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

翻译人员: Lingyan Ning 校对人员: Helen Chang

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

20世纪30年代，梅毒在美国肆虐

This sexually transmitted infection afflicted nearly 1 in 10 Americans,

近十分之一的美国人 感染这种性传播疾病

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

患者要经受近两年之久 疼痛难忍的溃疡和皮疹

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

这些初期症状过后 晚期的梅毒症状则是器官损害

heart and brain disorders, and even blindness.

心脏、脑部的功能受损，甚至失明

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

遏制梅毒的传播极为困难

Experts cautioned against unprotected sex,

专家们告诫大众，要警惕不安全性行为

but the infection could also be passed during childbirth.

但梅毒仍可通过母婴垂直传播

Worse still, existing treatments like mercury and bismuth

更糟糕的是 当时的治疗药物包括汞和铋

were considered unreliable at best and potentially harmful at worst.

最理想的情况下也不具有好的疗效

最坏的情况则是对机体有潜在性的伤害

Today these heavy metals are classified as toxic,

在今天看来 这些重金属已被归类为毒物

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

但当时的医生仍未认识到它们危害性

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

在充满着不确定性的迷雾中 医疗专家抓住了两个关键问题：

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

晚期的梅毒症状是否表明 现有治疗手段的危害性？

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

以及受感染个体的种族 是否改变了疾病的进展方式？

Many physicians were convinced syphilis affected

许多医生坚信

对于白人，梅毒侵害其神经系统

the neurological systems of white patients

and the cardiovascular systems of Black patients.

对于黑人，梅毒侵害其心血管系统

There was little evidence for this theory,

几乎没有任何证据支持这一理论

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

但美国公共卫生服务部 决定采取进一步的调查

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

1932年，他们在阿拉巴马州的 塔斯克基城开展了大型实验

The town had already possessed a small hospital,

当地已有的一家小医院

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

它即将成为大批潜在实验者的基地

The PHS collaborated with local doctors and nurses

美国公共卫生服务部 与当地的医护人员合作

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

招募了近400名无传染性 晚期梅毒的黑人作为实验组

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

另外招募了200名 未感染梅毒的黑人作为对照组

But their recruitment plan centered on a lie.

但他们的招募计划却是以谎言为基础

While the researchers planned to observe how syphilis

当研究人员准备观察

would progress with minimal treatment,

在最小剂量的治疗药物下 梅毒患者的病情如何发展变化

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

实验者被告知他们将会得到 免费的药物和治疗来改善病情

At first, researchers gave the men existing treatments,

实验的开始，研究人员给他们用了 现有的治疗药物

but these were soon replaced with placebos.

但之后，这些治疗药物 就被替换成了安慰剂

Under the false pretense of providing a special remedy,

以提供特殊疗法为借口

researchers performed painful and invasive spinal taps

研究人员对实验者实施了 痛苦的侵入性脊髓穿刺

to investigate the disease’s neurological consequences.

以便观察梅毒所带来的神经系统改变

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

即使实验者身亡 他们也会通过为他举行葬礼这一方法

by funding funerals in exchange for autopsies.

来换取遗体进一步剖验

In their published studies, they listed the men as volunteers

在发表的文章中 他们将实验者归为志愿者

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

以掩盖他们是被招募的实验者这一事实

Outside Alabama, syphilis treatment was advancing.

阿拉巴马州以外的地方 梅毒治疗方法也在发展

A decade after the study began,

距离这项实验开展之后的第十年

clinical trials confirmed that penicillin effectively cured the disease

临床实验证实了

在梅毒的早期使用青霉素 就可以有效治愈

in its early stages.

But in Tuskegee, researchers were determined to keep pursuing

然而，塔斯克基城的研究人员

仍在进行着这项他们自认为 至关重要的实验

what they considered vital research.

They had yet to confirm their theories about racial difference,

他们仍未能证实种族差异这一论点

and they believed they would never have another opportunity

同时他们也认为这个机会十分难得

to observe the long-term effects of untreated syphilis.

能够观察到未经治疗的梅毒患者 如此长时间的症状和体征

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

研究团队的高层决定隐瞒 梅毒新疗法的消息

from their subjects.

During World War II, researchers convinced the local draft board

在二战时期，研究人员 说服了当地征兵局

to exempt men from their study,

阻止招募的实验者入伍

preventing them from enlisting and potentially accessing penicillin.

以防他们可以（从军队）得到青霉素

The study even continued through the 1950s

这项实验一直持续到20世纪50年代末

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

而此时，青霉素已被证实 可以缓解晚期梅毒症状

By today’s bioethical standards,

以当今的生物伦理学标准来看

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

未经实验者知情同意的情况下 在研究中拒绝给予其治疗

is morally abhorrent.

从道德层面上看，是极其可憎的

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

但在20世纪的大部分时期 这类实验并非罕见

In the 1940s, US led studies in Guatemala infected

在20世纪40年代 美国在危地马拉开展实验

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

让不计其数的囚犯、性工作者、军人 精神病患者染上了性传播疾病

with sexually transmitted infections to study potential treatments.

是为了研究潜在的治疗方法

And other studies throughout the 50s and 60s

还有其他横贯了整个五六十年代的实验

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

医生偷偷使患者感染了病毒性肝炎 或是偷偷注射癌细胞

Eventually, researchers began objecting to these unjust experiments.

最终，研究人员开始反对 这种不公平的实验

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

在20世纪60年代末

一位名叫彼得·巴克斯顿的 性病患者的接触追踪员

convinced the PHS to consider ending the study.

试图说服了公共卫生服务部 考虑终止该实验

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

但他得到的是高层的反对 随后他将他的担忧诉诸媒体

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

1972年7月，塔斯克基城的实验曝光 成为了轰动全国的头条新闻

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

随之而来的是公众抗议 联邦调查、一纸诉讼

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

这项实验最终在1972年被终止

距离实验的开展已有40年

and 30 after a treatment for syphilis had been found.

距离发现梅毒的有效治疗药物已有30年

No evidence of any racial difference was discovered.

没有发现任何种族差异的证据

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

实验终止时，最初的600名 黑人实验者仅存74名

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

其中，40名实验者的妻子 和19名实验者的孩子被感染了梅毒

presumably from their husbands and fathers.

想必由其丈夫或其父亲传染的

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

悲剧发生之后 以及对类似实验的担忧

Congress passed new regulations for ethical research and informed consent.

美国国会通过了关于伦理研究 和知情同意的新规

But systemic racism continues to permeate medical care and research

但是，已成系统的种族主义

仍继续渗透到整个美国的 医疗保健和实验研究中

throughout the US.

To truly address these issues,

为了能真正解决这些问题

the need for structural change, better access to care,

我们迫切需要结构性改革 医疗资源分配均衡

and transparency in research remains urgent.

以及提高实验研究的透明度