Miss Evers’ Boys is a movie that narrates the story of a federally funded study that was titled “Tuskegee Study of Untreated Syphilis in the Negro Male”, which was conducted between 1932-1972 in Tuskegee Hospital, Alabama by the U.S. Public Health Service. The participants where 399 African American males that tested positive for syphilis and 201 counterparts that were used as a control. They were monitored and the researchers promised that they will receive free treatment, free medical exams, free meals and burial expenses (Center for Disease Control and Prevention [CDC], 2016). By the late 1940’s Penicillin was the treatment of choice for syphilis and the subjects under the study did not receive the promised treatment. The sick participants in the study were observed to deteriorate or to die by the health care professionals that promised to devote their lives to the care of others. Ethical Principles Polit and Beck (2014) states that self-government and the right to be fully explained are principles of respect for persons. Researchers, doctors and nurses violated the principles of respect for persons. In the Tuskegee syphilis study the participants were not informed of the real purpose of the study which halted their autonomy. …show more content…
Polit and Beck (2014) state that impartial treatment is one aspect of justice.
Arnold and Boggs (2011) also defines justice in ethics as being fair or impartial. There was no justice in what they did in the Tuskegee study. As explained in Miss Evers' Boys the health care providers and the broken system allowed an unethical situation to continue for over 40 years. Polit and Beck (2014) defines beneficence as the duty to prevent harm and to promote benefits. An example that beneficence and justice was not part of the researchers’ agenda was when Penicillin was discovered and widely available as the main treatment for syphilis, they denied the administration to the participants. By doing researchers negated the beneficence in the
study. Nuremberg Code and Belmont Report There are three primary ethical principles as per The Belmont Report which provides the standards of ethical research conduct. Those principles are: respect for persons, beneficence, and justice. (U.S. Department of Health & Human Services [HHS], 1979) Polit and Beck (2014) defines informed consent as the need for the researchers to provide adequate and true information to the prospects in order for them to decide if they will enroll in the study. Informed consent is an essential element in both Nuremberg Code and Belmont Report. Researchers and other health care providers violated respect for human dignity when they lied to the participants which prevented them from executing their right of autonomy which would had translated in the participants making better decision regarding their care (Polit & Beck, 2014; Nuremberg Code, 1947& Belmont Report, 1979) Researchers and other health care providers violated the principle of justice when they allowed these men to suffer (Nuremberg Code, 1947) the full spectrum of symptoms and complications of Syphilis when there was a known cure. The saddest part is that they also prevented them from getting it from other health care centers. Researchers and other health care providers violated the principle of beneficence when they caused harm to the participants and by deceiving those men they opened the door to disbelief in the health care providers (even from their same race). Behavior that in the long run did not prevent harm nor promoted benefits, (Polit & Beck, 2014). The degree of risk did not outweigh the problem to be solved by the experiment (Nuremberg Code,1947) Universal Declaration of Human Rights The Universal Declaration of Human Rights (UDHR) was proclaimed in 1948 by the United Nations General Assembly for all people and all nations (UDHR, 1948). Many rights of the Universal Declaration of Human Rights were violated in Tuskegee syphilis study: The participants were discriminated because of their race, colour, sex, social status and other status. Researchers did not act towards one another in a spirit of brotherhood. The right to life, liberty and security of person was violated. There is no security in knowing that the cure for the participant’s disease was available and they were not able to get it, that demonstrated lack of liberty. The participants were subjected to torture or to cruel, inhuman and degrading treatment. The right to an effective remedy for acts violating the essential rights granted him by the constitution or by law was violated (UDHR, 1948). An apology from the president and other institutions, money or any other indemnification to the survivors or their next of kin is not remedy for 40 years of such an inhuman experiment (CDC, 2016). It is important to point out that nobody was charged nor prosecuted for this incident. “The right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control” (UDHR, 1948) was violated. All of these was promised; although, the researchers created the spiral in which the participants’ health deteriorated to a point in which they could not even exercise the above right. Tuskegee Study Nurse Nurse Evers was an African American nurse that joined the Tuskegee Study with the best expectation about the study. She was persuaded to offer placebo to the participants while the government was trying to find a cure for a disease. The promise was that the participants were going to be given the treatment for the disease as soon as it was