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The man who has no imagination has no wings. 
Muhammad Ali


Rodney D. Coates
Professor


-----Original Message-----


American Science's Racist History Still Haunts the World

By Michelle Chen
Colorlines
October 10, 2010 

http://colorlines.com/archives/2010/10/human_subjects_guatemala_and_the_history_of_racism_in_experimental_medicine.html

Early in America's crusade to spread the wonders of modern
medicine, a group of researchers in Guatemala did something
unspeakable in the name of science. Documentation of the
project is just now coming to light, more than 60 years
later, and it reads like a horror novel: Hundreds of men
systematically infected with syphilis and other sexually
transmitted diseases in an effort, endorsed by both the U.S.
and Guatemalan governments, to research the effectiveness of
drug treatment.

Researchers exposed men to disease with varying degrees of
intent. At first, Guatemalan health official Juan Funes
selected prisoners in Guatemala City as subjects because
prostitution at the penitentiary would likely yield fresh
infections. But the researchers used more invasive tactics as
well. The Washington Post reports, 'in other cases, doctors
put infectious material on the cervixes of uninfected
prostitutes before they had sex with prisoners.' When they
needed more infections, they took more aggressive
measures-'direct inoculations made from syphilis bacteria
poured into the men's penises and on forearms and faces that
were slightly abraded - or in a few cases through spinal
punctures,' according to the research of the historian who
broke the story, Susan M. Reverby (interviewed recently on
Democracy Now!).

Many, but not all, of these people-who included prisoners,
soldiers and mental patients-were given penicillin to test
its effectiveness as an after-sex treatment of syphilis, a
disease that that can result in blindness or death. Medical
personnel carried out similar studies on gonorrhea, which can
lead to intense pain and infertility, and chancroid, which
causes genital ulcers.

The archival documents suggest the experiments didn't raise
significant ethical qualms in Washington. The surgeon general
at the time was quoted as saying, 'You know, we couldn't do
such an experiment in this country.'

Well, in a way, they could. A bizarre element in the story is
the connection to another shameful chapter in the history of
American medicine. The man behind the infection of
incarcerated Guatemalans, Dr. John Cutler, had a hand in the
infamous Tuskegee experiments as well.

That study (also conducted in the name of public health, of
course) involved recruiting syphilitic black men into a 40-
year program that denied them treatment without their
knowledge. The U.S. Public Health Service worked in
partnership with the Tuskegee Institute to rope hundreds of
men into serving as an unwitting control group. Many were
never told about their condition and received either
insufficient treatment or none at all. Although the Public
Health Service was administering penicillin for syphilis by
1943, the Tuskegee 'subjects' received none to continue the
controlled study. Modern day informed consent guidelines stem
from the bioethical scandal that laid bare the cruel
entanglement of racism and science.

The Guatemalan research is further proof that medical abuses
against people of color wasn't limited to Tuskegee. In Puerto
Rico, for example, starting in the 1950s poor women served as
'guinea pigs' for trials of high-dosage birth control pills,
which were later embroiled in an ethical scandal over their
potentially dangerous side effects. Exploiting Puerto Rican
women's wombs was seen as a convenient alternative to dealing
with all the political and ethical hurdles that would have
surrounded studies of the pill on the mainland.

Experimentation on marginalized groups, at home and abroad,
is something of a tradition in American medicine. A
Counterpunch article documents over a century of cases of the
government deliberately sickening unwitting subjects,
stretching from military detainees in the Philippines exposed
to the plague to incarcerated men in Chicago infected with
malaria.

Many of the researchers involved with these experiments may
have genuinely believed they were serving a higher purpose.
They might have thought the ends justified the means, that
the lives of these Guatemalan inmates or poor black men were
somehow being redeemed through their participation in the
trials, albeit unwittingly. But both Tuskegee and Guatemala
City reflect a deep, even subconscious belief among medical
practitioners in the inferiority of the other.

The subjects, meanwhile, are tied together by their utter
powerlessness under the coercion of medical authorities-poor,
often imprisoned by the state, and lacking the knowledge they
need to control their own bodies fully. One of the cruelest
outcomes of these experiments is that they've irrevocably
damaged public trust in medical science, which has undermined
the exploited communities' health on an even broader level.
Some advocates attribute the black AIDS crisis in part to a
broad alienation of the community from the health care
system.

'We are concerned about the way in which this horrendous
experiment, even though it was 60 years ago, may appear to
people hearing about it today as indicative of research
studies that are not conducted in an ethical fashion,'
National Institutes of Health Director Francis S. Collins
told the Post after the Guatemala story broke.

Collins is referring to yet another high-stakes consequence:
Globally, the impacts of today's most damaging diseases fall
heaviest in poor communities of color, and any new treatment
rightly demands clinical trials in those contexts. Scientists
continue to struggle to earn enough trust to fulfill those
trials, and the Guatemala history is a big reminder of why
that's so. For clinical trials currently operating in the
Global South, the scandals of past experiments will hopefully
serve as a lesson in ethics for the future. 

(c) 2010 Colorlines

Michelle Chen's work has appeared in AirAmerica, Women's
International Perspective, Extra!, Colorlines and Alternet.
She is a regular contributor to In These Times' workers'
rights blog, Working In These Times. She also blogs at
Racewire.org.

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