STD experiments in Guatemala

Following a nine-month intensive investigation, the Commission has concluded that the Guatemala experiments involved gross violations of ethics as judged against both the standards of today and the researchers’ own understanding of applicable contemporaneous practices.

Costs were borne by the PASB (for administration, travel, construction, and supplies)

the U.S. Public Health Service Venereal Disease Division (providing and paying directly for staff and supplies as well as funding the grant issued from the Research Grants Office of the then U.S. National Institute of Health)

negotiated agreements that gave the researchers authority to work with officials and institutions across the Guatemalan government

including public health service treatment centers for venereal diseases, government hospitals, medical installations and officers of the military, institutions caring for orphans and the insane, and the penal system

Dr. John C. Cutler, who directed the studies in Guatemala and later served as a faculty member at the University of Pittsburgh

But, Kaempffert observed, it would be “ethically impossible” to undertake such research and “shoot living syphilis germs into human bodies.”

were about to begin doing just what Kaempffert described as being ethically impossible with prisoners and psychiatric patients in Guatemala.

Dr. Cutler also emphasized the need to increase secrecy and limit information about the program to those “who can be trusted not to talk.”

Dr. Cutler arrived in August 1946.

Upon reading the New York Times article, Dr. Cutler called it to the attention of his superior Dr. Mahoney, VDRL Director.

a “Note on Science” that appeared in the April 27 New York Times

Dr. Arnold wrote to Dr. Cutler that he was “a bit, in fact more than a bit, leary [sic] of the experiment with the insane people” as they “cannot give consent”

Dr. Arnold appeared primarily concerned about exposure to criticism, because if “some goody organization got wind of the work, they would raise a lot of smoke.”

that the idea for the research in Guatemala originated with Dr. Juan Funes, a Guatemalan physician who worked as a one-year fellow with Drs. Mahoney, Arnold, and Cutler at the VDRL in Staten Island in 1945

Dr. Carlos Salvado, the Director of the Psychiatric Hospital, collaborated on the syphilis and gonorrhea experiments and made staff available to assist the researchers.

Research staff for the Guatemala experiments included leaders and senior medical personnel of the government of Guatemala

Following the NAHC meeting, Surgeon General Thomas Parran approved the grant, and the funds were transferred to the PASB

G. Robert Coatney, a PHS malariologist, wrote Dr. Cutler about Surgeon General Parran’s interest in his work.

You know, we couldn’t do such an experiment in this country.

he is very much interested in the project and a merry twinkle came into his eye when he said

PASB built and supplied a venereal disease research laboratory in Guatemala City to support the work

Subjects were exposed to syphilis, gonorrhea, and chancroid, and included prisoners, soldiers from several parts of the army, patients in a state-run psychiatric hospital, and commercial sex workers.

who in most cases were also intentionally infected with STDs, were used to transmit disease

Of the 1,308 subjects exposed to a STD, the researchers documented some form of treatment for 678 subjects

the researchers conducted diagnostic testing of 5,128 subjects

Not only was there no evidence of voluntary consent by the subjects, but also they were clearly exposed to the risk of serious physical harm posed by contracting various diseases.

The records show that these events involved many officials and researchers in the United States as well as Guatemala.

Moreover, much of the available information was written retrospectively by Dr. Cutler years after the experiments were actually conducted.

Documents were requested from the government of Guatemala as well, though none were received.

The de facto standards that they applied in the Terre Haute prison, particularly with respect to written consent, stand in stark contrast to those in the Guatemala experiments.

While some of the subjects involved in the diagnostic testing were also involved in the intentional exposure experiments

Dr. Cutler’s contemporaneous records note 83 deaths during the course of the experiments.

The exact relationship between the experimental procedures and the subject deaths is unclear.

The researchers conducted physical examinations, blood draws, and, in some cases, lumbar punctures, on 1,384 Guatemalan children between 1 and 18 years of age.

The Commission further concludes that the individuals who approved, conducted, facilitated, and funded these experiments are morally culpable to various degrees for these wrongs.

records reveal the unconscionable ways in which the researchers sometimes used people as a mere means

Subjects in Guatemala were deliberately exposed to infections

the majority of the subjects were not already infected, again unlike Tuskegee

In February 1948, Berta was injected in her left arm with syphilis.

Berta was not treated for syphilis until three months after her injection.

That same day he put gonorrheal pus from another male subject into both of Berta’s eyes, as well as in her urethra and rectum.

Several days later, Berta’s eyes were filled with pus from the gonorrhea, and she was bleeding from her urethra.

Berta died.

Three days later, on August 27,

Her age and the illness that brought her to the hospital are unknown.

Cutler wrote that Berta appeared as if she was going to die, but he did not specify why.