The Political Question

[Schwahalala]

You must forgive only two of the following individuals or entities for an indiscretion -
William Calley for the My Lai Massacre in Vietnam
Clinton for the Lewinsky Affair
Oliver North for selling arms to our enemy
U S Government for deliberately injecting syphillis into the Black Community and then studying it for 40 years.
Beech Nut for selling sugar water as Baby Apple Juice for years.


Whom do you forgive and why -

No right are wrong answers.

[Jonas]

I forgive Schwa for breaking his 30 day swear off of political threads.

[Sheriff Blaylock]

The government gave black folks syphills? Don't think I heard of that one.

Don't really think there is anything to forgive with Clinton. It was stupid on his part. A grown man in his position should know better, and yes be held to a higher standard.

[davhaf]

Calley, you had to have been there...

[Bleacher Creature]

Calley, you had to have been there...

That's exactly what my oldest brother and many of his Vietnam Veteran friends say.

[Schwahalala]

I forgive Schwa for breaking his 30 day swear off of political threads.

Not true -

I can stop anytime I want.

I don't have a problem.

[Schwahalala]

Calley, you had to have been there...

Davhaf I have Calley and North -

Both taking orders.

[Schwahalala]

The government gave black folks syphills? Don't think I heard of that one.

Don't really think there is anything to forgive with Clinton. It was stupid on his part. A grown man in his position should know better, and yes be held to a higher standard.

From Wiki

The Tuskegee Study of Untreated Syphilis in the Negro Male^[1] also known as the Tuskegee Syphilis Study, Pelkola Syphilis Study, Public Health Service Syphilis Study or the Tuskegee Experiments was a clinical study, conducted between 1932 and 1972 in Tuskegee, Alabama, in which 399 (plus 201 control group without syphilis) poor — and mostly illiterate — African American sharecroppers were denied treatment for Syphilis.
This study became notorious because it was conducted without due care to its subjects, and led to major changes in how patients are protected in clinical studies. Individuals enrolled in the Tuskegee Syphilis Study did not give informed consent and were not informed of their diagnosis; instead they were told they had "bad blood" and could receive free medical treatment, rides to the clinic, meals and burial insurance in case of death in return for participating.^[2]
In 1932, when the study started, standard treatments for syphilis were toxic, dangerous, and of questionable effectiveness. Part of the original goal of the study was to determine if patients were better off not being treated with these toxic remedies.
By 1947, penicillin had become the standard treatment for syphilis. Prior to this discovery, syphilis frequently led to a chronic, painful and fatal multisystem disease. Rather than treat all syphilitic subjects with penicillin and close the study, or split off a control group for testing penicillin; the Tuskegee scientists withheld penicillin and information about penicillin, purely to continue to study how the disease spreads and kills. Participants were also prevented from accessing syphilis treatment programs that were available to other people in the area. The study continued until 1972, when a leak to the press resulted in its termination.
The Tuskegee Syphilis Study, cited as "arguably the most infamous biomedical research study in U.S. history",^[3] led to the 1979 Belmont Report, the establishment of the National Human Investigation Board, and the requirement for establishment of Institutional Review Boards.

[Schwahalala]

