Ugly History: The U.S. Syphilis Experiment - Susan M. Reverby

Translator: Xosé María Moreno Reviewer: Xusto Rodriguez

In the 1930s, the United States was ravaged by syphilis.

Na década de 1930, os EE.UU. estaban sendo arrasados pola sífilis.

This sexually transmitted infection afflicted nearly 1 in 10 Americans,

Esta infección de transmisión sexual

afectaba a case 1 de cada 10 estadounidenses,

producing painful sores and rashes that persisted for roughly two years.

producindo dolorosas feridas e erupcións durante uns dous anos.

After these initial symptoms, late-stage syphilis was known to cause organ damage,

Logo destes síntomas iniciais, a seguinte fase causaba danos orgánicos,

heart and brain disorders, and even blindness.

problemas de corazón e cerebro, e ata cegueira.

It was incredibly difficult to slow the disease’s spread.

Era moi difícil lentificar o espallamento da enfermidade.

Experts cautioned against unprotected sex,

Os expertos advertían contra o sexo sen protección,

but the infection could also be passed during childbirth.

mais a infección podía transmitirse tamén durante o parto.

Worse still, existing treatments like mercury and bismuth

Aínda peor, os tratamentos existentes, baseados no mercurio e no bismuto

were considered unreliable at best and potentially harmful at worst.

eran considerados nada fiábeis e potencialmente perigosos.

Today these heavy metals are classified as toxic,

Hoxe eses metais pesados considéranse tóxicos,

but at the time, doctors were still uncovering their dangerous side effects.

pero daquela, os médicos aínda ocultaban os seus perigosos efectos secundarios.

Amidst the uncertainty, health care professionals had two key questions.

Nesta incerteza, o persoal sanitario facíanse dúas preguntas clave:

Did late-stage syphilis warrant the risks of existing treatments?

A fase avanzada da sífilis xustificaba os riscos dos tratamentos existentes?

And, did the infected individual’s race change how the disease progressed?

E, o avance da infección variaba dependendo da raza do infectado?

Many physicians were convinced syphilis affected

Moitos médicos crían que a sífilis afectaba

the neurological systems of white patients

os sistemas neurolóxicos dos enfermos brancos

and the cardiovascular systems of Black patients.

e os sistemas cardiovasculares dos negros.

There was little evidence for this theory,

Unha teoría con poucas evidencias,

but the U.S. Public Health Service was determined to investigate further.

pero o Servizo de Saúde dos EEUU estaba decidido a investigala.

In 1932 they launched a massive experiment in Tuskegee, Alabama.

En 1932 iniciaron un amplísimo experimento en Tuskegge, Alabama.

The town had already possessed a small hospital,

Na cidade xa había un pequeno hospital,

and the area was home to a large population of potential participants.

e na área había moita poboación potencialmente participante.

The PHS collaborated with local doctors and nurses

O Servizo de Saúde colaborou con médicos e enfermeiras locais

to recruit roughly 400 Black men presumed to have noncontagious late-stage syphilis,

para recrutaren case 400 negros enfermos de sífilis avanzada non contaxiosa

as well as 200 non-syphilitic Black men for their control group.

así como 200 negros sen sífilis como grupo de control.

But their recruitment plan centered on a lie.

Mais ese plan de recrutamento baseouse nunha mentira.

While the researchers planned to observe how syphilis

Mentres que os investigadores observaban como a sífilis

would progress with minimal treatment,

progresaba cun tratamento mínimo

participants were told they would receive free drugs and care for their condition.

díxoselle aos participantes que recibirían fármacos e atención de balde

At first, researchers gave the men existing treatments,

Ao comezo, os investigadores déronlles os tratamentos existentes

but these were soon replaced with placebos.

pero axiña os substituíron por placebos.

Under the false pretense of providing a special remedy,

Co falso pretexto de lles proporcionar un remedio especial,

researchers performed painful and invasive spinal taps

os investigadores realizaron dolorosas puncións lumbares

to investigate the disease’s neurological consequences.

para investigaren as consecuencias neurolóxicas da sífilis.

When patients died, the PHS would swoop in to study the body

Cando os pacientes morrían, aparecía o Servizo de Saúde para estudar o corpo

by funding funerals in exchange for autopsies.

financiando o funeral a cambio de autopsias.

In their published studies, they listed the men as volunteers

Nas súas publicacións, clasificaban os homes como voluntarios

to obscure the circumstances under which they’d been recruited.

para ocultar as circunstancias en que foran recrutados.

Outside Alabama, syphilis treatment was advancing.

