1. Responsible Conduct (MEDI 5070)
4/15/2017
Time Line for Human Subject Research and Protection
Tuskegee Study –
Declaration of Helsinki
Nuremberg Code
WWII –
Eugenics Movement
1900 10 20 30 40 50 60 70 80 90
2000
Tuskegee Study

2. Tuskegee Study of Untreated Syphilis
Responsible Conduct (MEDI 5070)
4/15/2017
Tuskegee Study of Untreated Syphilis
Tuskegee Study

3. Gender and Race Related Manifestations in 6,420 Cases of Late Syphilis
Responsible Conduct (MEDI 5070)
4/15/2017
Gender and Race Related Manifestations in 6,420 Cases of Late Syphilis
From: Sowder WT. An interpretation of Bruusgaard’s paper on the fate of untreated syphilitics. American Journal of Syphilology 1940; 24:
Tuskegee Study

4. Tuskegee Study Rationale - 1932
Was there enough information to justify a cohort study of untreated Negro men?
Were effective treatments available for managing syphilis?

5. Tuskegee Study of Untreated Syphilis
Negro Men
Infected with Syphilis
Macon County, Alabama

6. Alabama

7. Cotton Pickers – 1938 - Arkansas
Russell Lee – Farm Security Administration
Library of Congress - LC-USF M2

8. Incentives for Participation
Burial costs
Periodic Examinations

9. Nurse Eunice Rivers and Unidentified Subject
Cotton Field – Macon County, Alabama
(Centers for Disease Control, Atlanta, GA)

10. Field Follow-up: Tuskegee Study - 1952
Mr. David Albritton, Dr. Walter Edmondson, Nurse Eunice Rivers, and Unidentified Subject
Macon County, Alabama
(Centers for Disease Control, Atlanta, GA)

11. Tuskegee Study: Press Reaction - 1972

12. William Osler, M.D. “Believe nothing that you see in the newspapers –
they have done more to
create dissatisfaction than
all other agencies. If you
see anything in them that
you know is true, begin to
doubt it at once.”
1900

13. Rudolf H. Kampmeier, M.D.
Editorials:
The Tuskegee Study of Untreated Syphilis.
Southern Medical Journal
1972; 65 (10):
Final Report on the “Tuskegee Syphilis Study.”
1974; 67 (11):
Argues that the Tuskegee study should be interpreted in the context of the times in which it was conducted.

14. The Shibboleth of Informed Consent
“…I have no intention of becoming entrapped in this topic since to me the interpretation of customs and mores of a generation or two ago in today’s terms is a tilting at windmills…. In the days of the Tuskegee Study we used to walk into a patient’s room and announce ‘We’re going to take out your gallbladder tomorrow morning,’ the answer commonly was, ‘OK’ and that was it – no ‘informed consent,’no signed paper of permission – ergo, Jenner, the Hunters, Pasteur, and hundreds of thousands of physicians and surgeons of the past have been unethical in terms of ‘informed consent.’”
Kampmeier, RH. Southern Medical Journal 1974; 67:

15. Tuskegee Study
What is the evidence that treatment of tertiary syphilis with penicillin changes outcomes?
What proportion of cohort participants received antibiotics over the course of the study?
How complete was the cohort follow-up?

16. White House Apology Ceremony – May 16, 1997
Responsible Conduct (MEDI 5070)
4/15/2017
White House Apology Ceremony – May 16, 1997
Front Row (left to right):
Herman Shaw, Fred Simmons, Charles Pollard, Frederick Moss, Carter Howard.
Back Row (left to right):
Surgeon General David Satcher, President William J. Clinton, Vice-President Albert Gore.
Tuskegee Study