I had really expected to see this story diaried and discussed before I got back from Guatemala this morning. But it seems not, so I'll start:
Susan Reverby, a historian at Wellesley, has been researching the Tuskegee Experiment, a study of the effects of syphilis on 400 Black men carried out without their knowledge or consent from 1932 to 1972. While digging through the archives, she came across documents that Dr. John C. Cutler, who would join the Tuskagee project in the 1960s, conducted a similar experiment in Guatemala from 1946 through 1948.
From 1946 to 1948, American public health doctors deliberately infected nearly 700 Guatemalans — prison inmates, mental patients and soldiers — with venereal diseases in what was meant as an effort to test the effectiveness of penicillin.NYT 1 Oct 2010
The next paragraphs, below the fold, require a strong stomach.
(The main Guatemala paper, Prense Libre, says it was more like 1,500 persons. The confusion may be because 696 persons were infected with syphilis, while the others were infected with gonorrhea or chancre. CDC report [PDF])
American tax dollars, through the National Institutes of Health, even paid for syphilis-infected prostitutes to sleep with prisoners, since Guatemalan prisons allowed such visits. When the prostitutes did not succeed in infecting the men, some prisoners had the bacteria poured onto scrapes made on their penises, faces or arms, and in some cases it was injected by spinal puncture.
Deception was also used in Guatemala, Professor Reverby said. Dr. Thomas Parran, the former surgeon general who oversaw the start of Tuskegee, acknowledged that the Guatemala work could not be done domestically, and details were hidden from Guatemalan officials.
In a Spanish-language interview with Prense Libre, Reverby explained that "the US was looking for a place where it could find people already infected with these diseases" and that Guatemala was the "ideal place." [All translations and paraphrases are mine.] She said that she had been looking for documents relating to Tuskagee, and "was totally surprised [impresionada]" by what she found. Knowledge of the experiment reached at least as high as the Guatemalan Dept. of Health; she has not yet found anything in the archives to show if it went higher than that, and she thinks ["imaginaria"] that it may not have reached the Guatemalan president at the time (Juan José Arévalo).
Cutler knew he was treading on thin (nonexistent!) ethical ground, and his supervisor was troubled as well:
Cutler seemed to recognize the delicate ethical quandaries their experiments posed, particularly in the wake of the Nuremberg "Doctors' Trials," and was concerned about secrecy. "As you can imagine," Cutler reported to his PHS overseer, "we are holding our breaths, and we are explaining to the patients and others concerned with but a few key exceptions, that the treatment is a new one utilizing serum followed by penicillin. This double talk keeps me hopping at time."
Cutler also wrote that he feared "a few words to the wrong person here, or even at home, might wreck it or parts of it ... "
PHS physician R.C. Arnold, who supervised Cutler, was more troubled, confiding to Cutler, "I am a bit, in fact more than a bit, leery of the experiment with the insane people. They can not 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. I think the soldiers would be best or the prisoners for they can give consent." CNN 1 Oct 2010
Reverby had actually given a talk about this back in January, but it somehow escaped everyone's notice. In June or July, she informed the CDC, which conducted its own investigation, after which SoS Hilary Clinton and HHS Secretary Kathleen Sibelius called Álvaro Colom, the president of Guatemala, to tell what they had learned. And to apologize.
The joint statement from Mrs Clinton and Health Secretary Kathleen Sebelius said: "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.
"We deeply regret that it happened, and we apologise to all the individuals who were affected by such abhorrent research practices." BBC 1 Oct
The next day, President Obama personally apologized to Colom, a story (with pictures) that was on the front page of every Guatemalan newspaper yesterday (Saturday). WH Press Secretary Gibbs also called the study "shocking," "tragic" and "reprehensible."
As you might imagine, the Guatemalans are livid. Comments that I read in Prense Libre before we left included demands for reparations or indemnities.
On the other hand, a counselor at the Guatemalan embassy in DC said that "We thank the United States for its transparency in telling us the facts."
Along those same lines, I spent some time explaining to our hostess in Antigua, who couldn't believe that our government would allow this to be revealed, that this is how the US operates (or is supposed to); it is better to reveal the truth, however embarrassing, as soon as possible, rather than try to hide it and suffer worse embarrassment when it is exposed by someone else.
Which is one lesson to be learned here - what I've long called the "Chappaquidick factor" in politics - if there's something embarrassing, get it out there first, fast, apologize for it, and then everyone will move on. (If Ted Kennedy had done that, he could well have been president.) It's something that Meg Whitman should have realized when the stories about her hiring of an undocumented worker started coming to light. (Fortunately for us, she didn't.) Obama is that rare politician, elected official, person, who understands this and is willing to live up to it.
"Moving on" is, of course, not something we can do yet. Guatemala is starting its own investigation, and while Colom said he accepts Obama's apology, his government reserves the right to make an opportune ["oportuna"] claim later on.
Despite a lot of looking around, I cannot find any Republican reaction to the Obama apology yet (one off-the-wall remark by a blogger doesn't count, and I didn't even bother to bookmark it). But right-wing pundits have previously blasted the president for what they call "apology tours," and Newt Gingrich recently made headlines with his crack that Obama was following a "Kenyan, anti-colonial" worldview. So I am expecting some more foaming at the mouth from the batshit crowd any moment now.