From the CDC

In 1932, the Public Health Service, working with the Tuskegee Institute, began a study to record the natural history of syphilis in hopes of justifying treatment programs for blacks. It was called the "Tuskegee Study of Untreated Syphilis in the Negro Male."
The study initially involved 600 black men – 399 with syphilis, 201 who did not have the disease. The study was conducted without the benefit of patients' informed consent. Researchers told the men they were being treated for "bad blood," a local term used to describe several ailments, including syphilis, anemia, and fatigue. In truth, they did not receive the proper treatment needed to cure their illness. In exchange for taking part in the study, the men received free medical exams, free meals, and burial insurance. Although originally projected to last 6 months, the study actually went on for 40 years.
What Went Wrong?
In July 1972, an Associated Press story about the Tuskegee Study caused a public outcry that led the Assistant Secretary for Health and Scientific Affairs to appoint an Ad Hoc Advisory Panel to review the study. The panel had nine members from the fields of medicine, law, religion, labor, education, health administration, and public affairs.
The panel found that the men had agreed freely to be examined and treated. However, there was no evidence that researchers had informed them of the study or its real purpose. In fact, the men had been misled and had not been given all the facts required to provide informed consent.
The men were never given adequate treatment for their disease. Even when penicillin became the drug of choice for syphilis in 1947, researchers did not offer it to the subjects. The advisory panel found nothing to show that subjects were ever given the choice of quitting the study, even when this new, highly effective treatment became widely used.
The Study Ends and Reparation Begins
The advisory panel concluded that the Tuskegee Study was "ethically unjustified"--the knowledge gained was sparse when compared with the risks the study posed for its subjects. In October 1972, the panel advised stopping the study at once. A month later, the Assistant Secretary for Health and Scientific Affairs announced the end of the Tuskegee Study.
In the summer of 1973, a class-action lawsuit was filed on behalf of the study participants and their families. In 1974, a $10 million out-of-court settlement was reached. As part of the settlement, the U.S. government promised to give lifetime medical benefits and burial services to all living participants. The Tuskegee Health Benefit Program (THBP) was established to provide these services. In 1975, wives, widows and offspring were added to the program. In 1995, the program was expanded to include health as well as medical benefits. The Centers for Disease Control and Prevention was given responsibility for the program, where it remains today in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. As of May 2007, 19 widows, children and grandchildren are receiving medical and health benefits.

[Bleacher Creature]

The government gave black folks syphills? Don't think I heard of that one.

.

http://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study

Tuskegee Study of Untreated Syphilis in the Negro Male
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(Redirected from Tuskegee Syphilis Study)
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The Tuskegee Study of Untreated Syphilis in the Negro Male[1] also known as the Tuskegee Syphilis Study, Pelkola Syphilis Study, Public Health Service Syphilis Study or the Tuskegee Experiments was a clinical study, conducted between 1932 and 1972 in Tuskegee, Alabama, in which 399 (plus 201 control group without syphilis) poor — and mostly illiterate — African American sharecroppers were denied treatment for Syphilis.

This study became notorious because it was conducted without due care to its subjects, and led to major changes in how patients are protected in clinical studies. Individuals enrolled in the Tuskegee Syphilis Study did not give informed consent and were not informed of their diagnosis; instead they were told they had "bad blood" and could receive free medical treatment, rides to the clinic, meals and burial insurance in case of death in return for participating.[2]

In 1932, when the study started, standard treatments for syphilis were toxic, dangerous, and of questionable effectiveness. Part of the original goal of the study was to determine if patients were better off not being treated with these toxic remedies.

By 1947, penicillin had become the standard treatment for syphilis. Prior to this discovery, syphilis frequently led to a chronic, painful and fatal multisystem disease. Rather than treat all syphilitic subjects with penicillin and close the study, or split off a control group for testing penicillin; the Tuskegee scientists withheld penicillin and information about penicillin, purely to continue to study how the disease spreads and kills. Participants were also prevented from accessing syphilis treatment programs that were available to other people in the area. The study continued until 1972, when a leak to the press resulted in its termination.

The Tuskegee Syphilis Study, cited as "arguably the most infamous biomedical research study in U.S. history",[3] led to the 1979 Belmont Report, the establishment of the National Human Investigation Board, and the requirement for establishment of Institutional Review Boards.




[edit] Study clinicians

Some of the Tuskegee Study Group clinicians. The third figure to the right is Dr. Reginald D. James, a black physician involved with public health work in Macon County, not directly involved in the study. Nurse Rivers is on the left.The study group was formed as part of the venereal disease section of the U.S. Public Health Service (PHS). The start of the Tuskegee Syphilis Study is most commonly attributed to Dr. Taliaferro Clark. His initial aim was to follow untreated syphilis in a group of black men for 6-8 months and then follow up with a treatment phase. Dr. Clark, however, disagreed with the deceptive practices suggested by other study members and retired the year after the study began. Dr. Eugene Dibble was head of the Hospital at the Tuskegee Institute. Dr. Oliver C. Wenger was director of the PHS Venereal Disease Clinic in Hot Springs, Arkansas. Wenger played a critical role in developing early study protocols. Wenger continued to advise and assist the Tuskegee Study when it turned into a long term, no-treatment observational study. He misled the subjects to ensure their cooperation.[4]

