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

Prevodilac: Milena Petrovic Lektor: Ivana Korom

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

Sjedinjene Američke Države su 1930. bile opustošene sifilisom.

This sexually transmitted infection afflicted nearly 1 in 10 Americans,

Ova polno prenosiva zaraza je nanela bol približno jednom od deset Amerikanaca,

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

uzrokujući bolne rane i osipe koji su trajali približno dve godine.

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

Posle prvih simptoma, zna se da je kasna faza sifilisa izazvala oštećenje organa,

heart and brain disorders, and even blindness.

poremećaje srca i mozga, a čak i slepilo.

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

Bilo je neverovatno teško usporiti širenje zaraze.

Experts cautioned against unprotected sex,

Stručnjaci su upozoravali na nezaštićene seksualne odnose,

but the infection could also be passed during childbirth.

ali infekcija je mogla da se prenese i tokom porođaja.

Worse still, existing treatments like mercury and bismuth

Još gore, postojeći tretmani poput žive i bizmuta

were considered unreliable at best and potentially harmful at worst.

u najbolju ruku, su smatrani nepouzdanim a u najgorem slučaju moguće štetnim.

Today these heavy metals are classified as toxic,

Danas su ovi teški metali svrstani u toksične,

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

ali u to vreme, doktori su još uvek otkrivali njihove opasne nuspojave.

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

Usred te neizvesnosti, zdravstveni radnici su imali dva ključna pitanja.

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

Da li je kasna faza sifilisa garantovala rizike već postojećih tretmana?

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

I, da li rasa zaražene osobe menja način na koji se bolest razvija?

Many physicians were convinced syphilis affected

Mnogi lekari su bili ubeđeni da sifilis utiče

the neurological systems of white patients

na neurološki sistem kod pacijenata bele puti

and the cardiovascular systems of Black patients.

i kardiovaskularni sistem kod pacijenata tamne puti.

There was little evidence for this theory,

Bilo je malo dokaza o ovoj teoriji,

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

ali je Javni Zdravstveni Servis u SAD odlučio da dalje istraži o tome.

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

Godine 1932. pokrenuli su veliki ogled u Taskigiju, Alabama.

The town had already possessed a small hospital,

Gradić je već imao malu bolnicu,

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

i ovo područje je već bio dom velikoj populaciji potencijalnih učesnika.

The PHS collaborated with local doctors and nurses

JZS je sarađivao sa lokalnim doktorima i sestrama

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

na regrutovanju oko 400 crnaca sa mišlju da su u kasnoj nezaraznoj fazi,

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

kao i 200 nezaraženih crnaca za njihovu kontrolnu grupu.

But their recruitment plan centered on a lie.

Ali, njihov plan regrutovanja počivao je na laži.

While the researchers planned to observe how syphilis

Dok su istraživači posmatrali kako bi sifilis

would progress with minimal treatment,

napredovao uz minimalni tretman,

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

učesnicima je bilo rečeno da će dobiti besplatne lekove i negu za njihovo stanje.

At first, researchers gave the men existing treatments,

Prvo, istraživači su dali muškarcima postojeće tretmane,

but these were soon replaced with placebos.

ali su ih brzo zamenili placebo lekovima.

Under the false pretense of providing a special remedy,

Pod izgovorom da im pružaju posebne lekove,

researchers performed painful and invasive spinal taps

istraživači su izvodili bolne i invazivne zahvate na kičmi

to investigate the disease’s neurological consequences.

kako bi istražili neurološke posledice bolesti.

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

Kada bi pacijenti umrli, JZS bi nasrnuo da proučava telo

by funding funerals in exchange for autopsies.

tako što bi platili sahrane u zamenu za obdukcije.

In their published studies, they listed the men as volunteers

U svojim objavljenim studijama, naveli su muškarce kao volontere

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

kako bi okolnosti pod kojima su regrutovani ostali nejasni.

Outside Alabama, syphilis treatment was advancing.

Van Alabame, tretman protiv sifilisa je napredovao.

