WASHINGTON (AP) — EDITOR'S NOTE: On July 25, 1972, Associated Press reporter Jean Heller broke news that rocked the American medical establishment. The federal government, she reported, had let hundreds of black men in rural Alabama go untreated for syphilis for 40 years for research purposes. A public outcry ensued, and the "Tuskegee Syphilis Study" ended three months later. The men filed a lawsuit that resulted in a $9 million settlement, and then-President Bill Clinton formally apologized years later.
Still, the chilling effects of the study linger to this day — it's routinely cited as a reason some African-Americans are reluctant to participate in medical research, or even go to the doctor for routine check-ups.
In observance of the 45th anniversary of Heller's groundbreaking story, the AP is republishing Heller's original report as well as its coverage of Clinton's apology on May 16, 1997.
During a 40-year federal experiment, a group of syphilis victims was denied proper medical treatment for their disease. Some participants died as a result, but survivors now are getting whatever aid is possible, the U.S. Public Health Service says.
The experiment, conducted by the PHS, was designed to determine through autopsies what damage untreated syphilis does to the human body.
Dr. Merlin K. DuVal, assistant secretary of Health, Education and Welfare, expressed shock on learning of the study. He said he was launching an investigation immediately.
Of about 600 Alabama black men who originally took part in the study, 200 or so were allowed to suffer the disease and its side effects without treatment, even after penicillin was discovered as a cure for syphilis. Treatment then probably could have saved or helped many of the experiment participants, PHS officials say.
They contend that survivors of the experiment are now too old to treat for syphilis, but add that PHS doctors are giving the men thorough physical examinations every two years and are treating them for whatever other ailments and diseases they have developed.
Members of Congress reacted with shock to disclosure Tuesday by The Associated Press that the PHS syphilis experimentation on human guinea pigs had taken place.
Sen. William Proxmire, D-Wis., a member of the Senate appropriations subcommittee which oversees PHS budgets, called the study "a moral and ethical nightmare."
"It's incredible to me that such a thing could ever have happened," he said in a statement. "The Congress should give careful consideration to compensating the families of these men."
Sen. Edward M. Kennedy, D-Mass., chairman of the Senate health subcommittee, said through a committee spokesman that he deplores the facts of the case and is concerned about whether any other such experiments exist.
The syphilis experiment, called the Tuskegee Study, began in 1932 in Tuskegee, Ala., an area which had the highest syphilis rate in the nation at that time.
When the study began, the discovery of penicillin as a cure for syphilis was still 10 years away and the general availability of the drug was 15 years away. Treatment in the 1930s consisted primarily of doses of arsenic and mercury.
Of the 600 original participants in the study, one third showed no signs having syphilis; the others had the disease. According to PHS data, half the men with syphilis were given the arsenic-mercury treatment, but the other half, about 200 men, received no treatment for syphilis at all.
Men were persuaded to participate by promises of free transportation to and from hospitals, free hot lunches, free medical treatment for ailments other than syphilis and free burial.
Seventy-four of the untreated syphilitics were still alive last January.
Syphilis is a highly contagious infection spread through sexual contact. If left untreated it can cause blindness, deafness, deterioration of bones, teeth and the central nervous system, insanity, heart disease and death.
In 1969, the PHS' Center for Disease Control in Atlanta, which has been in charge of the Tuskegee Study, reviewed records of 276 syphilitics, both treated and untreated, who participated in the experiment.
It found that seven men had died as a direct result of syphilis. Another 154 died of heart failure, but CDC officials say they cannot determine now how many of these deaths were caused by syphilis or how many additional deaths may have been linked to the disease.
PHS officials responsible for initiating the Tuskegee Study have long since retired and current PHS officials said initially they did not know their identity.
But later a PHS official said the study was initiated in 1932 by Dr. J.R. Heller, assistant surgeon general in the service's venereal disease section, who subsequently became division chief.
Of the decision not to give penicillin to the untreated syphilitics once it became widely available, the official, Dr. J.D. Millar, said:
"I doubt that it was a one man decision. These things seldom are. Whoever was director of the VD section at that time, in 1946 or 1947, would be the most logical candidate if you had to pin it down."
Dr. Millar, current chief of the venereal disease branch of the CEC, said he did not know who headed the VD section in those years.
Earlier, Dr. Millar said, "I think a definite moral problem existed when the study was undertaken, a more serious problem was overlooked in the post-war years when penicillin became available but was not given to these men, and a moral problem still exists."
"But the study began when attitudes were much different on treatment and experimentation," he added. "At this point in time, with our current knowledge of treatment and the disease and the revolutionary change in approach to human experimentation, I don't believe the program would be undertaken."
Don Prince, another official in the venereal disease branch of CDC, said the Tuskegee Study had shown that the morbidity and mortality rate of untreated syphilitics was not as high as previously believed, but he said he thought the study should have been halted with penicillin treatment for participants after World War II.
"I don't know why the decision was made in 1946 not to stop the program," Prince said. "I was unpleasantly surprised when I first came here and found out about it. It really puzzles me."
Because of their age, the CDC cannot now treat the 74 survivors of the Tuskegee Study for syphilis, Dr. Millar said. Possible ill side effects of massive penicillin therapy constitute too great a risk to the individuals, particularly those whose syphilitic condition is dormant.
However, he added, there was a point when the men could have been treated with some measure of success.
"The most critical moral issue about this experiment arises in the post-war era, the years after the end of World War II, when penicillin became widely available.
"I know some were treated with penicillin for other disease and then dropped from the program because the drug had some positive effect on the primary disease syphilis. Looking at it now, one cannot see any reason they could not have been treated at that time."