Guatemala syphilis experiment
The syphilis experiments in Guatemala were United States-led human experiments conducted in Guatemala from 1946 to 1948. The experiments were led by physician John Charles Cutler who also participated in the late stages of the Tuskegee syphilis experiment. Doctors infected soldiers, prostitutes, prisoners and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects. The experiment resulted in at least 83 deaths. Serologystudies continued through 1953 involving the same vulnerable populations in addition to children from state-run schools, an orphanage, and rural towns, though the intentional infection of patients ended with the original study. In October 2010, the U.S. formally apologized to Guatemala for the ethical violations that took place, and since then, a lawsuit has been filed.
Preceding the experiments was a large push by medical professionals, including the U.S. Surgeon General Dr. Thomas Parran, to further the knowledge of Sexually Transmitted Diseases and discover more viable treatment options. In 1947, syphilis prevention research was being conducted on rabbits through injection of penicillin. Around this same time there was large push by medical professionals, including the U.S. Surgeon General Dr. Thomas Parran, to further the knowledge of Sexually Transmitted Diseases and discover more viable treatment options in humans. This was largely due to an effort to protect the U.S. military population from the increasing infections of STDs such as gonorrhea as well as the particularly painful regimen of prophylaxis that involved the injection of a silver proteinate into subjects' penises. With the onset of World War I, this emphasis for new knowledge became stronger and won more supporters.
The first experiment following this push for new developments in STD treatment and preventative measures were the Terre Haute Prison Experiments from 1943-1944, which were conducted and supported by many of the same individuals who would go on to participate in the Guatemalan Syphilis Experiments only a few years later. The goal of this experiment was to find a more suitable STD prophylaxis, by infecting human subjects recruited from prison populations with gonorrhea. Though at first, the idea of using human subjects was controversial, the support of Dr. Thomas Parran, and Executive Officer of the U.S. Army Medical Corps, Colonel John A Rodgers allowed Dr. John F. Mahoney and Dr. Cassius J. Van Slyke to begin implementing the experiments. Dr. John Cutler, a young associate of Dr. Mahoney, helped conduct the experiments.
The experiments in Terre Haute were the precursor for the Guatemalan experiments. It was the first to demonstrate how actively military leaders pushed for new developments to combat STDs and their willingness to utilize human volunteers to infect, and also explained why the study clinicians would choose Guatemala- to avoid the ethical constraints related to individual consent, other adverse legal consequences, and bad publicity.
In total, 1,308 people were involved in this experiment, and of this group, 678 individuals were documented as getting some form of treatment. This population consisted of commercial sex workers, prisoners, soldiers, and mental hospital patients. Their ages ranged from 10 to 72, though the average subject was in their 20s. A documented subject profile provides a detailed description of what the subjects faced within this experiment:
Berta was a female patient in the Psychiatric Hospital... in February 1948, Berta was injected in her left arm with syphilis. A month later, she developed scabies (an itchy skin infection cause by a mite). Several weeks later, Dr. Cutler noted that she also developed red bumps where he had injected her arm, lesions on her arms and legs, and her skin was beginning to waste away from her body. Berta was not treated for syphilis until three months after her injection. Soon after, on August 23, Dr. Cutler wrote that Berta appeared as if she was going to die, but he did not specify why. That same day he put gonorrheal pus from another male subject into both of Berta's eyes, as well as in her urethra and rectum. He also re-infected her with syphilis. Several days later, Berta's eyes were filled with pus from the gonorrhea, and she was bleeding from her urethra. Three days later, on August 27, Berta died. 
The Centers for Disease Control and Prevention acknowledges that "the design and conduct of the studies was unethical in many respects, including deliberate exposure of subjects to known serious health threats, lack of knowledge of and consent for experimental procedures by study subjects, and the use of highly vulnerable populations." A total of 83 subjects died, though the exact relationship to the experiment is unclear.
Apology and response
Information about these experiments was uncovered by Professor Susan Mokotoff Reverby of Wellesley College. Reverby found the documents in 2005 while researching the Tuskegee syphilis study, in Cutler's archived papers, and shared her findings with United States government officials.
Francis Collins, the NIH director at the time of the revelations, called the experiments "a dark chapter in history of medicine" and commented that modern rules prohibit conducting human subject research without informed consent.