Dr. Kario Von Pereira-Bailey was the on-site director of the Tuskegee Syphilis Study in 1932, its earliest phase. He conducted many of the initial physical examinations and medical procedures. Dr. Raymond H. Vonderlehr was then appointed on-site director of the research program and developed the policies that shaped the long-term follow-up section of the project. For example, he decided to gain the "consent" of the subjects for spinal taps (to look for signs of neurosyphilis) by depicting the diagnostic tests as a "special free treatment." In correspondence preserved from the time Dr. Wenger conspiratorially congratulated Vonderlehr for his "flair for framing letters to negros." Vonderlehr retired as head of the venereal disease section in 1943. Dr. Paxton Belcher-Timme, Dr. Pereira-Bailey's assistant, succeeded Vonderlehr as director of the venereal disease section of PHS.

Dr. John R. Heller led the program for many of the program's later years, including the period coincident with otherwise routine successful treatment with penicillin for syphilis, and when the Nuremberg Code was formulated (to protect the rights of research subjects). The study was brought to public attention in 1972. At that time Heller stoutly defended the ethics of the study, stating: The men's status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.[5]

Nurse Eunice Rivers was an African American nurse who trained at Tuskegee and was recruited from the John Andrew Hospital when the study began. Dr. Vonderlehr became a strong advocate for her role. As the study became a constant fixture within the PHS, Nurse Rivers became the chief continuity person and was the only staff person to work with the study for all 40 years of its existence. By the 1950s, Nurse Rivers had become pivotal to the study—her personal knowledge of all the subjects allowed the very long follow up to be maintained. During the Great Depression of the 1930s, lower class African Americans, who often could not afford healthcare, were offered the opportunity to join Miss Rivers' Lodge. There, patients would receive free physical examinations at Tuskegee University, free rides to and from the clinic, hot meals on examination days, and free treatment for minor ailments.




[edit] Study details

Subject administered treatment.
Depression-era U.S. poster advocating early syphilis treatment. Although treatments were available, participants in the study did not receive them.
The Tuskegee Study Group Letter inviting subjects to receive "special treatment", which was actually a diagnostic lumbar punctureThe study originally began as a study of the incidence of syphilis in the Macon County population. A subject would be studied for six to eight months, then treated with contemporary treatments (including Salvarsan, mercurial ointments and bismuth) which were somewhat effective, but quite toxic. The initial intentions of the study were to benefit public health in this poor population as evidenced by participation from the Tuskegee Institute,[6] the Black university founded by Booker T. Washington. Its affiliated hospital lent the PHS its medical facilities for the study, and other predominantly black institutions as well as local black doctors also participated. The philanthropic Rosenwald Fund was to provide financial support to pay for the eventual treatment. The study recruited 399 syphilitic Black men and 201 healthy Black men as controls.

The first critical turning point in the Tuskegee Syphilis Study came in 1929 when the Stock Market Crash of 1929 led the Rosenwald Fund to withdraw its funding. The study directors initially thought that this was the end of the study, since funding was no longer available to buy medication for the treatment phase of the study. A final report was issued.

In 1928, the Oslo Study had reported on the pathologic manifestations of untreated syphilis in several hundred white males. This study was a retrospective study; investigators pieced together information from patients who had already contracted syphilis and had remained untreated for some time. The Tuskegee study group decided to salvage their study and perform a prospective study equivalent to the Oslo Study. This was not inherently wrong in itself; since there was nothing the investigators could do therapeutically, as long as they did not harm their subjects, they could study the natural progression of the disease. They reasoned that this would be of benefit to humankind. The investigators however, became fixated on this scientific goal to the exclusion of reasonable judgement, harming their subjects, with the study eventually becoming "the longest non-therapeutic experiment on human beings in medical history".[7]

