In breaking news, a $1 billion lawsuit brought against Johns Hopkins University, pharmaceutical company Bristol-Myers Squibb Co, and the Rockefeller Foundation for conducting highly unethical medical testing in Guatemala that had been approved to go forward by a federal judge in Maryland.
Plaintiffs in the case are victims of intentional infection with syphilis during 1940s government medical experiments in Guatemala. They claimed the U.S. study “subjected them or their family members to medical experiments in Guatemala without their knowledge or consent during the 1940s and 1950s.”
On January 3, 2019, U.S. District Judge Theodore Chuang rejected defense arguments that a recent Supreme Court decision protecting foreign companies from U.S. lawsuits over human rights abuses abroad also applied to domestic firms.
The U.S. Public Health Service Sexually Transmitted Disease Inoculation Study of 1946-1948 looked at how well the recently-introduced germ-killing penicillin treated sexually transmitted diseases (STDs).
The study reported that over 1,600 people were infected: 696 with syphilis, 772 with gonorrhea, and 142 with chancroid.
Subjects selected for testing from 1946 to 1948 were mostly children, orphans, female commercial sex workers, prisoners in the national penitentiary, patients in the national mental hospital, and soldiers.
After World War II, American scientists were unsuccessfully battling a formidable threat to military manpower: gonorrhea and syphilis. One 1943 correspondent attributed 7 million lost working days annually among Army personnel to these two STDs.
Researchers hoped to find a prophylactic medication, one that could prevent STDs in those previously exposed. Testing prophylaxis would require them to introduce the diseases to previously unexposed human subjects.
The National Research Council’s Subcommittee on Venereal Diseases approved going forward with this line of scientific inquiry even though it might go against popular opinion – with the condition that all volunteers must be informed about the risks and provide informed consent before beginning.
A prison population was judged the best-suited to carry out such a study on STDs. Isolated men capable of making informed-consent decisions were better than psychiatric patients or military personnel.
Dr. John Charles Cutler was a member of the Public Health Service. He had begun studying gonorrhea in the prison population at the federal prison in Terra Haute, Indiana. Within ten months, he and Dr. John F. Mahoney, assistant chief of the Public Health Service Venereal Disease Research Laboratory in Washington, who headed the project, called it a failure.
The scientists had “deposited several strains and concentrations of gonorrhea on subjects’ sex organs, but they couldn’t seem to produce infections.”
The researchers figured there must be something about the act of sex that made gonorrhea easier to transmit, conditions untestable in a laboratory setting in Indiana, where prostitution was illegal.
To continue testing penicillin as a preventative for STDs, research moved to Guatemala after Cutler arrived there in August 1946. He “spent his first few months building goodwill by helping to build labs, training physicians, and providing supplies.” Then, he launched his intentional exposure experiments within the Guatemalan army, using prostitutes to trick the soldiers into STD exposure.
“In one early study, he infected prostitutes by moistening a cotton swab with pus carrying gonorrhea bacteria and inserting it into their genitals ‘with considerable vigor.’ There is no evidence they were informed about the risk. All of them contracted the disease.”
Cutler then introduced the sex workers to the men he wanted to study, first in prisons and then the army. The targeted men were given alcohol to loosen them up.
“The women were asked to have sex with multiple men in a row. In one case, one prostitute had sex with eight soldiers in 71 minutes. The soldiers were never informed that this was part of a medical experiment, obliterating any possibility that consent was obtained and making the experiments ethically unsound.”
In 2010, Reverby revealed details of the experiment she uncovered from related research. President Barack Obama subsequently issued a formal apology to the victims and their families.
Obama phoned Guatemalan President Alvaro Colom, “offering profound apologies and asking pardon for the deeds of the 1940s.”
The research was carried out in Guatemala, according to Dr. Susan Reverby of Wellesley College, Massachusetts, because “prostitution was legal and prisoners were allowed to bring prostitutes in for sex.”
U.S. National Institutes for Health Director Dr. Francis Collins called the Guatemalan study “a dark chapter in the history of medicine” and said it “appears to have been funded” by the U.S. National Institutes of Health.
The persons behind the study were guilty of “four primary ethical violations:”
1) Study subjects “were members of one or more vulnerable populations.
2) There is no evidence test subjects gave informed consent.
3) Study subjects were often deceived about what was being done to them.
4) Test subjects were intentionally infected with pathogens that could cause serious illness without their understanding or consent.
The “vast majority” of study subjects were treated adequately for the illness that had been imposed on them, but overall, the unethical medical inquiry “made little impact on syphilis research,” assessed Reverby.
In 2015, about 775 study victims and relatives filed a civil suit. As of the January 2019 decision by Judge Chuang to reject the defendants’ argument regarding the extension of foreign protections over human rights abuses to domestic corporations, 444 of them were still alive to receive benefits from a winning outcome.
The wheels of justice will now continue to grind, slowly and inexorably, onward.
But how many Guatemalan victims of unethical post-WWII U.S. medical testing will survive long enough to see the outcome of this drawn-out and sordid affair?