis was known to affect the central nervous system.Investigators questioned if relatively "primitive" and "underdeveloped" black brains would be spared.Other racist ideas about African-American people and sexually transmitted diseases supported the idea of the Tuskegee experiments.U.S. Public Health Service (PHS) physician Thomas Murrell said: "Those that are treated are only half cured, and the effort to assimilate a complex civilization drives their diseased minds until the results are criminal records.Perhaps here, in conjunction with tuberculosis, will be the end of the negro problem" 2 .Taliford Clark, also of the PHS explained that "Macon County is a natural laboratory; a ready-made situation.The rather low intelligence of the Negro population, depressed economic conditions, and the common promiscuous sex relations not only contribute to the spread of syphilis but the prevailing indifference with regards to treatment" 2 .