President Barack Obama received from his bioethics commission today the exhaustive report that investigates US-funded experiments conducted in Guatemala between 1946 and 1948, in which nearly 700 Guatemalan prisoners, soldiers and mental patients were intentionally infected with syphilis without their knowledge or consent. Additional experiments involved orphans and prostitutes and other sexually-transmitted diseases; children as young as ten years old were infected.
In the 201-page report, entitled “Ethically Impossible,” the bioethics commission comes to a blunt conclusion about John Cutler and other US researchers who conducted the experiments with National Institutes of Health funding: “Their failure to exercise moral leadership cannot be excused, and their failure led to practices that were so wrong as to be fairly characterized as heinous.”
It continues: “Those who committed these actions were not under any unusual pressure to do so. They thought that they were above the rules, and went to some lengths to shield themselves from normal institutionally imposed scrutiny.”
The report includes previously unreleased details gleaned by the commission from 125,000 pages of documents, along with photos of patients with psychiatric disorders who were intentionally infected with syphilis. One such patient, a 16-year-old who was twice infected, “was uncooperative”, according to the report.
Another psychiatric patient infected with syphilis, the report says, “fled the room after being subjected to scarification (cutting) of the penis, and he was not found for several hours.”
According to the report, Cutler was disappointed that cultural norms did not permit him to examine naked women, but conceded that under their “stated studies” there was “no good reason which could be offered [to the women] to explain the necessity for complete examinations.” Therefore, he wrote, “[i]t was unfortunately not feasible to attempt mucosal inoculation in the female genitalia to compare the male with the female.”
The researchers were in a hurry, according to the report:
“The researchers achieved a 96.8% transmission rate in the first artificial inoculation prison experiment via injection. But, ‘[i]n view of the importance of gaining information as rapidly as possible,’ the researchers decided to begin the next experiment ‘without waiting to determine the outcome’ of the first.
The researchers also used the same needle ‘repeatedly’ and without sterilization of any kind from one patient to the next. The practices significantly raised the risk of infection and other adverse health effects for individual subjects.”
These snapshots only touch the voluminous detail and shoddy science documented in the report, which also examines experiments that infected subjects with gonorrhea and chancroid.
In all, the commission notes in this press release, researchers conducted diagnostic tests including blood draws and spinal taps on as many as 5,500 Guatemalan prison inmates, psychiatric patients, soldiers, commercial sex workers, orphans and school children. Of those, about 1,300 inmates, psychiatric patients, soldiers and commercial sex workers were deliberately exposed to the sexually transmitted diseases syphilis, gonorrhea or chancroid.
The report comes two weeks after the commission announced at a public meeting that its investigation had found the research ethically indefensible.
Wellesley College historian Susan Reverby first uncovered the experiments late in 2010, prompting Obama to ask the commission to investigate. A second part of its investigation, to be submitted to Obama in December, examines whether current rules are adequately protecting research volunteers.