U.S. apologizes for 'abhorrent' syphilis study in Guatemala

McClatchy NewspapersOctober 1, 2010 

MEXICO CITY — Exposing a dark page in its history, the U.S. government acknowledged Friday that government scientists had infected some 1,500 Guatemalans with syphilis and gonorrhea in experiments from 1946 to 1948 in "appalling violations" of medical ethics.

U.S. scientists infected prostitutes with syphilis or gonorrhea and sent them to have unprotected sex with soldiers or prison inmates, later testing them for possible cures, U.S. officials said.

When few became infected, scientists turned to patients at a mental health hospital, exposing them to infection by rubbing it on their genitals.

None of the subjects were informed about the study or offered consent, U.S. officials said. At least one patient is known to have died.

"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," Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius said in a joint statement.

"We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices."

The statement said current regulations prohibit such "appalling violations" of ethics regarding human medical research and added that the two departments would launch "a thorough investigation" of the 1946-1948 study in Guatemala.

Clinton called President Alvaro Colom of Guatemala Thursday night "to express her personal outrage, deep regret," Arturo Valenzuela, the assistant Secretary of State for Western hemisphere affairs, said in a message on Twitter.

Colom voiced anger on Friday: "These should be considered crimes against humanity and Guatemala reserves the right to petition the relevant international court at an opportune time."

Friday's acknowledgment shed new light on U.S. medical experiments that included the infamous Tuskegee study in which scientists observed, but didn't treat, hundreds of African American men with late-stage syphilis in Macon County, Alabama, starting in 1932 until it was exposed by the media in 1972.

A Wellesley College professor of history and women's studies, Susan M. Reverby, discovered evidence of the secret U.S. tests in Guatemala while examining papers on the Tuskegee study held at the University of Pittsburgh archives.

"I was very shocked when I saw all of this," she said in a telephone interview, adding that she pieced together details of the study from letters and reports in the archive.

"Whoever knew about it was long dead," Reverby said.

The papers showed that a U.S. Public Health Service team led by physician John C. Cutler, who infected men and women in the Guatemalan National Penitentiary, an army barracks, and a mental health hospital.

Cutler, who was a former deputy director of the Pan American Sanitary Bureau, a precursor of the Pan American Health Organization, had little difficulty winning Guatemalan support for the study through pledges of medicine, such as penicillin and an anti-convulsant drug for epileptics.

U.S. tax dollars paid for the program. Cutler later took up a post at the University of Pittsburgh.

"The doctors used prostitutes with the disease to pass it to the prisoners (since sexual visits were allowed by law in Guatemalan prisons) and then did direct inoculations," either on the men's genitalia, forearms, face or through spinal injections, Reverby wrote in a research paper.

U.S. scientists grew frustrated at the slow pace of infection in the prison, so they turned to a mental health hospital.

"They would hold a guy's penis for an hour to an hour and a half to make sure it got in there," Reverby said. "It was pretty gruesome."

Patients never offered consent, but were given cigarettes, she wrote.

The purpose of the study was to determine how to prevent infection from syphilis, using different doses of penicillin, as well as to find effective treatments, she wrote.

The HHS fact sheet said "some of the persons infected with syphilis were prescribed only partial treatment or not treated at all."

Cutler, who died in 2003, was aware that his research skirted ethical rules even at that time, Reverby wrote. In one June 1947 letter, Cutler wrote a colleague, "a few words to the wrong person here, or even at home, might wreck it . . . "

Cutler's supervisor, R.C. Arnold, was unsettled, writing Cutler in April 1948, shortly before ending the project, that "I am a bit, in fact more than a bit, leery of the experiment with the insane people. They cannot give consent, do not know what is going on, and if some goody organization got wind of the work, they would raise a lot of smoke."

The study came to the attention of the U.S. government after Reverby shared her work with David Sencer, a retired director of the Centers for Disease Control and Prevention, whom Reverby had interviewed for a book she did on the Tuskegee experiment. He then passed a paper she'd written on the subject to the CDC, Wellesley College said in a news release.

CDC officials sent a leading syphilis specialist to see the archival material. The subsequent report backed up Reverby's findings, Wellesley said. Wellesley said efforts are being made to determin if any of the people involved in the study, or their contacts, are still alive.

(Miami Herald reporter Carol Rosenberg contributed)

ON THE WEB

HHS Fact Sheet about Guatemala STD study

The Wellesley Report

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