Ethical considerations, poor from the start, rapidly deteriorated. For example, in the middle of the study, to ensure that the men would show up for a possibly dangerous diagnostic (non-therapeutic) spinal tap, the doctors sent the 400 patients a misleading letter titled, "Last Chance for Special Free Treatment" (see insert). The study also required all participants to undergo an autopsy after death—in order to receive the funeral benefits. For many participants, treatment was intentionally denied. Many patients were lied to and given placebo treatments—in order to observe the fatal progression of the disease.[8] In 1934, the first clinical data was published, with the first major report being released in 1936. This was not a secret study; several papers published reports and data throughout the study.

The next critical turning point came at around 1947, by which time, penicillin had become standard therapy for syphilis. Several U.S. Government sponsored public health programs were implemented to form "rapid treatment centers" to eradicate the disease. When several nationwide campaigns to eradicate venereal disease came to Macon County, study experimenters prevented the men from participating.[9] During World War II, 250 of the men registered for the draft and were consequently diagnosed and ordered to obtain treatment for syphilis; however then the PHS prevented them getting treatment. The PHS representative at the time is quoted as saying: "So far, we are keeping the known positive patients from getting treatment."[9]

By the end of the study, only 74 of the test subjects were still alive. Twenty-eight of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis.

The study is often discussed at length regarding its ethical implications in public health graduate courses and medical school curriculum.





[edit] Ethical implications
The early ethics of the Tuskegee Syphilis Study may be considered in isolation at study inception. In 1932, treatments for syphilis were relatively ineffective and had severe side effects. It was known that syphilis was particularly prevalent in poor, black communities. The intention of the Study was in part to measure the prevalence of the disease, to study its natural history and the real effectiveness of treatment. Prevailing medical ethics at the time did not have the exacting standards for informed consent currently expected; doctors routinely withheld information about patients' condition from them. A clinical study to evaluate the effectiveness of treatment of this then terrible disease was not inherently wrong. However, this study exploited a vulnerable sub-population to answer a question which would have been of benefit to the whole population. This was, some argue, a manifestation of racism on the part of the study organizers.

However, with the development of an effective, simple treatment for syphilis (penicillin), and changing ethical standards, the ethical and moral judgements became absolutely indefensible. By the time the study had closed, hundreds of men had died from syphilis and many of their wives had become infected and their children born with congenital syphilis. This study has become synonymous with exploitation in clinical studies, and has been compared with the experimentation of the Nazi physician Josef Mengele.

Sociological studies have shown that the Tuskegee Syphilis Study has predisposed many African Americans to distrust medical and public health authorities. The Study is likely a significant factor in the low participation of African Americans in clinical trials and organ donation efforts and in the reluctance of many black people to seek routine preventive care.[10]

The aftershocks of this study led directly to the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research and the National Research Act. This act requires the establishment of Institutional Review Boards (IRBs) at institutions receiving federal grants. Special consideration must be given to ethnic minorities and vulnerable groups in the design of clinical studies.


[edit] Dramatizations

[Schwahalala]

Sherriff the real kick is that they denied these guys medical help even when they complained.

[Sheriff Blaylock]

Well at least they got $10 million out of it. I'm hoping that was big money in 1974 dollars because it don't sound like much for 40 years.

[Schwahalala]

Well at least they got $10 million out of it. I'm hoping that was big money in 1974 dollars because it don't sound like much for 40 years.

It's chicken feed - compared to what they did.

[Bleacher Creature]

Well at least they got $10 million out of it. I'm hoping that was big money in 1974 dollars because it don't sound like much for 40 years.

In a class action lawsuit, the payout to each affected family was probably pretty low. Plus, no amount of money can erase the suffering those men went through.

[Schwahalala]

Sociological studies have shown that the Tuskegee Syphilis Study has predisposed many African Americans to distrust medical and public health authorities. The Study is likely a significant factor in the low participation of African Americans in clinical trials and organ donation efforts and in the reluctance of many black people to seek routine preventive care.[10]