Tuskegee redux: evolution of legal mandates for human experimentation

Abstract

Human health experiments systematically expose people to conditions beyond the boundaries of medical evidence. Such experiments have included legal-medical collaboration, exemplified in the U.S. by the Public Health Service (PHS) Syphilis Study (Tuskegee). That medical experiment was legal, conforming to segregationist protocols and specific legislative authorization which excluded a selected group of African Americans from any medical protection from syphilis. Subsequent corrective action outlawed unethical medical experiments but did not address other forms of collaboration, including PHS submission to laws which may have placed African American women at increased risk from AIDS and breast cancer. Today, anti-lobbying law makes it a felony for PHS workers to openly challenge legally anointed suspension of medical evidence. African Americans and other vulnerable populations may thereby face excess risks-not only from cancer, but also from motor vehicle crashes, firearm assault, end stage renal disease, and other problems-with PHS workers as silent partners.

Figure 1

HIV Mortality Among Black Women 15-85+ Years of Age in States with Contact Tracing by Name Beginning in 1990-93 and States in Which Contact Tracing by Name was Delayed Until 1999-2008.

Figure 2

Difference in Absolute white and Absolute Balck Percent Change in Regular Mammography Among United States Medicare Beneficiaries from 1992-95 to 2005-08. US Census Regions.