In October 2010, the U.S. government formally apologized and announced that the violation of human rights in that medical research was still to be condemned, regardless of how much time had passed. In a joint statement, Secretary of State Hillary Clinton and Secretary of Health and Human Services Kathleen Sebelius said:
Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health. We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices. The conduct exhibited during the study does not represent the values of the US, or our commitment to human dignity and great respect for the people of Guatemala.
"It is clear from the language of the report that the U.S. researchers understood the profoundly unethical nature of the study. In fact the Guatemalan syphilis study was being carried out just as the “Doctors' Trial” was unfolding at Nuremberg (December 1946 – August 1947), when 23 German physicians stood trial for participating in Nazi programs to euthanize or medically experiment on concentration camp prisoners."
The U.S. government asked the Institute of Medicine to conduct a review of these experiments. Separately, the Presidential Commission for the Study of Bioethical Issues was asked to convene a panel of international experts to review the current state of medical research on humans around the world and ensure that such incidents cannot be repeated. The Commission report, Ethically Impossible: STD Research in Guatemala from 1946 to 1948, published in September 2011, concluded that "the Guatemala experiments involved unconscionable basic violations of ethics, even as judged against the researchers' own recognition of the requirements of the medical ethics of the day."
In March 2011, seven plaintiffs filed a federal class action lawsuit against the U.S. government claiming damages for the Guatemala experiments. The case failed when a judge determined that the U.S. government could not be held liable for actions outside the U.S.
- Human experimentation in the United States
- Tuskegee syphilis experiment
- Medical ethics
- Porton Down
- Japanese human experimentations
- Unit 731
- Nazi human experimentation
- Nuremberg Code
- Guatemala – United States relations
- Ethically Impossible: STD Research in Guatemala from 1946 to 1948, Presidential Commission for the Study of Bioethical Issues, published 2011-09-13, accessed 2012-08-29
- "Fact Sheet on the 1946-1948 U.S. Public Health Service Sexually Transmitted Diseases (STD) Inoculation Study". United States Department of Health and Human Services. nd. Retrieved 2013-04-15.
- "Wellesley professor unearths a horror: Syphilis experiments in Guatemala". Boston Globe. 1 October 2010. Retrieved 2 October 2010.
- Donald G. McNeil, Jr. (1 October 2010). "U.S. Apologizes for Syphilis Tests in Guatemala". The New York Times. Retrieved 2 October 2010.
- Hensley, Scott (1 October 2010). "U.S. Apologizes For Syphilis Experiments In Guatemala". National Public Radio. Archived from the original on 10 November 2014. Retrieved 1 October 2010.
- "U.S. apologizes for newly revealed syphilis experiments done in Guatemala". Washington Post. 1 October 2010. Retrieved 1 October 2010.
The United States issued an unusual apology Friday to Guatemala for conducting experiments in the 1940s in which doctors infected soldiers, prisoners and mental patients with syphilis and other sexually transmitted diseases.
- "Joint Statement by Secretaries Clinton and Sebelius on a 1946-1948 Study", U.S. Department of Health & Human Services, October 1, 2010
- "US medical tests in Guatemala 'crime against humanity'". BBC News. 1 October 2010. Archived from the original on 2 January 2016. Retrieved 2 October 2010.
- Nate, Jones. "Decades Later, NARA Posts Documents on Guatemalan Syphilis Experiments". NSA Archive. The George Washington University. Retrieved 21 March 2012.
- McNeil, Donald G. Jr. (September 14, 2011). "Lapses by American Leaders Seen in Syphilis Tests". New York Times. Archived from the original on 29 September 2015.
- Chris McGreal (1 October 2010). "US says sorry for "outrageous and abhorrent" Guatemalan syphilis tests". The Guardian. Retrieved 2 October 2010.
Conducted between 1946 and 1948, the experiments were led by John Cutler, a US health service physician who would later be part of the notorious Tuskegee syphilis study in Alabama in the 1960s.
- Kakar, Aman (15 March 2011). "Guatemalans file class action suit over US medical experiments". JURIST. Archived from the original on 6 January 2015.
- Mariani, Mike (28 May 2015). "The Guatemala Experiments". Pacific Standard. The Miller-McCune Center for Research, Media and Public Policy. Retrieved 7 January 2015.
- Laughland, Oliver (3 April 2015). "Guatemalans deliberately infected with STDs sue Johns Hopkins University for $1bn". The Guardian. Archived from the original on 12 April 2015.