made available. Nurse Evers failed to model her role as an advocator for the best interest of her patients. An example is that even when she was aware of the deceit the patients were subject to, she encouraged them to continue with their participation in the study that she knew was in detriment of their health. Although this case posed an ethical dilemma, her actions were not justified. I consider that Ms. Evers to a certain extent meant well; however, when she became aware of the unethical principles of the experiment she did not proceed in the best interest of the patients. Moreover, she was dishonest and lied to the participants even when they asked her directly. Eventually, she did not use her nursing judgment to come to a conclusion that the greatest good for the patient would have been the administration of the available curative treatment. Thus, she allowed the research protocol to blur her ethical considerations towards her patients. Although she meant well, the lack of loyalty to her patients caused many individuals to lose their lives and at the end, she facilitated the death her patients. At a given point nurse Evers felt overwhelmed and wanted to give up due to the many irregularities, I believe that she should have followed her heart. Polit and Beck (2014) explains that full disclosure is the detailed explanation of the treatment, the benefits, financial implications and the like. She could have requested the health care professional to give the patients insight so they could have advocated for themselves or she could have reported the many un-ethical practices that she witnessed to the pertaining authorities. Researchers' Behavior in Tuskegee Study Compared to Present Day Expectations It is difficult to understand how health care professionals and people that are in power can intentionally harm others in the name of research. I think that research should be closely monitored in order to avoid violations, like the ones in the Tuskegee Study. The few regulations, the lack of clearly stated codes of ethics and the poor supervision from the pertinent authorities allowed this study to be so cruel, causing such harm and to last that long. The researchers were more focused on getting the answer to the research question than caring for the human rights. In the present time there are multiple rules, code of ethics and other regulatory institutions that intend to prevent or minimize the human and even animal jeopardy caused by research. I said minimize because as explained in Polit and Beck (2014) there are minimal risk that are risk expected to be no greater than those encountered on a daily basis or during a standard test or procedure. Nowadays researchers are more conscious of the impact of their practice as well as they are concerned with being compliant with all the regulatory bodies. Conclusion It is unfortunate that cases like the Tuskegee Study, the Nazi atrocities and others had occurred in order for the human research industry to be regulated in such a way that can virtually guarantee that human rights are being protected. As expressed by Polit and Beck (2014) Ethics in research must satisfy human and animal rights defense as well as ensuring the protection of the public trust. We cannot negate the importance of research which make it imperative that all the aspects of the research are closely regulated.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
The book, Bad Blood: The Tuskegee Syphilis Experiment, by James H. Jones, was one of the most influential books in today’s society. The Tuskegee Syphilis Experiment study began in 1932 and was terminated in 1972. This book reflects the history of African Americans in the mistrust of the health care system. According to Colin A. Palmer, “James H. Jones disturbing, but enlightening Bad Blood details an appalling instance of scientific deception. This dispassionate book discusses the Tuskegee experiment, when a group of physicians used poor black men as the subjects in a study of the effects of untreated syphilis on the human body”(1982, p. 229). In addition, the author mentioned several indications of discrimination, prejudice,
The treatment of African Americans in The Immortal Life of Henrietta Lacks demonstrates the lack of ethics in the United States health care system during the 1950s and 1960s. Under the impression that medical doctors at Johns Hopkins Hospital were solely injecting radium treatment for cervical cancer, Henrietta Lacks laid on the surgical bed. During this procedure Dr. Lawrence Wharton Jr. shaved two pieces of tissue from her vagina, one from a healthy cervical tissue and one from the cancerous tumor, without Henrietta’s prior knowledge. After recovering from her surgery Henrietta exited the door marked, “Blacks Only,” the door that signified the separation between White and African-American patients. Had Henrietta been White, would the same outcomes have occurred? How badly did a country that proclaimed to be “One Nation under God” divide this very land into two separate nations? The Immortal Life of Henrietta Lacks truly exhibits the racial disparity in the health care system.
The Belmont Report identifies three core principles that are to be respected when using human subjects for research. The three ethical principles are: respect for persons, beneficence and justice. In the case of Henrietta Lacks each of these fundamental components are violated. The consent that Henrietta provided was not sufficient for the procedures that were conducted.
