40 Years of Human Experimentation in America: The Tuskegee Study. The goal was to “observe the natural history of untreated syphilis” in black populations, but the subjects were completely unaware and were instead told they were receiving treatment for bad blood when in fact, they received no treatment at all.
Scientific and medical authorities of the late 19th/early 20th centuries held extremely harmful pseudoscientific ideas specifically about the sex drives and genitals of African Americans. It was widely believed that, while the brains of African Americans were under-evolved, their genitals were over-developed. Black men were seen to have an intrinsic perversion for white women, and all African Americans were seen as inherently immoral, with insatiable sexual appetites.
This all matters because it was with these understandings of race, sexuality and health that researchers undertook the Tuskegee study. They believed, largely due to their fundamentally flawed scientific understandings of race, that black people were extremely prone to sexually transmitted infections (like syphilis). Low birth rates and high miscarriage rates were universally blamed on STIs.
They also believed that all black people, regardless of their education, background, economic or personal situations, could not be convinced to get treatment for syphilis. Thus, the USPHS could justify the Tuskegee study, calling it a “study in nature” rather than an experiment, meant to simply observe the natural progression of syphilis within a community that wouldn’t seek treatment.
The USPHS set their study in Macon County due to estimates that 35% of its population was infected with syphilis. In 1932, the initial patients between the ages of 25 and 60 were recruited under the guise of receiving free medical care for “bad blood,” a colloquial term encompassing anemia, syphilis, fatigue and other conditions. Told that the treatment would last only six months, they received physical examinations, x-rays, spinal taps, and when they died, autopsies.
Researchers faced a lack of participants due to fears that the physical examinations were actually for the purpose of recruiting them to the military. To assuage these fears, doctors began examining women and children as well. Men diagnosed with syphilis who were of the appropriate age were recruited for the study, while others received proper treatments for their syphilis (at the time these were commonly mercury- or arsenic-containing medicines).
In 1933, researchers decided to continue the study long term. They recruited 200+ control patients who did not have syphilis (simply switching them to the syphilis-positive group if at any time they developed it). They also began giving all patients ineffective medicines ( ointments or capsules with too small doses of neo-arsphenamine or mercury) to further their belief that they were being treated. Author Harriet Washington, who chronicled the history of clinical experimentation on African Americans, drew a standing-room only-crowd to a lecture room at UCSF on Nov. 29. Renee Navarro, MD, director of academic diversity, introduced Washington to the audience gathered at the UCSF Parnassus campus. "It is important for those of us in the medical community to gain awareness of the history because it provides a richer cultural context when engaging the African American community and our patients," said Navarro. Washington, a journalist, bioethicist, former Knight Fellow in journalism at Stanford University and former ethics fellow at Harvard Medical School, gave a synopsis of her recently published book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present. The book cites instances from throughout US history where medical schools disproportionately used African Americans in clinical trials and live surgical demonstrations. Washington was drawn to the topic because she wanted to examine the relationship between African Americans and the US health care system.
"I'd always been troubled by my perception that many black people were leery of medicine and seeking care, even when it was in their best interest," said Washington. "When I began working in a hospital, I heard these same fears intensified." While an undergraduate student at the University of Rochester, Washington discovered that physicians dismissed the fears of many of their African American patients. "There was a perspective from the physicians that black people were fearful for no good reason," she said. Washington's book uncovers the horrific details of several experiments, including one of the most notorious medical experiments, the Tuskegee trials. For 40 years, from 1932 to 1972, the US Public Health Service (PHS) conducted an experiment on African American men who suffered from syphilis. The PHS, which lured the men with the prospect of free medical care and meals, withheld treatment. As a result, hundreds of men died slow, painful deaths. Washington believes the emphasis placed on Tuskegee has actually led to the perception that such clinical trials were a onetime incident, thereby supporting the notion that the fears of individuals in the African American community are unfounded.
In the 1840s, James Marion Sims, a white doctor in Montgomery, Alabama, performed painful experiments without anesthesia on Lucy, an enslaved Black woman, while other doctors observed.
Sims was lauded as the “Father of Gynecology” after his experiments on at least seven enslaved Black women and girls in Montgomery between 1845 and 1849 helped him develop a technique to repair a chronic complication of childbirth. Though the potentially life threatening experiments caused excruciating pain, Sims legally needed permission only from the enslaved women’s “owners.”
Sims’s experiments on Lucy were unsuccessful and nearly killed her with severe blood poisoning. He nonetheless continued to perform procedures on enslaved women, sometimes drugging them so they could not resist. Sims subjected Anarcha, an enslaved teenager, to at least 13 operations without anesthesia before he developed a repair technique that was deemed safe to attempt on white patients.
Unable to refuse treatment or withhold consent, Lucy, Anarcha, and Sims’s other enslaved patients were powerless to protect themselves from medical exploitation. During and after enslavement, physicians often denied Black people basic dignity and personhood through mistreatment that reflected the prevailing and dehumanizing myth that Black people were less sensitive to pain than white people.
Sims was celebrated for his medical achievements; his statue remains on the Alabama State Capitol grounds today. But increasingly, his brutal mistreatment of Black women is informing a broader understanding of his legacy as an especially cruel chapter in our history of racial injustice. In April 2018, a statue of Sims was removed from New York City’s Central Park. If there is an afterlife we must pity Sims somewhere in Hell getting the terror what he doled out during his lifetime!