Report calls 1940s syphilis research 'unconscionable'

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A report on the medical research of John C. Cutler in Guatemala in the 1940s released this morning by a presidential commission concludes that the syphilis experiments he conducted for the U.S. Public Health Service involved "unconscionable" violations of ethics.

"The individuals who approved, conducted, facilitated and funded these experiments are morally culpable to various degrees for these wrongs," said Amy Gutmann, chair of the Presidential Commission for the Study of Bioethical Issues.

"The best thing we can do when faced with a dark chapter is to bring it to light," she said. "The commission worked to provide an unvarnished ethical analysis to both honor the victims and to make sure it never happens again."

The commission released its final report after first delivering a briefing on its contents at the White House.

Dr. Cutler, an assistant U.S. surgeon general and later an acting dean and professor at the University of Pittsburgh, intentionally infected soldiers, prostitutes, mental patients and prisoners with syphilis from 1946 to 1948. His boss at the time was U.S. Surgeon General Thomas Parran, who came to Pitt in 1948 to start the Graduate School of Public Health.

After reviewing more than 125,000 pages of documents and traveling to Guatemala, the commission's 12 full-time researchers concluded that Dr. Cutler and his colleagues conducted diagnostic tests, including blood draws and spinal taps, on up to 5,500 Guatemalan inmates, soldiers, prostitutes, orphans and school children. Of those, about 1,300 inmates, mental patients, soldiers and prostitutes were deliberately exposed to syphilis, gonorrhea and chancroid.

At least 83 of those patients died, although researchers aren't sure what killed them.

In a statement, Dr. Gutmann said the key to determining moral culpability was discovering that Dr. Cutler and some of his colleagues had conducted similar experiments that involved intentionally infecting prisoners to gonorrhea at the federal prison in Terre Haute, Ind., in 1943. In those experiments, however, the researchers obtained consent from the subjects.

In Guatemala, they did not.

"The double standard is shocking," said Dr. Gutmann. "The researchers in Guatemala treated the rules of the day as obstacles to be overcome."

After his career with the Public Health Service, Dr. Cutler followed Dr. Parran to Pitt, where he became a professor of international health at the Graduate School of Public Health from 1967 to 1993. After he died in 2003, Pitt began a lecture series in his honor that was later canceled by a new dean, Donald Burke, who said he discontinued it because of community sensitivities over Dr. Cutler's role in the infamous experiments at Tuskegee, Ala., in which the PHS withheld syphilis treatment for black sharecroppers for 40 years to track the progression of the disease.

Dr. Burke said today that any questions about Dr. Cutler's research with the PHS should be directed to the U.S. Department of Health and Human Services.

"The University of Pittsburgh has a continuing commitment to the highest ethical standards in research," he said in a statement, "especially when the research involves human subjects. Today, regulations that govern human medical research prohibit these kinds of appalling violations."


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