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The Tuskegee Syphilis Study

The Tuskegee Syphilis Study is research intended to identify the natural history of Syphilis among Black males from Macon County, Alabama, and took place on the campus of Tuskegee Institute. The study titled "Tuskegee Study of Untreated Syphilis in the Negro Male." It began when medical professionals had not yet discovered the treatment for Syphilis. Ideally, the researchers convinced the participants that they would treat them for "bad blood" that included Syphilis, anemia, and fatigue, thus easily convincing about 600 poor and illiterate Black American males to enroll as samples in the case study. Among these, 201 were used as the control subjects, while 399, who had Syphilis, were the experimental samples in the group. In exchange for their participation, the men received services that poor Black Americans could rarely achieve. For instance, they were offered free transport to and from the clinic, medical exams, free treatment of minor sicknesses, meals during the examination days, and guarantees that their survivors would be paid after their death.

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Eventually, Penicillin was introduced as the standard cure for Syphilis, but the researchers withheld treatment for both the control and experimental group. This behavior resulted in Jean Heller questioning the study's ethics since many men had died and others were infected even after the introduction of the medicine. Therefore, a panel was formed to evaluate if the study was necessary. The team concluded that the research was ethically unjustified because the participants were not allowed to quit after introducing Penicillin. Also, the treatments they received during the study had life-threatening impacts on their wives and children, and they had not been told the purpose and actual name of the study. Thus, the Tuskegee Syphilis Study led to the introduction and emphasis of research ethics and principles.

Ethical Principles in this Case

The research should have followed the distinct research principles: beneficence, justice, autonomy, and non-maleficence.

Autonomy

It refers to the right to independence, freedom, and self-determination for the participants to choose during the study. Although there are situations in which autonomy can be restricted, it is an ethical obligation for researchers to uphold this principle, especially in cases where the client's health is involved. In the Tuskegee Study, the participants should have been given the right to quit participating when Penicillin was introduced. In this case, the choices would have enabled most Black men to seek medical attention, save their wives and children from being infected, and reduce the number of people who died from the disease even after the medicine was introduced.

Justice

While distributive justice requires that individuals should be equally treated regardless of their ethnic groups, age, gender, culture, and marital status, social justice entails equal rights to goods and services in the community regardless of the characteristics of the individual. This principle is complex and demands fairness in how each participant is treated. Tuskegee researchers violated the distributive justice rule by exploiting black men's poverty and illiteracy. Instead, they should have provided all the necessary information before beginning the research, similar to how they could have treated rich white men.

Non-maleficence

Providing services and benefits for the good of the majority is significant. It dictates that researchers should not intentionally or unintentionally harm their participants. The Tuskegee study should have avoided providing treatments that had debilitating consequences on their health and that of their partners. Besides, failing to allow them to seek medical help risked the participants' life in danger.

Beneficence

It requires that researchers provide benefits to their participants and improve their life. The Tuskegee study could benefit the male participants by compensating them for their time during the research, such as improving their lifestyles since their families lived in a poverty-stricken environment. Besides, they could extend their help to the wives and children of the participants.

Legal and Ethical Lessons from the Study

The Tuskegee study reveals the importance of the Public Health Service (PHS) in ensuring that participants' health is upheld during research. Ideally, this organization should practice professionalism and avoid personal biases to enhance research standards. For example, the PHS could have comprehended the complexities of the research before the poor and uneducated Black community was lured into taking part in the study. Despite the clear research ethics and principles, some researchers are overly determined to get the findings without considering the health and consequences of their study. They highly devalue the principle of justice and beneficence, thus harming the participants physically or emotionally. Further, the government and the concerned organizations should implement strategies of compensating ill-treated participants during a study and punishment for the research. The Tuskegee study was a great turning point for researchers and the implementation of research principles. It led to the evaluation of the PHS body and the development of a committee that would get the then-US president to apologize to the survivors of the Black men's families on behalf of the researchers and a permanent compensation plan. Besides, the committee held public education to enlighten society on the information they should know before participating in research. Thus, scientific researchers should be careful with their research activities and consider all the research principles to avoid interfering with the health and emotional well-being of the participants.

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