What principles of the Belmont Report were violated in the Tuskegee Syphilis Study?

The Tuskegee Syphilis Study was conducted from 1932 to 1972 around Tuskegee, Alabama. Six hundred poor — and mostly illiterate — African-American males, 400 of whom were infected with syphilis, were monitored for 40 years. Free medical examinations were given; however, subjects were not told about their diagnosis. Even though a cure (penicillin) became available in the 1950s, the study continued until 1972 with participants being denied proper treatment or given fake treatments and placebos, instead. In some cases, when subjects were diagnosed as having syphilis by other physicians, researchers intervened to prevent treatment. Many of the subjects died slow and painful deaths of syphilis during the study, which was stopped in 1973 by the U.S. Department of Health, Education, and Welfare only after its existence was publicized and became a political embarrassment.

Congressional intervention eventually led to the publication of the Belmont Report in 1979, which is now required reading for everyone involved in human subject research. The Belmont Report identifies three basic ethical principles regarding all human subject research: respect for persons, beneficence, and justice.

  • Respect for persons requires medical researchers to obtain informed consent from their study participants, which means that participants must be given accurate information about their circumstances and treatment options so that they can decide what will happen to them.
  • Beneficence means the all test subjects must be told of all possible risks as well as benefits of the treatment(s) they agree to undergo.
  • The principle of justice is actually two-fold. Individual justice means that a doctor or researcher cannot administer potentially helpful treatment to some favored class of participants while offering riskier treatments to anyone else. Societal justice maintains that research participants must be selected fairly and randomly, without consideration of any economic, social, and gender class.

Obviously, researchers in the Tuskegee Syphilis Study violated all three of these principles, as participants were lied to about their condition, lied to about the treatment they were receiving, and selected based on race, gender, and economic class.

The few survivors of the study received a formal apology from President Bill Clinton in 1997.