The Sleeping Sickness and Tuskegee Syphilis experiment are examples of the government targeting men who were socially disconnected with the majority of society. Whether it was the prisoners, who were separated to serve out their sentence, or the African-American males, who were separated economically and educationally, they were both targeted based on their social standings. Therefore, the conductors ideally would receive no criticism if harm were to happen to subjects because they did not contribute, monetarily or economically, to the modern
In 1932, in the area surrounding Tuskegee, Macon County, Alabama, the United States Public Health Service (PHS) and the Rosenwald Foundation began a survey and small treatment program for African-Americans with syphilis. Within a few months, the deepening depression, the lack of funds from the foundation, and the large number of untreated cases provided the government’s researchers with what seemed to be an unprecedented opportunity to study a seemingly almost “natural” experimentation of latent syphilis in African-American men. What had begun as a “treatment” program thus was converted by the PHS researchers, under the imprimatur of the Surgeon General and with knowledge and consent of the President of Tuskegee Institute, the medical director of the Institute’s John A. Andrew Hospital, and the Macon County public health officials, into a perspective study-The Tuskegee Study of Untreated Syphilis in the Negro Male (Jones1-15). Moreover, the Tuskegee Syphilis Study, which began in 1932 and was terminated in 1972 by the protest of an enraged public, constituted the longest nontherapeutic experiment on human beings in medical history. Since the premise on which the experiment was based did not involve finding a cure or providing treatment, the question then remains why did the study begin and why was it continued for four decades?
Ethical violations committed on underprivileged populations first surfaced close to 50 years ago with the discovery of the Tuskegee project. The location, a small rural town in Arkansas, and the population, consisting of black males with syphilis, would become a startling example of research gone wrong. The participants of the study were denied the available treatment in order further the goal of the research, a clear violation of the Belmont Report principle of beneficence. This same problem faces researchers today who looking for an intervention in the vertical transmission of HIV in Africa, as there is an effective protocol in industrialized nations, yet they chose to use a placebo-contro...
The Deadly Deception video scrutinizes the unjust practices of a syphilis study that began in the 1930’s on the campus of Tuskegee Institute by the U.S. Public Health Service. The experiment was conducted using hundreds of African American men that were mainly poor and illiterate. The study was called the Tuskegee Study of Untreated Syphilis in the Negro Male. Participates were deceived and lured in by promises of free medical care and survivors insurance.
The Tuskegee Experiment is one of the unethical Health Researches done in the United States. The way the research was conducted was against people 's civil rights. Totally secretive and without any objectives, procedures or guidance from any government agency. During the time that the project was launched there were very few laws that protected the public from medical malpractice or from plainly negligence. Also the Civil Rights act did not pass until the 1960 's.
The movie “Miss Evers’ Boys” discusses the experiment of using a clinical trial treatment for syphilis. The film is based on the real-life study called “The Tuskegee Study” that took place in Macon County, Alabama, in which the study selected 412 men infected with syphilis and promised them free medical treatment for what was called "bad blood". After watching the movie, I could observe how race was tied into the statement, "Racism is a pathogen with biological consequences." It means racism is like a disease that spreads everywhere and attaches to innocent human beings and causes physical suffering for years. In addition, in those days especially, black men were considered inferior to white men,
In 1987, there was a Syphilis outbreak in a small town Alabama, Tuskegee. Ms. Evers went to seek out African Males that had this disease and did not. They were seeking treatment for this disease, but then the government ran out of money and the only way they can get treatment if they studied. They named this project “The Tuskegee Study of African American Man with Syphilis”, so they can find out where it originated and what will it do to them if go untreated for several months.
When penicillin was discovered in 1940 and was the only cure for syphilis at that time. The participants form Tuskegee Syphilis Experiment were excluded from many campaigns that were taking place in Macon County, Alabama to eliminate venereal diseases (Person Education, 2007). This experiment lasted forty years and by the end 28 of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis (info please, 2007). The directors of this experiment used ethical, interpersona... ... middle of paper ... ...
Not all cases is patient autonomy the most important thing to respect and honor. There will always be situations where Medical paternalism is justified. Justifiable paternalism in a medical perspective is prolonging patients’ lives allowing them to exercise their autonomy. Failing to respect a patient’s treatment requests or denials is a violation of the autonomy at that point in time during their illness. While the previous statement is true, the medical professional is violating a patient’s future autonomy. For this reason, medical professionals have the right to act paternalistically, therefore medical paternalism is justified by means of future autonomy and obligations to promote patient
..., beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and adequate. These principles are used to protect the rights of a patient and the physician from being dishonored. The principle autonomy allow an individual to act freely in accordance to their self-chosen plan. This means that healthcare providers must always get the patients consent before making any decision about patient’s life. The of non-maleficence states one must cause no harm to an individual. This means that we must always restrain from harming others. The principle of beneficences say that one must always promote good. This means that healthcare providers must always do what is good for the patient. Lastly the principle of justice promote fairness and equally. This mean that healthcare providers cannot act in a prejudice manner toward patients.
Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987; 317(3): 141-145