Public Health

Commission: Researchers Knew Of Ethical Problems In Guatemala STD Study

U.S. researchers knowingly breached medical ethics by infecting Guatemalans with venereal diseases in the 1940s without informing them of the risks, a presidential commission has found.

The Presidential Commission for the Study of Bioethical Issues, which was asked by President Obama to investigate the Guatemala study in October 2010, came to the conclusion after learning that the researchers had conducted similar research with American prisoners in 1943 but had given them the chance to make informed consent.

The U.S. government formally apologized for the "reprehensible research" last year.

Medical ethics have come a long way in the last few decades, but many are still worried about how U.S. research is conducted overseas. In the wake of revelations of the Guatemala study, the president also asked the panel to review the rules that ensure that people who participate in research today are protected from harm or unethical treatment. On Tuesday, the panel released recommendations for how to improve those rules, including a suggestion that the U.S. compensate research subjects if they are injured in studies.

In the Guatemala experiments between 1946-1948, U.S. scientists sought out people in mental institutions, prisoners, commercial sex workers, and members of the Guatemala army and intentionally infected 1,300 of them with venereal diseases.

The aim of the Guatemala study was to investigate the use of penicillin to treat and prevent infection, but the results were never published. Only 700 of the people who were infected received some kind of treatment.

"These researchers knew these were unethical experiments, and they conducted them anyway," said Harvard geneticist and panel member Raju Kucherlapati, according to the Washington Post.

"I kept asking the question, 'How could they do this?' ... My conclusion is, and it has to be a reluctant one: ... the doctors did not treat these human beings as if they were worthy of respect or consideration," said Amy Gutmann, chairwoman of the commission, in the Monday briefing.

Susan Reverby, a professor of women's studies at Wellesley College, originally uncovered documents detailing the study and publicized her findings last fall. Reverby was interviewed by NPR's Robert Siegel then.

The commission said Monday that the researchers, including John Cutler, a physician who was also involved with the notorious Tuskegee syphilis experiments, apprised Indiana prisoners involved in a 1943 STD study of the risks. Those who volunteered to participate gave informed consent. But the Guatemalans were not given the same chance. Some 83 of the Guatemalan study participants had died by 1953, the panel said, but it's not clear if those deaths were from the STDs or other causes.

The Guatemalan government is also doing its own review of the research project, but hasn't released its findings.

Commission members said Monday that the scientists never published any results probably because of the ethical issues.

"What stings the most in terms of bad science is that it never passed peer review and was never published," said commission member Dr. Nelson Michael of the Walter Reed Army Institute of Research.

A full report of the commission's findings on the Guatemala experiment is due to President Obama in September.

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