The Experiments in Guatemala

A medical historian’s discovery that American researchers in the 1940s deliberately infected hundreds of people in Guatemala with syphilis or gonorrhea has provoked outrage in both countries. President Obama and Secretary of State Hillary Rodham Clinton rightly apologized to President Álvaro Colom of Guatemala. More will be needed to make amends, beginning with a planned investigation of this appalling breach of medical ethics.

The experiments were brought to light by Susan Reverby, a professor at Wellesley College, who found unpublished records in the archives at the University of Pittsburgh. The studies were led by Dr. John C. Cutler, an internationally known expert on sexually transmitted diseases and a former assistant surgeon general.

From 1946 to 1948, American public health doctors under his command infected nearly 700 Guatemalans — prisoners, mental patients and soldiers — without their permission or knowledge. Anyone who became infected was given penicillin and presumed to be cured, although records suggest that many were not adequately treated.

The aim of the research was to test whether penicillin could prevent the transmission of syphilis, whether better blood tests for the disease could be developed, and what dosages could cure syphilis. That cannot justify experimenting on human beings without their consent.

Although the American government, which financed the research, bears the chief responsibility, the studies were carried out in collaboration with Guatemala’s top venereal disease expert and several Guatemalan ministries and institutions.

Top health officials insist that current rules governing federally financed research would prohibit such experiments. They require that subjects be fully told of the risks and give their informed consent. Institutional review boards must approve the research.

The Obama administration has said it will ask the Institute of Medicine to investigate the experiments; a presidential bioethics commission will suggest methods to ensure that all human research around the globe meets rigorous ethical standards. The Guatemalan government plans to conduct its own investigation. The United States should also pay reparations to any survivors that can be found and compensate Guatemala by paying for ethical health projects there.

Editorial, New York Times

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Full article: http://www.nytimes.com/2010/10/08/opinion/08fri3.html