Lapses by Leaders Seen in Guatemala Syphilis Tests

A White House bioethics panel on Tuesday condemned 1940s-era studies in which US health and medical school officials approved the deliberate infection of Guatemalan patients with STDs to test the efficacy of penicillin. First revealed last year by a Wellesley College historian, the experiments constituted "gross violations of ethics" even by the standards of the time, said the Presidential Commission for the Study of Bioethical Issues.

During World War II, STDs sidelined thousands of soldiers, contributing to the rush to find new ways to prevent and treat the infections. Military, academic, and government physicians first debated human experiments with penicillin -- then a scarce new drug -- in 1942.

While not everyone knew precisely who would be infected, advance approval in principle for the experiments was granted by the surgeon general; attorney general; Army and Navy medical officials; presidents of the American Medical Association and National Academy of Sciences; and experts from Harvard, Johns Hopkins, and the Universities of Pennsylvania and Rochester.

In 1943 a US Public Health Service (PHS) team under the direction of Dr. John C. Cutler began the research at a federal prison in Terre Haute, Ind. It was decided not to use university researchers and to keep the work secret. Prisoners were given clear consent forms, and upon completion they could be paid $100 and recommended for release at their parole hearing.

But by July 1944, this trial was abandoned as a failure, since researchers could not consistently infect prisoners with lab-grown gonorrhea. Meanwhile, penicillin had proven effective in treating syphilis in eight days and was adopted by the Army in June 1944.

Shortly after, Dr. Juan Funes, a former director of a Guatemalan government clinic for sex workers, proposed Cutler transfer his STD research to Guatemala, according to papers left by Cutler, who died in 2003. Pledges of a new laboratory, training for doctors, and access to penicillin helped pave the way to research that intentionally infected about 1,300 Guatemalan sex workers, prisoners, soldiers, and psychiatric patients with syphilis, gonorrhea or chancroid.

Years later, Cutler helped run the infamous Tuskegee study, a decades-long experiment in which poor black Alabamans with syphilis were left untreated to study how the disease progressed.

To view the full report, visit: http://bioethics.gov/cms/node/306.

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