When government scientists came up with the following idea, someone in the room should have said, “You want to do WHAT?”
No one did, and so the U.S. Public Health Service in 1946 began paying diseased prostitutes to visit Guatemalan prisoners and infect them with syphilis.
If the women weren’t already carrying the deadly disease, the U.S. government gave it to them to pass along.
Still, the infection rate among the prisoners wasn’t as high as hoped, darn it.
Determined to get a large enough sample of diseased inmates, researchers tried other, more painful means, as you will see. Some of that is now laid out in a lawsuit seven Guatemalans filed this week against U.S. officials.
It was an atrocious program, all now admit. Apologies from the president on down have been sweeping and on-target. A new presidential commission is investigating that program and, gulp, others.
But words aren’t compensation, and hence the suit. Lawyers hope to make it into a class action for the hundreds of Guatemalans -- or their heirs -- who were unwittingly made a part of the experiment.
The Guatemala program came to light last year after a Wellesley College professor, Susan Reverby, happened upon evidence of it while researching another atrocity, the now-notorious project at the Tuskegee Institute in Alabama.
In that one, the Public Health Service offered free medical care to 600 syphilitic, black sharecroppers, who were largely illiterate, so the government could track the disease, beginning in 1932.
The tragedy was that the no one ever told the men what they had, and no one ever treated them. By the mid-1940s, scientists saw that penicillin cured syphilis, but the health service made sure that none of it went to the Tuskegee men.
For the next 25 years researchers kept watching the Alabamans sicken and die until publicity in 1972 shut the program down.
At least the Tuskegee subjects had contracted the disease on their own, with no help from the government. Not so in Guatemala, where a U.S. program purposefully infected healthy men and women with the debilitating disease without their consent or knowledge. The aim of the experiment was to find a way to prevent syphilis, oddly enough.
Still, most of the Guatemalans fared better in the long-run. While the disease was killing the Alabamans under the watchful eye of government researchers, the same agency was giving penicillin to the Guatemalans they had infected.
To most of them, at any rate. Reverby’s research shows that about 14 percent weren’t given an adequate dose, and follow-up was spotty.
And that was after researchers had used invasive and painful techniques to infect some of the subjects because the prostitutes (whose prison visits were legal) produced too few infections.
Trying a more direct approach, researchers scraped the penises of male prisoners and applied a strain of the disease to the area. For female inmates, modesty limited the scraping to exposed areas such as forearms and faces.
Still unhappy with the results, the program began the scrape-and-infect technique with institutionalized mental patients in Guatemala. At one point, Guatemalan soldiers were used as subjects, who were paired with prostitutes.
The lawsuit aims to represent any victims still living, as well as family members. Plus, there were hundreds of Guatemalan orphans subjected to blood tests -- but not infection -- as part of the research. The claim seeks to draw them into the plaintiffs’ class, too.
The litigation, the government apologies and the outrage that Reverby’s research touched off show an evolution in medical ethics. No one much complained when studies related to the Tuskegee program were published time and again until the 1970s.
The Guatemala project was kept secret, and those behind it were aware it would be controversial if disclosed, according to Reverby’s research.
A certain consciousness raising took place in the 1940s when Nazis went to trial for war crimes because of their medical experiments on Jews. New international law forbade that sort of thing.
But to whatever degree medical ethics were evolving, it was happening slowly.
It didn’t stop researchers from infecting mentally retarded children at a state school on Staten Island, New York, with hepatitis from 1963 to 1966, as the Associated Press reported.
Nor did it prevent scientists from injecting cancer cells into 19 chronically ill elderly people at a Brooklyn, New York, hospital in 1963.
And it didn’t happen quickly enough to cure the Alabamans of their syphilis.
It was only when the Washington Star and New York Times ran an AP story about Tuskegee that outrage prompted congressional hearings and new laws and standards.
The government also paid compensation to Tuskegee subjects and their family members, which is what the Guatemalans are seeking.
The Justice Department isn’t discussing the suit, but the case will have some hurdles to jump to succeed, not the least of which is governmental immunity.
It shouldn’t take a lawsuit for the U.S. to do the right thing. While the government is apologizing for what it’s done, it should acknowledge the wrongdoing with compensation for those who were made sick and for the family members who suffered because of it.
(Ann Woolner is a Bloomberg News columnist. The opinions expressed are her own.)
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