Fóra de Alabama, o tratamento contra a sífilis avanzaba.

A decade after the study began,

Unha década despois de iniciado o estudo,

clinical trials confirmed that penicillin effectively cured the disease

os ensaios clínicos confirmaron que a penicilina curaba a doenza

in its early stages.

nas súas fases iniciais.

But in Tuskegee, researchers were determined to keep pursuing

Pero en Tuskegee, os investigadores decidiran continuar

what they considered vital research.

a, para eles, vital investigación.

They had yet to confirm their theories about racial difference,

Tiñan aínda que confirmar as súas teorías das diferenzas raciais,

and they believed they would never have another opportunity

e pensaron que nunca terían outra oportunidade

to observe the long-term effects of untreated syphilis.

de observar os efectos a longo prazo da sífilis non tratada.

The study’s leadership decided to withhold knowledge of new treatments

Os líderes do estudo decidiron non informar

sobre os novos tratamentos aos pacientes.

from their subjects.

During World War II, researchers convinced the local draft board

Na II Guerra Mundial, os investigadores convenceron á oficina de recrutamento

to exempt men from their study,

para eximiren aos homes do seu estudo,

preventing them from enlisting and potentially accessing penicillin.

así evitaban que se alistasen e tivesen acceso á penicilina.

The study even continued through the 1950s

O estudo prolongouse durante a década dos 50

when penicillin was shown to help manage late-stage syphilis.

cando a penicilina xa era eficaz na fase avanzada da sífilis.

By today’s bioethical standards,

Para os estándares bioéticos de hoxe,

withholding treatment in a research study without a patient’s informed consent

privar dun tratamento durante un estudo sen o consentimento informado do paciente

is morally abhorrent.

é moralmente aberrante.

But for a large part of the 20th century, this practice was not uncommon.

Pero durante boa parte do s. XX esta práctica non era rara.

In the 1940s, US led studies in Guatemala infected

Nos 40, EEUU liderou estudos en Guatemala infectando

numerous prisoners, sex workers, soldiers, and mental health patients

moitos presos, prostitutas, soldados e enfermos mentais

with sexually transmitted infections to study potential treatments.

con infeccións de transmisión sexual para estudar posibles curas.

And other studies throughout the 50s and 60s

Noutros estudos durante os 50 e os 60

saw doctors secretly infecting patients with viral hepatitis or even cancer cells.

médicos infectaron en segredo pacientes co virus da hepatite e células tumorais.

Eventually, researchers began objecting to these unjust experiments.

Co tempo, os investigadores empezaron a rexeitar estes inxustos tratamentos.

In the late 1960s, an STI contact tracer named Peter Buxtun

Ao final dos 60, Peter Buxton, un rastrexador de ETS

convinced the PHS to consider ending the study.

propúxolle ao Servizo de Saúde que considerase pór fin ao estudo.

But after leadership decided against it, Buxtun sent his concerns to the press.

Pero despois da súa negativa, Buxton informou a prensa.

In July of 1972, an exposé of the Tuskegee study made headlines across the country.

En xullo do 72, un resumo do estudo Tuskegge ocupou titulares en todo EE.UU.

Following public outcry, a federal investigation, and a lawsuit,

A consecuencia do clamor popular, unha investigación federal e unha querela,

the study was finally shut down in 1972— 40 years after it began

o estudo foi clausurado en 1972, 40 anos despois de iniciarse

and 30 after a treatment for syphilis had been found.

e 30 de descubrirse un tratamento para a sífilis.

No evidence of any racial difference was discovered.

Non se descubriron probas de diferenzas raciais.

When the study ended, only 74 of the original 600 men were alive.

Cando o estudo acabou, só 74 dos 600 homes estaban aínda vivos.

40 of their wives and 19 of their children had contracted syphilis,

40 das súas mulleres e 19 dos seus fillos contraeran sífilis,

presumably from their husbands and fathers.

probablemente dos seus homes e pais.

In the wake of this tragedy, and concerns about similar experiments,

A consecuencia desta traxedia, e preocupados por experimentos similares,

Congress passed new regulations for ethical research and informed consent.

o Congreso ditou novas regulacións sobre ética na investigación e consentimento.

But systemic racism continues to permeate medical care and research

Pero o racismo sistémico segue a impregnar os coidados médicos e a investigación

throughout the US.

en todos os EE.UU.

To truly address these issues,

Para abordar en serio estes asuntos,

the need for structural change, better access to care,

é urxente un cambio estrutural,

mellor ácceso á atención e transparencia na investigación.

and transparency in research remains urgent.