Tuskegee Syphilis Study: Failing to Treat Black Men for 40 Years

Young boys like the ones here grew up to be unwitting subjects of an experiment that tracked (and neglected to treat) syphilis over several decades. ilbusca / Getty Images

The Tuskegee syphilis study, also known as the U.S. Public Health Service (USPHS) Untreated Syphilis Study at Tuskegee, is one of the most infamous chapters in the history of U.S. public health and scientific research. PHS, in collaboration with the Tuskegee Institute, conducted the study, which aimed to observe the natural history of untreated syphilis in Black men from Macon County, Alabama.

Over its 40-year duration, the study profoundly influenced research and health care practices, raising critical questions about ethics, informed consent and the protection of human subjects (now called "participants" instead of "subjects").

What Was the Tuskegee Syphilis Study?

The Tuskegee syphilis study began in 1932 as a collaboration between the Public Health Service and the Tuskegee Institute. The goal of the study was to observe the progression of untreated syphilis in 600 Black men, 399 of whom had syphilis and 201 who served as a control group.

Researchers justified their work by claiming they were contributing to the understanding of venereal disease and its impact on health and disease control.

Lies and Placebos

Recruited under the pretense of receiving free medical care for "bad blood," participants did not learn of their syphilis diagnosis, nor were they provided with penicillin when it became the standard treatment in the 1940s.

Instead, researchers subjected the men to periodic medical examinations and often gave them placebos. The study continued until 1972 when a whistleblower exposed its unethical practices, leading to public outrage and its eventual termination. An ad hoc advisory panel called for the end of the study after the backlash.

Racist and Unethical Practices

What makes the Tuskegee study particularly egregious is the deliberate exploitation of vulnerable communities under the guise of scientific research.

Researchers promised the participants — most of whom were poor sharecroppers — free medical care and treatment for what was described as "bad blood," a term that encompassed various ailments, including venereal diseases like syphilis.

Lack of Informed Consent

The study violated multiple ethical principles in research and health care, particularly informed consent, a fundamental requirement in modern scientific research. As researchers misled participants about the purpose of the study, they were unaware of the risks they faced.

Withholding Treatment

Additionally, even after the discovery of penicillin, researchers withheld effective treatment, constituting a gross breach of medical ethics. This neglect not only prolonged the suffering of the men but also exposed their families and communities to further harm.

The PHS prioritized the study's "natural history" observations over the well-being of the participants, ignoring their basic rights as humans.

Measures to Prevent Similar Injustices

In response to the Tuskegee syphilis experiment, there were significant reforms to ensure the ethical treatment of human subjects in scientific research.

The National Research Act of 1974 established the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research to oversee and approve research involving human participants, ensuring that studies adhere to ethical standards, including obtaining informed consent and minimizing harm.

The resulting guidelines are a part of the Belmont Report. You can read the full 705-page report here.

Additionally, federal guidelines now mandate that all research involving human subjects must prioritize the well-being and rights of participants. Researchers must disclose the nature, purpose and risks of their studies, so participants can make informed decisions.

The Tuskegee study also spurred the creation of the National Center for Bioethics in Research and Health Care at Tuskegee University to promote ethical research practices and educate future generations.

Efforts to Bring Justice

The federal government has taken several steps to address the harm the Tuskegee syphilis experiment caused, though people continue to disagree on whether or not these efforts are enough.

In 1973, the Tuskegee Health Benefit Program began to provide lifetime medical care and financial compensation to the study participants and their families. This program aimed to offer some form of restitution to those affected by the decades-long injustice.

There was also an out-of-court settlement of $10 million. The money went to the heirs of the late control group participants ($5,000), heirs of the late participants who had syphilis ($15,000), to the members of the control group who were alive ($16,000) and to the living syphilitic participants ($37,500).

In 1997, President Bill Clinton formally apologized on behalf of the federal government, acknowledging the profound harm the study inflicted and committing to rebuilding trust in public health initiatives. Additionally, the National Archives has preserved records of the study to ensure transparency and accountability, allowing future generations to learn from this dark chapter in history.

We created this article in conjunction with AI technology, then made sure it was fact-checked and edited by a HowStuffWorks editor.