Last fall, it came to light that researchers had infected 700 Guatemalan soldiers, prisoners, and mental patients with syphilis in a US Public Health Service study between 1946 and 1948. The American government apologized for these “abhorrent” practices, and promised to investigate what had happened. A White House bioethics commission released its report on the study this Tuesday—and as horrific as the experiments sounded initially, the full story is even worse.
The studies were approved by an astonishing list of government, military, and academic public health and legal experts, the report shows, including the surgeon general; this was sanctioned, government-backed research, not a couple scientists going rogue. The researchers performed diagnostic tests on a total of 5,500 people, the report notes, and infected a total of 1,300, including schoolchildren, with syphilis and other sexually transmitted infections. The report also details evidence that the researchers knew this work wasn’t ethically above board, including the publication of the Nuremberg Code governing medical ethics in 1947, and the fact that they’d asked for subjects’ informed consent in a similar study in the US, but did not do so in Guatemala. “They thought that they were above the rules, and went to some lengths to shield themselves from normal institutionally imposed scrutiny,” the committee wrote [pdf]. Perhaps most chilling are the details the report gleans from the researchers’ own notes, such as the scientists’ disappointment at not being able to surreptitiously infect women during routine exams, the use of needles on multiple patients without sterilization, and anecdotes of patients who fled or resisted infection.