A decade after the study began,

Deceniju nakon početka studije,

clinical trials confirmed that penicillin effectively cured the disease

klinička ispitivanja su potvrdila da je penicilin uspešno izlečio bolest

in its early stages.

u njenim ranim fazama.

But in Tuskegee, researchers were determined to keep pursuing

Ali u Taskigiju, istraživači su odlučili da nastave

what they considered vital research.

sa onim što su smatrali bitnim istraživanjem.

They had yet to confirm their theories about racial difference,

Imali su još da utvrde svoje teorije o rasnima razlikama,

and they believed they would never have another opportunity

i verovali su da nikad više neće imati ovakvu priliku

to observe the long-term effects of untreated syphilis.

da posmatraju dugotrajne posledice nelečenog sifilisa.

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

Rukovodioci studije su odlučili da zadrže nova saznanja

from their subjects.

od svojih ispitanika.

During World War II, researchers convinced the local draft board

Za vreme Drugog svetskog rata, istraživači su ubedili regrutni centar

to exempt men from their study,

da izuzmu muškarce iz njihove studije,

preventing them from enlisting and potentially accessing penicillin.

sprečavajući ih da se regrutuju i potencijalno dođu do penicilina.

The study even continued through the 1950s

Studija se nastavila čak tokom 1950-ih godina

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

kada je dokazano da penicilin pomaže i kod kasnije faze sifilisa.

By today’s bioethical standards,

Po današnjim bioetičkim standardima,

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

uskraćivanje tretmana tokom istraživanja bez saglasnosti pacijenta

is morally abhorrent.

je moralno nedopustivo.

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

Ali većim delom 20. veka, ova praksa je bila česta.

In the 1940s, US led studies in Guatemala infected

1940-ih godina, američka studija u Gvatemali je zarazila

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

brojne zatvorenike, seks radnike, vojnike, i pacijente sa mentalnim problemima

with sexually transmitted infections to study potential treatments.

polno prenosivim infekcijama kako bi proučavala moguća lečenja.

And other studies throughout the 50s and 60s

I u drugim studijama tokom pedesetih i šezdesetih godina

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

doktori su potajno zaražavali pacijente virusnim hepatitisom ili ćelijama raka.

Eventually, researchers began objecting to these unjust experiments.

Najzad, istraživači su počeli da se protive ovim nepravednim ogledima.

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

Kasnih šezdesetih, Piter Bakston, tragač za polno prenosive bolesti,

convinced the PHS to consider ending the study.

ubedio je JZS da razmotre okončanje ove studije.

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

Ali, kada je rukovodstvo odbilo, Bakston je svoje brige izneo u novinama.

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

U julu 1972, izveštaj o studiji iz Taskigija je bio glavna tema u zemlji.

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

Propraćena javnim protestom, federalnom istragom, i tužbom,

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

studija je konačno zaustavljena 1972, 40 godina nakon početka

and 30 after a treatment for syphilis had been found.

i 30 godina nakon što je lečenje za sifilis pronađeno.

No evidence of any racial difference was discovered.

Nijedan dokaz o rasnoj razlici nije bio pronađen.

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

Kada se studija završila, samo 74 od prvobitnih 600 muškaraca je preživelo.

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

40 njihovih žena i 19 njihove dece je dobilo sifilis,

presumably from their husbands and fathers.

najverovatnije od svojih muževa i očeva.

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

Nakon ove tragedije i zabrinutosti zbog drugih sličnih eksperimenata,

Congress passed new regulations for ethical research and informed consent.

Kongres je prosledio nove propise o etičkom istraživanju i saglasnosti.

But systemic racism continues to permeate medical care and research

Ali sistemski rasizam nastavlja da se prožima kroz zdravstvo i istraživanje

throughout the US.

širom SAD.

To truly address these issues,

Za stvarno rešenje ovih problema,

the need for structural change, better access to care,

potreba za strukturalnom promenom, boljem pristupu nezi,

and transparency in research remains urgent.

i transparentnosti u istraživanju je hitna.